Insurance company to ensure that the treatment being provided is necessary and within the scope of the policy coverage. These reports help the insurance company determine the extent of the treatment required and the associated costs, which are then compared against the policy limits and conditions to approve the cashless treatment.
By doing so, the insurance company ensures that the treatment is medically necessary and not fraudulent or unnecessary, thereby protecting both the policyholder and the insurance company's interests.
The above documents may need to be submitted in their original form. The insurance/TPA company may also require additional documents or information, depending on their specific policies and procedures. It is recommended to check with your insurance/TPA company or the hospital beforehand to ensure that you have all the required documents for a smooth KYC process.
Name and other personal details – It is mandatory that the Full Name ( with exact spelling ) and Date of Birth are identical in the KYC documents submitted, Medical documents including prescription, and those provided at the time of Registration with the Hospital. Any discrepancy will result in the denial of approval by the Insurance /TPA and payment for the treatment has to be borne out of pocket by the patient.
By having this information readily available, you can help to expedite the pre-authorization process and receive the maximum outcomes in the shortest time from our Helpdesk.
· If you are planning a planned admission through OPD, your treating consultant will sign the pre-authorization form.
· If you are being admitted through the emergency department, please ensure that your treating consultant fills out and signs the pre-authorization form within 24 hours of your admission.
· For patients who are already admitted, your treating consultant will need to fill out and sign the pre-authorization form within 24 hours of your admission. Cashless / Pre-authorization forms can be obtained from the Help Desk by producing Insurance Policy papers/TPA Cards.