Cashless & TPA
Patients can avail the benefit of Cashless hospitalization at Polaris Neurosciences Hospital if the TPA / Insurance co. has a tie up with the hospital (refer the list). The TPA helpdesk at the Hospital Reception will assist and guide you for the process of availing the cashless facility from the TPA / Insurance Company. However the primary responsibility of obtaining the authorization would be of the patient / relative.
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The patient is required to fill up a pre-authorization form before admission. You are requested to check your insurance card/insurance policy (or speak to your insurance agent) about the TPA before downloading and filling the form. (Forms are available on our website)
The patient must give a true medical history to the doctor at the time of filling in the pre-authorization form to avoid any discrepancy which may result in the denial of the claim and cancellation of the approval in the future.
• In the case of planned admissions, the patient needs to submit the required documents as given below to the TPA help desk at least 2 days prior to the date of admission.
• The preauthorization form has two parts:
– General Information – The first part of the form to be filled in by you (TPA Help Desk will assist you in case of any difficulty)
– Medical information – The second part which is the treatment recommended for you has to be filled in and duly signed by the treating doctor.
• The following documents are required to be submitted:
– Insurance ID Card
– Consultation/Prescription paper or Doctor Advise for admission.
– Any Relevant Investigations reports supporting the diagnosis
– Photo Id and address proof of the patient
– Recent passport size photo of the patient
• The TPA help desk will be sending these documents to your TPA/insurance company for further processing.
• The TPA/insurance company can revert with either of the following:
Initial Approval – The same will be alerted to you by a phone call
Queries – Our team will get in touch with you to resolve the queries at the earliest. This will also be notified to you via a telephone call
For patients who do not avail the benefit of Cashless hospitalization or whose claims are denied for Cashless, they can do the following process:
Inform the insurance/TPA company(Planned cases – In advance) (emergency case – within 24 hours for hospitalization)
Fill the Reimbursement Form*
Fill the request form for Indoor case paper
Fill the Doctors part in the Reimbursement form
Fill the Hospital details and provide the sign and stamp in the Reimbursement form#
Collect the Indoor case papers from the Medical records department
* Please collect the form from your agent or the TPA/Insurance Company
# Timing – between 9:00 am to 5:00 pm from Monday to Saturday only
Kindly check with your TPA/Insurance Company regarding the requirement of a minimum duration of hospitalization of 24 hours for eligibility of your insurance claim