Aster MIMS provides cashless treatments in association with all leading insurance providers in the country and outside the country. Aster MIMS provides cashless treatments to our patients in association with all leading insurance providers in the country and outside the country.
Identification of Clients?
Patients desirous of admission (24 hours minimum stay is mandatory) are identified on the basis of the ID cards issued by the TPA/ Insurance company
The consultant will assess the need for hospitalization. If hospitalization is not required the patients will be treated on an OPD basis and the fees will be collected from the patient directly. TPA/ Insurance company will not pay such fees.
The Process of Cashless Admission
If hospitalization is advised, the MIMS Insurance desk may be contacted with a TPA ID card and MIMS registration card. MIMS insurance desk will send the details in the format prescribed by empanelled TPA / Insurance company in the Pre-authorisation request form. On receipt of the pre-authorization request, TPA / Insurance company according to the health insurance policy coverage will issue the authority letter(AL) (Guarantee of payment Letter)The ID cards issued to the members of TPA / Insurance company’s are just to confirm the identity of the patient. The production of the ID card does not entitle the patient to a cashless treatment facility.
It is advisable to keep TPA / Insurance company informed of the primary diagnosis, duration of sickness or illness past history of the sickness, similar, related and relevant sickness, disease or disorder, any history of diabetes or hypertension.
The identification of the coverage will be done by TPA / Insurance company and eligibility will be informed in the form of an authority Letter (A/L) (Guarantee or Payment Letter).
A/L is a precursor to the confirmation of the credit facility to the beneficiary by the TPA / Insurance company without which MIMS will not extend the credit facility. The MIMS Insurance desk acts as only a facilitator between the policyholder and the TPA / Insurance company. Working hours: 9.00 am to 6.00 pm
At the time of discharge, the MIMS Insurance desk will send the final bill and discharge summary to the respective TPA to confirm the status of the initial authorization letter/ enhancement of the amount. Once the doctor advises discharge, please inform the MIMS insurance desk which will help to speed the discharge procedure.
Normally it will take a minimum of 4hours to get the reply from the concerned TPA after sending the discharge summary and final bill. However, you may if you wish make the payment and get the reimbursement subsequently.
Insurer/TPA will not pay what is not covered under the insurance policy. Therefore the patient has to pay the amount of such services (Nonmedical expenses) even though the full amount of approval is received from the TPA
Post Discharge Procedures
MIMS will submit the following documents in ORIGINAL to the TPA’s within a week after the discharge of the patient/ cardholder.
- The final hospital bill duly signed by the patient and as per the format given by TPA
- Discharge summary and supporting investigation reports
- ID card & Address proof
Services that are generally not covered
Investigations and tests, which are not related to the ailment.
Telephone charges, food & beverage charges, barber services, luxury tax, relative stay charges, dental treatment not related to the ailment for which the Authorization letter (A/L) is issued, transport/ ambulance to hospital/home, consumables, external implants, and others as mentioned in the approval letter/ list of nonmedical issued by the TPA.
- GeoBlue International Health Insurance
- Aditya Birla Health Insurance
- Appolo Munich
- Family Health Plan Ltd
- Future Generali Insurance
- HDFC ERGO
- ICICI Lombard
- IFCO TOKIYO
- Liberty General Insurance
- Manipal Signa Health Insurance
- MaxBupa Health Insurance
- Reliance General Insurance
- Religare Health Insurance
- Star Health & Allied Insurance
- Good Health Plan
- Health India TPA
- Heritage TPA
- Health Insurance TPA
- MD India Insurance
- Medi Assist
- Paramount Healthcare
- Raksha TPA
- Safeway Insurance TPA Ltd
- United Healthcare Parekh
- Vidal Healthcare
- Vipul Med Corp