Hospitalization of self or a loved one can be distressing, unexpected medical emergency or prolonged illness can strain finances if such expenses are not provisioned for through Medical Insurance taken in form of individual policy or covered by the employer. Central and State Governments also provide medical benefits to their employees in varying forms. Sir Ganga Ram hospital encourages all individuals responsible for families to take up Medical Insurance as early as possible in their life. Individuals can also opt for increased cover by taking separate medical insurance apart from that provided by the employer (please check the total sum assured of the Group Insurance policy provided by the employer). Medical emergency and cost cannot be forecasted hence it is important to take up medical insurance.
Medical Insurance
Your consultant will decide about the treatment, investigation and procedure which are required. Insurance/TPA require a cost estimate of treatment planned before the treatment is rendered to check it against the provisions in the policy taken by you. The beneficiary is responsible to obtain this cost estimate from the treating consultant get a pre-authorization from the Insurance/ TPA service provider. On the basis of pre-authorization, the Hospital will start treatment.
The service provider may provide pre-authorization for an amount < sum assured (insured amount), during the course of treatment the cost may go beyond the pre-authorized amount. In this scenario the beneficiary can submit an updated ‘Case summary’ along with a revised estimate/ reports as required by the service provider for the enhancement of authorized amount.
In a scenario that the sum assured is exhausted or not authorized by the service provider the additional cost is to be paid by the beneficiary in Cash.
Insurance/TPA services provider offer cashless treatment facility only in the Network Hospital of the service provider. Hospital submits the treatment directly to the service provider which directly settles the bill.
Planned Admission
In case of a planned admission which is a scheduled In-Hospital stay based on decisions made by the treating Doctor and the beneficiary, there is enough time with the beneficiary to decide the admission in any of the network hospitals of their insurance service provider. It is important to let the Insurance provider aware of the nature of illness well before the planned day of admission as the application may get approved or rejected basis of the terms and conditions of the subscribed policy. It is important to note that there may be diseases which may not be covered for the policy holder.
- Authorization forms can be obtained from the Service provider website or from the Insurance desk at SGRH.
- Insurance/TPA desk needs to be informed 3-4 days before the day of admission.
- Once the authorization letter is issued to the Hospital it can initiate the treatment.
Emergency Admission
When a patient is admitted in case of a sudden and unexpected change in the individual's physical or mental condition. It is important for the beneficiary to obtain cashless approval from the Insurance/TPA within 24 hours of admission. The policy holder can also foot the hospital bills and later submit claim for expenses.
Please contact Admission desk or your treating consultant for an estimated cost of treatment
Steps for Cashless Hospitalization for Insurance/TPA beneficiaries
Step 1: Get admitted to the Hospital after filling Admission form with details of Insurance policy subscribed to.
Step 2: Approach Insurance desk of Hospital (within 24 hours of admission).
Step 3: Use Health card issued by Insurance/TPA or share your policy number and Passport, PAN card or voter’s Card for identification purposes.
Step 4: Obtain Estimated cost of treatment from the Treating Consultant.
Step 5: Obtain Pre-Authorization form from the Insurance Desk, fill in the details, attach Admission advice/prescription and Estimate. Submit the documents to the Insurance Desk.
If you want to seek further assistance or have any queries regarding admissions, Pre-authorization, Cashless treatment, Reimbursement under Insurance/TPA you can reach the Hospital Insurance Helpdesk
Insurance Helpdesk Contact No. : 011 4225 1003
Email : tpa.helpdesk@sgrh.com
Counter No. 9 in Admissions
Medical cover - Corporate Employees
Corporate, PSUs provide medical facilities to their employees through Group Health Insurance Policy or directly on cashless or reimbursement basis. The medical entitlement to employees may differ in different companies. A company may request Sir Ganga Ram Hospital to provide Medical facilities OPD, IPD,
Pre-employment Health Check-up, Executive Health Check-up to their employees.
Sir Ganga Ram Hospital follows its own Schedule of Charges which are revised every Financial Year. Sir Ganga Ram Hospital does not accept CGHS (Central Government Health Scheme), ESIC (Employee’s State Insurance Corporation) or any other State Government rate lists for medical treatment.
Planned Admission - In case of a planned admission which is a scheduled In-Hospital stay based on decisions made by the treating Doctor and the Corporate beneficiary, there is enough time with the beneficiary to decide the admission in any of the empaneled hospitals of their company.
Steps to avail Cashless treatment under Corporate Medical schemes when admission is planned
- Consult with a SGRH Consultant regarding a symptom, condition, or disease.
- SGRH consultant needs to be consulted if you have already sought consultation from a Medical practitioner outside Sir Ganga Ram Hospital or you have been referred by a Doctor from a Hospital of your company.
- If Admission is advised ask for an estimated cost of treatment on a prescribed format.
- Connect with your Human Resource/ Personnel department
If you are employed with any Government PSU and want to seek further assistance or have any queries regarding admissions, Pre-authorization, Cashless treatment, Reimbursement you can reach the Hospital Corporate Helpdesk
Corporate Helpdesk Contact No.: 011 4225 1005
For New empanelment 011 4225 1017
Email : corporate.assistance@sgrh.com
Counter No. 8 in Admissions
Medical Loan
Medical loan facilities are also provided by various Medical Service providers
For those wanting to opt for Medical Loan may contact a Unofin Relationship Manager at admission desk
Ms. Deepika Gaur 8700025075
Before coming to Hospital
Please enquire about your available Medical insurance cover.
Insurance Policy number
Insurance/TPA Identity card
Your Insurance/TPA Relationship Manager contact number
International patients
Financial Counselling
Medical Loan
Glossary of Billing and Insurance/Corporate payment terms
