Cashless Insurance & TPA
Vijayakrishna Multi Speciality Hospital provides insurance facilities to support patients who have applicable health insurance coverage.
For eligible patients, cashless healthcare can reduce the need to arrange the full treatment cost directly at the time of hospitalisation, subject to the patient's insurance policy, hospital arrangements and approval from the concerned insurer or TPA.
Our team can guide patients regarding the applicable insurance process and documentation.
Under a cashless insurance arrangement, eligible medical expenses may be settled directly between the hospital and the patient's insurance company or authorised TPA, subject to policy coverage and approval.
The patient may still be responsible for expenses that are:
Not covered under the policy
Outside the approved treatment package
Subject to applicable deductibles or co-payment
Excluded under the policy
Not approved by the insurer or TPA
The exact amount payable by the patient depends on the applicable insurance policy and approval.
A Third-Party Administrator (TPA) acts as an intermediary between the health insurance company, hospital and insured patient for applicable healthcare claims and cashless processes.
Depending on the patient's insurance arrangement, the TPA may be involved in:
Processing cashless requests
Reviewing submitted documents
Coordinating pre-authorisation
Communicating approval details
Processing claim-related documentation
Coordinating with the hospital's insurance desk
The actual process can vary according to the insurer, TPA and policy.
For planned hospitalisation, the general cashless process may involve the following steps:
Inform the hospital that you intend to use health insurance or a cashless facility.
Provide your insurance or health card details for verification.
The hospital's insurance support team may collect relevant policy and patient information and check the applicable arrangements.
The patient is evaluated by the appropriate medical team and the proposed treatment is determined according to the patient's medical requirements.
Where applicable, the hospital submits the required cashless or pre-authorisation request to the insurer or TPA.
The insurer or TPA reviews the request and may approve, partially approve, request additional information or decline it according to the applicable policy and process.
Once the applicable requirements and approvals are completed, treatment proceeds according to the medical team's advice.
At discharge, the hospital and insurer/TPA complete the required claim-related documentation and settlement process according to the applicable arrangement.
Important: This is a general process. The actual steps and timelines may vary depending on the insurer, TPA, treatment and policy.
For many planned cashless treatments, the insurer or TPA may require pre-authorisation before treatment or admission.
Pre-authorisation may involve submitting information such as:
Patient details
Insurance policy details
Health insurance card
Doctor's consultation information
Proposed treatment details
Medical reports, where required
Estimated treatment expenses
Other documents requested by the insurer or TPA
Approval is subject to the applicable insurance policy and the insurer/TPA's assessment.
Patients planning to use cashless insurance should keep relevant documents available.
Depending on the insurer, TPA and treatment, documents may include:
Insurance health card
Policy details
Government-issued identity proof
Patient information
Previous medical records, where applicable
Doctor's consultation documents
Investigation reports, where applicable
Employer or scheme-related documents, where applicable
Other documents requested by the insurer or TPA
Please confirm the exact requirements with the hospital before admission, as documentation can vary.
If your treatment or admission is planned, it is advisable to contact the hospital before the proposed admission date.
This allows patients to discuss:
Insurance availability
Cashless facility
Required documents
Pre-authorisation requirements
TPA coordination
Applicable patient contribution
Other insurance-related procedures
Early communication can help reduce delays during the admission process.
In an emergency, immediate medical attention is the priority.
Insurance and cashless formalities may be addressed alongside or after the initial medical assessment, depending on the circumstances and applicable insurance process.
Patients or attendants should provide the patient's insurance details to the hospital as soon as reasonably possible.
The hospital and insurer/TPA may then complete the required documentation and authorisation process according to the applicable arrangements.
Emergency & Critical CareCashless approval does not necessarily mean that all hospital expenses will be covered.
Depending on the policy, patients may have to pay certain amounts relating to:
Non-covered treatments or services
Policy exclusions
Deductibles
Co-payment
Non-medical expenses
Room category differences
Expenses exceeding the approved amount
Items outside the applicable insurance coverage
Patients should check their policy terms and discuss applicable expenses with the hospital's insurance support team.
Cashless treatment is subject to approval by the relevant insurance company or TPA.
The hospital can facilitate the applicable documentation and communication, but the final approval and coverage are determined according to the patient's policy and the insurer/TPA's process.
Patients should therefore confirm the approved amount and any applicable personal contribution before proceeding with planned treatment whenever possible.
The hospital's insurance support process may involve communication with the relevant TPA or insurance provider for applicable cashless cases.
This can include:
Pre-authorisation requests
Additional document submission
Treatment-related information
Approval communication
Discharge-related documentation
Claim processing support
The specific TPA involved depends on the patient's insurance policy.
Understanding the insurance process before admission can help patients and families prepare the necessary documents and information.
Vijayakrishna Multi Speciality Hospital provides insurance facilities and supports patients in understanding the applicable process for their healthcare requirements.
Patients should contact the hospital in advance for the latest information about cashless availability for their particular insurance policy and treatment.
Insurance & Health SchemesContact Our Insurance Support Team
If you are planning hospitalisation and want to understand the cashless insurance or TPA process, contact Vijayakrishna Multi Speciality Hospital before admission.
Telephone: 08684-222288
WhatsApp: 8688749461
