TPA Insurance - MITR

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.

Mediclaim Information (TPA & Insurance)
Individual and Corporate Card-Holders of the following Insurance
companies are entitled to Cashless Benefit in MITR
Bajaj Allianz
ICICI Lombard
Future Generali
CholaMandalam MS Insurance
Max Bupa
Star Health
Reliance General Insurance
Manipal Cigna Insurance
L&T Insurance
Care Health Insurance
Liberty General Insurance
Aditya Birla Insurance
SBI General Insurance
TATA AIG Insurance
GO DIGIT Insurance
Universal Sompo Insurance
Royal Sundram General Insurance
Following Individual Card Holders of the following TPAs are entitled to Cashless Benefit in MITR:
MD India
Medi Assist
Family Health Plan
United Healthcare India
Health India
I –care
Spurthi Meditech
Employees of Following Corporate are entitled to Cashless benefit in MITR
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.

2. Preauthorization can be availed within 7 days prior to admission. However in case of Emergency admission patient can apply within 24 hours of admission.

3. Preauthorization can be availed within 7 days prior to admission. However in case of Emergency admission patient can apply within 24 hours of admission.

4. 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

5. Patient’s TPA /Insurance card or Medicard (Mandatory)

6. Patient’s Photo ID Card (Pancard / Aadharcard / Driving license / Passport)

7. Doctor’s OPD consultation Paper

8. Relevant pre-operative Investigation reports

9. 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.

10. 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.

11. 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.

12. 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.

13. 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

14. 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.

15. 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.

16. TPA formalities will be done from 10:30 am to 6.30 pm (Monday to Saturday).

17. Advance Deposit (Refundable) of Rs 10,000/- payable on admission.