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TPA Insurance

As a patient seeking medical treatments in a hospital, you might be interested in knowing about cashless mediclaim. We have tie-ups with various insurance companies for easy payments and would be glad to discuss payment options with your insurance provider, in case your policy covers services rendered away from your place of residence.


TPA Services at The Mission Hospital
To avail cashless treatments at The Mission Hospital, please refer to the list of insurance companies offering TPA services mentioned on our panel below.


Cashless Mediclaim


The Insured is entitled for cashless access at the provider for all such ailments which are covered under the medical/health insurance policy sum insured limit/sub limits i.e. not specifically excluded under the policy.

Mentioned below are the TPA insurance providers associated with The Mission Hospital.

  • Anmol Medicare (TPA) Ltd.
  • Bajaj Allianz General Insurance Company Limited
  • Dedicated Healthcare Services India Pvt.Ltd.
  • E-Meditek (TPA) Services Ltd.
  • Star Health and Allied Insurance Co. Ltd.
  • ICICI Lombard General Insurance Co. Ltd.
  • HDFC ERGO General Insurance Co Ltd.
  • MDIndia Healthcare Services (TPA) Pvt. Ltd.
  • Medi Assist India TPA Pvt. Ltd.
  • Medicare TPA Services (I) Pvt. Ltd.
  • Medsave Healthcare (TPA) Limited.
  • Paramount Health Services (TPA) Pvt. Ltd.
  • Park Mediclaim TPA Pvt. Ltd.
  • UnitedHealthcare Parekh TPA Pvt. Ltd.
  • Rothshield Healthcare (TPA) Services Ltd.
  • TTK Healthcare TPA Pvt. Ltd.
  • The New India Assurance Co. Ltd
  • Future Generali.
  • Health India.
  • Max Bupa.
  • Raksha TPA Pvt. Ltd.
  • Vipul MedCorp TPA.
  • Oriental Insurance Co. Ltd.
  • National Insurance Co. Ltd.
  • United India Insurance Co. Ltd.
  • Safeway TPA Services.
  • Family Health Plan Ltd.
  • Genins India TPA Ltd.
  • Good Health Plan Ltd.
  • Heritage Health TPA Pvt. Ltd.
  • Reliance General Insurance Co Ltd.
  • L&T General Insurance.
  • Religare Health Insurance
  • Universal Sompo GIC. Ltd.
 

Policies & Procedures

Pre-Admission & Admission Requirements

  • Request for hospitalization shall be forwarded by the provider immediately after obtaining due details from the treating doctor in the preauthorization form i.e. request for authorization letter (RAL).
  • The RAL shall be sent electronically along with all relevant details in the electronic form to the 24 hour authorization/cashless department of the insurer or of its representative. TPA's medical team may consult the treating physician and the insured.
  • The insurer's or its representative TPA's medical team may consult the treating physician or the insured, if necessary.
  • If the treating physician of the provider identifies any disease or ailment as pre-existing, the treating physician shall record it and also inform the insured immediately.
  • In the case where the symptoms appear vague/no effective diagnosis is arrived at, the medical team of the insurer or its representative TPA may consult with treating physician/insured if necessary.

Getting Discharged (Document Requirements)

The following documents shall be included by the patient in the list of documents to be sent along with the claim form to the insurer or its representative TPA.

  • Original pre-authorization request form
  • Copy of authorization letter
  • Original investigation report
  • All original prescription & pharmacy receipt etc. where the insured requires the discharged card/reports or other relevant medical documents.

Emergency Hospitalization - Requirements

In case of Emergencies, the procedures are as follow:

  • Request for hospitalization shall be forwarded by the provider immediately after obtaining due details from the treating doctor in the preauthorization form i.e. request for authorization letter (RAL)
  • The RAL shall be sent electronically along with all relevant details in the electronic form to the 24 hour authorization/cashless department of the insurer or of its representative. TPA's medical team may consult the treating physician and the insured.
  • The insurer's or its representative TPA's medical team may consult the treating physician or the insured, if necessary.
  • If the treating physician of the provider identifies any disease or ailment as pre-existing the treating physician shall record it and also informed the insured immediately
  • If the treating physician of the provider identifies any disease or ailment as pre-existing, the treating physician shall record it and also inform the insured immediately.
  • In the case where the symptoms appear vague/no effective diagnosis is arrived at, the medical team of the insurer or its representative TPA may consult with treating physician/insured if necessary.
  • However, any life saving, limb saving, sight saving, and emergency medical attention cannot be withheld or delayed for the purpose of waiting for authorization.
  • Provider – in the meanwhile - may consider treating him by taking a token of deposit or so, as per their norm.
  • Once authorization is issued after ascertaining the coverage, the provider shall refund the deposit amount to the insured.

 

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Contact Details
The Mission Hospital
Immon Kalyan Sarani,
Sector IIC Bidhan Nagar,
Durgapur - 713212, Burdwan, West Bengal
Phone No.: 8687500500