TPA Insurance


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Mediclaim Information (TPA & Insurance)

MITR Hospital, Kharghar, Navi Mumbai is empaneled with all the major insurance companies and Third party administrators for cashless or reimbursement basis treatments and surgeries. MITR Hospital is preferred by insurance companies as we have the shortest hospital stay and very reasonable charges for surgery and this is beneficial to the patient and also to the insurance and TPA.

The short hospital stay is possible due to advanced laparoscopic and endoscopic techniques, good patient care, superspecialist surgeon doctors and well run processes at MITR Hospital. This benefits the patient as the patient can be back home quickly, resume work faster and has lesser chances of infection.

LIST OF EMPANELMENTS

Insurance Company: 

  • NEW INDIA ASSURANCE COMPANY LIMITED
  • UNITED INDIA ASSURANCE COMPANY LIMITED
  • ORIENTAL INSURANCE COMPANY LIMITED
  • NATIONAL INSURANCE COMPANY LIMITED

 

 

Individual and Corporate Card-Holders of the following Insurance companies are entitled to Cashless Benefit in MITR

Bajaj Allianz ICICI Lombard Future Generali
HDFC Ergo India First Max Bupa
Star health Reliance General Insurance Apollo Munich
L&T Insurance IFFCO TOKIO Religare Health Insurance

Following Individual Card Holders of the following TPAs are entitled to Cashless Benefit in MITR

  • HDFC ERGO
  • RELIANCE GENERAL
  • L & T INSURANCE
  • VIDAL HEALTH
  • GOOD HEALTH
  • CHOLAMANDAL INSURANCE
  • IFFCO TOKIO
  • RELIGARE HEALTH INSURANCE
  • DHS
  • GRAND HEALTHCARE SERVICES
  • SRI GOKULAM HEALTH SERVICES
  • HAPPY INSURANCE
  • ERICSON
  • HEALTH INSURANCE
  • GENINS INDIA
  • ANYUTA TPA
  • MEDI CARE
  • FOCUS HEALTH SERVICE
  • MEDICARE
  • EAST WEST ASSIST
  • SAFEWAY
  • ANMOL
  • RAKSHA
  • ALANKIT HEALTH CARE
  • PARK MEDICLAIM
  • INDIA FIRST
  • I-CARE
  • MED SAVE HEALTH CARE

 

E-Meditek MD India Medi Assist
Paramount Family Health Plan United Healthcare India
DHS Health India Heritage
I –care Rothshield Spurthi Meditech

Employees of Following Corporate are entitled to Cashless benefit in MITR

  • MTNL
  • Maharashtra Government Retired Employee (with Swasthya mediclaim)
  • MSEB
  • LIC
  • Airtel
  • Asahi Glass
  • Wartsila

Specific Notification for Cashless Patient

  1. Patients or their relatives should inform the front desk at the time of admission/ registration, if they have any Medical coverage through insurance Companies or through third party.
  1. Preauthorization can be availed within 7 days prior to admission. However in case of Emergency admission patient can apply within 24 hours of admission.
  1. To avail the cashless facility patient has to sign the Preauthorization form at front desk and submit all the necessary documents or scan & mail all the relevant documents.Required documents are the following
  • Patient’s TPA /Insurance card or Medicard (Mandatory)
  • Patient’s Photo ID Card (Pancard / Aadharcard / Driving license / Passport)
  • Doctor’s  Advise Paper 
  • Relevant pre-operative Investigation reports
  1. It usually takes 4 to 5 hours for the initial approval from TPA, however it may take longer than that depending upon the concerned TPA’s processing time. Hospital facilitates the cashless approval but it’s the obligation of the patient’s relative to follow up the process with their insurance company and/or Company HR for swift processing and approval. 
  1. Patient bill for cashless preauthorization is raised by the hospital as per the agreed tariff of the hospital with that particular insurance company, no alteration or manipulation can be made in the bill under any circumstance. 
  1. If the initial approval is not received till the patient is taken for surgery, an advance amount (as desired by the hospital) has to be deposited for the surgery, in cash. This advance amount will be adjusted at the time of discharge after scrutinizing the authorization received for the patient after deducting non-medical charges or co-pay amt. Balance amount, if any, will be returned back to the patient by the hospital at the time of discharge.
  1. At the time of discharge patient’s final bill and discharge summary will be sent to the concerned TPA for final approval, which may take 6 to 7 hours. Patient has to sign on the final bill and the final approval. Patient has to wait till the final approval is received by the hospital from the insurance company.
  1. Any co-payment (if applicable) as advised by the insurance company in the final  authorization, has to be paid by the patient at the time of discharge 
  1. At the time of discharge the initial approval stands invalid and the patient has to wait for discharge till the time final approval is received.
  1. Hospital will provide photocopies of the Discharge Summary and approval letter to the patient at the time of discharge; the original papers are retained by the hospital for processing the final claim with the insurance company.
  1. TPA formalities will be done from 10:30 am to 6.30 pm (Monday to Saturday).
  1. Advance Deposit (Refundable) of Rs 10,000/-  payable on admission


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