FAQ Categories: Guide to Avail Cashless Hospitalization

ISIC Corporate / TPA help desk is manned by hospital itself, open on all working days & holidays. The Insurance / TPA help desk staff entertains only insured & policyholders having medical insurance from empanelled TPA / Insurance Co. & different corporates to help them avail cashless approval & Credit letters from TPA / Corporates. ...

Today, most health Insurance policies do offer cashless hospitalization facility and route your policy through a Third Party Administrator (TPA). However you should be familiar with the terms Network Hospital and Non-network Hospital. Network hospital are those hospitals that your TPA has an agreement with, if you get admitted to a Network hospital you will be eligible for cashless hospitalization ...

No, cashless hospitalization does not means the free of cost treatment. The assigned TPA will mediate between the hospital and the insurance company and settle the bills on behalf of the of the insured customer. The hospital is only a facilitator and has no authority to approve or disapprove any request for cashless hospitalization. Certain protocols lay down by the Insurance Regulatory and Develo ...

Hospitalization occur under two conditions: Planned & Emergency.

Planned Hospitalization:

If doctor advised you on the probable date of hospitalization in such case, you must have applied for an approval of the estimated hospital expenses directly with your TPA at least 4-5 days prior to the date of hospitalization

Emergency Hospitalization:

For cashless ...

In case hospitalization expenses exceed the pre-approved amount; you can approach the Corporate / TPA Help Desk to apply for an enhancement of the pre-approved amount. In case you have not exhausted your medical insurance limit, it is most likely that your TPA will approve the application for the enhancement either for the requested enhanced amount or up to your insured limit after deducting the v ...

For complete details on the medical expenses which are covered & not covered, you need to go through your health insurance policy. However, in general, the expenses listed below are not reimbursable under cashless hospitalization like:

Do’s

• Obtain Pre-Authorization request form from TPA help desk at least 4-5 days prior to planned hospitalization.
• Inquire the status about the approval from Insurance help desk in the next 24 hrs.
• Bring all relevant past treatment records while coming to Insurance help desk to seek cashless benefit from TPA.
• Bring your TPA ID Card, previous y ...