Insurance & TPA
Vijayakrishna Multi Speciality Hospital provides insurance and TPA support to help eligible patients understand and complete the required process for hospital treatment. The hospital also provides insurance facilities along with support for Aarogyasri and EHS.
Our hospital team can assist patients with the relevant documentation and coordination required for insurance or TPA processing, subject to the applicable policy, scheme and approval requirements.
TPA stands for Third-Party Administrator.
A TPA may act as a link between the insured patient, insurance company and hospital for processing eligible healthcare claims and related documentation.
The exact process and requirements can vary depending on the patient's insurance policy and the concerned insurance/TPA organisation.
For eligible insured patients, the hospital team can help with the general insurance-related process, including:
Collecting required patient informationChecking available insurance documentsCoordinating required documentationSupporting the cashless/pre-authorisation process where applicableCommunicating relevant information to the concerned insurance/TPA teamAssisting with required hospital documentationInsurance approval is subject to the patient's policy terms and the decision of the concerned insurance provider or TPA.
Under a cashless facility, eligible medical expenses may be settled directly between the hospital and the insurance/TPA organisation, subject to applicable policy terms and approval.
Cashless treatment is not automatic for every patient or every treatment.
Eligibility, coverage, exclusions, limits and approval requirements depend on the patient's insurance policy and the concerned insurance provider/TPA.
Learn About Cashless InsuranceFor eligible cashless treatment, the insurance company or TPA may require a pre-authorisation request from the hospital.
The process may generally involve:
Patient details and insurance information are collected.
Required medical and insurance documents are submitted.
The hospital submits the required request to the concerned insurance/TPA organisation.
The request is reviewed according to the policy terms and applicable conditions.
The insurer or TPA may approve the request, ask for additional information or communicate the applicable decision.
Treatment and claim settlement proceed according to the applicable approval and policy terms.
Actual processing requirements may vary between insurance providers and policies.
Patients may be asked to provide documents such as:
Health insurance card or policy detailsGovernment-issued identificationPatient detailsInsurance/TPA authorisation information, where applicablePrevious medical records, where relevantDoctor's consultation or treatment-related documentsInvestigation reports, where applicableAdditional documents may be requested depending on the insurance provider, TPA, treatment and claim requirements.
For planned treatment or hospitalisation, patients should inform the hospital about their insurance coverage as early as possible.
This can help the hospital team understand the applicable insurance process and initiate required documentation or pre-authorisation procedures where applicable.
Patients should carry their insurance documents and identification when visiting the hospital.
In an emergency, patients should seek immediate medical attention without delaying necessary treatment for insurance formalities.
Insurance and TPA documentation can be coordinated according to the applicable process after the patient's immediate medical needs are addressed.
The availability and timing of cashless approval depend on the insurance provider/TPA and applicable policy requirements.
Insurance coverage can differ from one policy to another.
Patients should understand that:
Not every treatment may be covered.Policy limits may apply.Certain exclusions may apply.Deductibles or co-payments may apply.Approval may be required for cashless treatment.Additional documentation may be requested.Final claim settlement is subject to the insurer/TPA and policy terms.The hospital cannot determine coverage independently of the applicable insurance policy and approval process.
Patients and their attendants should:
Provide accurate insurance information.Carry the required identification and policy documents.Inform the hospital about existing insurance coverage.Provide requested documents promptly.Respond to requests for additional information when required.Understand their policy's coverage, limits and exclusions.Pay any applicable non-covered or patient-responsibility amount.Insurance processing may involve coordination between three parties:
Provides insurance details, identification and required information.
Provides relevant medical and treatment documentation required for processing.
Reviews the request according to the applicable policy and communicates the approval or other decision.
The exact process can vary depending on the insurance provider, TPA and patient's policy.
Vijayakrishna Multi Speciality Hospital provides insurance facilities along with support for Aarogyasri and EHS.
Separate information about these healthcare schemes is available on the Aarogyasri & EHS page.
View Aarogyasri & EHSOur insurance support is intended to help patients navigate the documentation and coordination involved in eligible hospital treatment.
Patients are encouraged to contact the hospital before planned treatment to understand the applicable process and documents required.
Hospital Contact:
Telephone: 08684-222288
WhatsApp: +91 86887 49461
Speak to Our Hospital Team
If you are planning hospital treatment and have health insurance, contact Vijayakrishna Multi Speciality Hospital to understand the applicable insurance and TPA process, required documents and available support.
