Pragati Netra Rugnalaya brings forth provisions of Cashless Hospitalization facilities to people who are assured with different healthcare insurance claims. Our polite and humble team of management are always ready to help you with all the paper work and make your hospital visit convenient and easy.

The hospital is impaneled with Third Party Administrators (TPA) and directly with Insurance companies. Cashless services are available for following.

TPAs

  • MD India TPA
  • Medi Assist TPA
  • Safeway TPA
  • Health India TPA
  • Ericson TPA Healthcare
  • Star Health
  • United Health Care Parekh
  • Medi Care
  • Apollo Munich
  • Med Safe
  • Vidal Health
  • Family Health
  • Cigna TTK
  • Paramount

Process for Cashless Facility

Planned hospitalization:

In a planned hospitalization, you have a recommendation for hospitalization by your doctor and have time to schedule the surgery/treatment. It is advisable to complete the formalities at least 3-4 days before the scheduled day of surgery.

  • You need to present your health insurance card along with some form of photo-ID. You also have to fill up the first part of the ‘pre-authorization’ form and sign the form.
  • You may sometimes have to present current & previous year health insurance policies (maximum 3 years).
  • The other parts of the form will be filled by the doctors.
  • The person at the insurance desk will verify its completeness and then fax or email it to the TPA.
  • The TPA will then process the form and either approve or reject the request.
  • If your form is approved, the TPA will send the authorization letter with an approved amount for the treatment.
  • The help-desk will inform you the status of authorization as soon as possible.
  • Many times you will get full amount authorization. However, depending on your health policy you may have to make a co-payment or pay additionally if your insurance policy does not cover the expenses totally.
  • Sometimes the TPA only approves a part of the expenses of the treatment and only after the hospital sends the final bill along with the discharge summary and other reports does it approve the entire amount.
  • The approved claims are settled by the insurance company directly to the hospital. All you need to do is sign on the relevant papers before getting discharged!
Emergency hospitalization:

In an emergency hospitalization, the important thing is to get the patient treatment at the earliest. You need to start the procedure for cashless mediclaim facility within 24 hours of hospitalization.

  • You need to present your health insurance card along with some form of photo-ID. You also have to fill up the first part of the ‘pre-authorization’ form and sign the form.
  • You may sometimes have to present current & previous year health insurance policies (maximum 3 years).
  • The insurance desk in the hospital will fast track the process for your cashless process but in case you cannot wait for the approval, you can pay the deposit if demanded by the hospital and start the treatment and reimburse the expense later on.
  • Generally the time to taken to process an emergency case is 6 hours.

Some pointers about the Service

  • Cashless service is only available for the TPAs with whom the hospital has a tie-up.
  • If the TPA does not approve your request, you can pay the bill now and reimburse it later. Remember, Denial of cashless is not denial of treatment.
  • Cashless facility is subject to the policy terms and conditions.

Cashless Facility