In a planned hospitalization, when you have a recommendation for hospitalization by your doctor, you are required to inform the treating doctor to complete the PAF formalities at least 2 days before your treatment date.

• Show your health card and fill up the first part that is to be filled by the patient of the ‘pre-authorization’ form.
• The other part of the form will be filled by the attending physician.
• Provide the filled form to the Hospital Admission Desk and request them to email / system upload / fax to the number stated on the form
• We will process the admission as issue a Letter of Guarantee for settlement of bills in accordance to your plan benefits and available limit .
• You are advised to follow up to know the status of the request.

In an emergency hospitalization, the important thing is to get the patient treatment at the earliest. You need to start the procedure for cashless claims within 24 hours of hospitalization.

• Show your health card and fill up the first part that is to be filled by the patient of the ‘pre-authorization’ form.
• Our Contact Centre and Medical Team will fast track the process for your cashless process but in event you cannot wait for the approval, you can pay the deposit requested by the hospital and start the treatment and reimburse the expense later or request for a cashless discharge process 24hrs prior to discharge.
• Generally the time to taken to process an emergency case is within 24 hours subject to the availability of completed treatment information by the treating physician.

Notes:

You may notice that even with the cashless service, there are some expenses that you may have to bear subject to your financing policy, such expenses like:

• Registration or admission fee
• Visitors/ Attendant’s fee
• Charges for diet
• Ambulance charges
• Toiletries
• Document charges
• Service charge
• Expenses for pads, diapers, oxygen masks, nebulizers which are considered under medicines category.

• If the diagnosis for which you are hospitalized is not covered in your policy.
• If the information contained in pre-authorization form is insufficient to approve the request, though most of the time IA will request the hospital if additional information is needed.
• If you have exhausted the sum assured for that year.
• Pre Existing Conditions
• Non Disclosure of specific illnessKindly refer to HR or your Insurance Agent

Generally we only approve part of the expenses of the treatment and only after the hospital sends the final bill along with the discharge summary and other reports does it approve the entire amount.

Sometimes the hospitals will request us to increase the approved amount if needed during the treatment.

Some pointers about the Service

• Cashless service is only available within our panel of network hospitals.
• All the medical documents including the lab reports, claim forms, discharge summary and final bill has to be submitted us before being discharged.
• To ensure that your request is not rejected, send a completely filled pre-authorization form and send it within the required time frame.
• If for some reason or the other we do not approve your cashless request, you may pay the bill now and reimburse it later.
• Cashless facility is subject to the terms and conditions of your benefits.

Cashless is an excellent facility for customers and takes away some of the stress and tension during the hospitalization.