Insurence/TPA


In health industry now a days there are  many health insurence companies which offers various health insurenec policies through a third party Administrator (TPA).The TPA or Health insurence companies offers network hospitalisation to patients. Network hospitals are the hospitals that your TPA has an agreement with. In case of hospitalisation, if you get admitted to a network hospital you will be eligible for cashless hospitalisation.


In case you are admitted to a non network hospital , you have to settle the bills directly to the hospital and then see re-imbursement through your health insurence company or through your TPA.


In case of cashless hospitalisation the Insurence company or TPA bears the treatment cost either fully or partially cashless hospitalisation.


In case of cashless hospitalisation the hospital is only a facillator (service provider) and has no authority to approve or disapprove any request for cashless hospitalisation.


In case of cashless hospitalisation if you do not get, your approval you will need to bear the entire expenditure incurred on the treatment.


In case patients hospitalisation expence exceed the pre-approval amount.


You can approach the corporate help desk to apply for an enhancement of the pre-approval amount.


The corporate help desk will apply for an enhancement on your behalf wise the TPA and provide the necessary documents,it is most likely that your TPA will approve the application for enhancement.