Insurance

Insurance Home screen Caption Aster MIMS provides cashless treatments in association with all leading insurance providers in the country and outside the country. Aster MIMS provides cashless treatments to our patients in association with all leading insurance providers in the country and outside the country.IDENTIFICATION OF CLIENTS?

Patients desirous of admission (24 hours minimum stay is mandatory) are identified on the basis of the ID cards issued by TPA/ Insurance company

The consultant will assess the need for hospitalization. If hospitalization is not required the patients will be treated on OPD basis and the fees will be collected from the patient directly. TPA/ Insurance company will not pay such fees.

THE PROCESS OF CASHLESS ADMISSION

If hospitalization is advised, MIMS Insurance desk may be contacted with TPA ID card and MIMS registration card. MIMS insurance desk will send the details in the format prescribed by empanelled TPA / Insurance company in the Pre-authorisatin request form. On receipt of the pre-atuthorisatin request, TPA / Insurance company according to the health insurance policy coverage, will issue the authority letter(AL) (Guarantee of payment Letter)The ID cards issued to the members of TPA / Insurance company’s are just to confirm the identity of the patient. The production of the ID card does not entitle the patient for a cashless treatment facility.

It is advisable to keep TPA / Insurance company informed of the primary diagnosis, duration of sickness or illness past history of the sickness, similar, related and relevant sickness, disease or disorder, any history of diabetes or hypertension.

The identification of the coverage will be done by TPA / Insurance company and eligibility will be informed in the form of authority Letter (A/L) (Guarantee or Payment Letter).

A/L is a precursor to the confirmation of the credit facility to the beneficiary by TPA / Insurance company without which MIMS will not extend credit facility. The MIMS Insurance desk acts as only a facilitator between the policy holder and the TPA / Insurance company. Working hours: 9.00 am to 6.00 pm

At the time of discharge, MIMS Insurance desk will send the final bill and discharge summary to the respective TPA to confirm the status of initial authorization letter/ enhancement of the amount. Once the doctor advices discharge, please inform MIMS insurance desk which will help to speeden the disharge procedure.

Normally it will take a minimum of 4hours to get the reply from concerned TPA after sending the discharge summary and final bill. However, you may if you wish make the payment and get the re-imbursement subsequently.

Insurer/TPA will not pay what is not covered under the insurance policy. Therefore the patient has to pay the amount of such services (Non medical expenses) even though full amount approval is received from the TPA

POST DISCHARGE PROCEDURES

MIMS will submit the following documents in ORIGINAL to the TPA’s within a week after the discharge of the patient/ card holder.

  • The final hospital bill duly signed by the patient and as per the format given by TPA
  • Discharge summary and supporting investigation reports
  • ID card & Address proof

SERVICES WHICH ARE GENERALLY NOT COVERED

Investigations and tests, which are not related to the ailment.

Telephone charges, food & beverage charges, barber services, luxury tax, relative stay charges, dental treatment not related to the ailment for which the Authorization letter (A/L) is issued, transport/ ambulance to hospital/home, consumables, external implants, and others as mentioned in the approval letter/ list of non medicals issued by the TPA.,/p>

Insurance Provides (India)

Star Health and Allied Insurance Company

Medi Assist

TTK Healthcare

Emeditek Solutions

Family Health Plan Ltd

ICICI Lombard General Insurance

Paramount Healthcare

Medicare TPA Pvt. Ltd.

Cholamandalam General Insurance

HDFC Ergo

Spruthi Meditek

Future Generali

Iffco Tokiyo

Reliance General Insurance

United Healthcare Parekh

MaxBupa

Religare

DHS

Appollo Munich Health Insurance

Insurance Providers (International )

Oman Insurance

MSH International

Pentacare>

Al-Madallah

Wealth International

For further clarifications please contact:

0495 2488000/ 3911400 Insurance desk at Ext. No: 91194, 91191 or insurancedesk@astermims.com