TPA/CASHLESS PROCESS AT TEWARI EYE CENTRE
Information to be furnished by patient
1. Coverage of all insurance policy (in lacs). For individual policy holder they can ask their agent and for corporate policy holders they have to ask their Human Resource manager.
2. Any capping on the implant ( lens | cost / lens type. And are any premium lenses like multifocal, trifocal, EDOF, toric excluded from policy?
3. Is the policy more than 2 years old. ( as cataract surgery is covered in policies more than 2 years)? Yes /no
4. Is there any break in the policy in case patient has shifted from one insurer to the other ? Yes /no
5. Are there any declared pre existing diseases declared at the time of purchasing the policy? Yes /no
Documents to be submitted
1. Adhar card of policy holder and primary insured.
2. PAN CARD of primary insured.
3. TPA Card
4. Policy papers (Not applicable for corporate policies).
5. Cancelled Cheque / Screenshot of transaction in case of any upgradation.
CASHLESS PROCESS
- Our team will then send your documents to TPA / insurance and raise a preauthorization request for the desired package (on mutually agreed date of surgery).
- TPA will give a preauthorization letter (usually within 6 hours of raising the request). Please note that preauthorization amount does not in any way convey the final amount of settlement. This amount is usually lesser than the final settlement amount I finalised only after final bill submission - i.e. after surgery).
If your preauthorization amount is lesser than your selected package.
Then you will Deposit the difference amount to hospital as a security amount (cash, card, UPI). Proceed for surgery and hospital will send final bill and discharge for final approval. After final approval hospital will refund the balance amount to patient (preferablyfrom the same payment mode). If final approval is lesser than the selected package then hospital is obliged to deduct the difference from security deposit. Since final approval sometimes takes 3-4 hours to process, you need not wait for final approval and can get discharged immediately from hospital after surgery and any refund will be done
NATIONAL HEALTH INSURANCES
PRIVATE HEALTH INSURANCE
