Tata AIG Cashless Hospital Locator
Over the last few years, the cost of medical and healthcare facilities in the country has risen manifold. Particularly, hospitalisation expenses have sharply increased, creating huge financial stress for the family of the patient, especially during emotionally stressful times. Now, given such a situation, have you ever wondered if you have instant money to pay for a health emergency? Would your family be able to pay the bills if you were hospitalised?
Well, with a health insurance policy that offers cashless hospitalisation cover, you do not have to worry about any of the above circumstances. Cashless hospitalisation means you and your family do not have to pay any money to the hospital. Your insurance company or the TPA (third-party administrator) will directly settle your bill with the hospital upon fulfilment of specific conditions.
Tata AIG offers cashless hospitalisation across 7000+ large network of hospitals across India, which guarantees easy hospitalisation, seamless claim settlement and quality treatment.
How does the cashless system work in hospitals?
When you buy a Tata AIG health insurance policy, you will get a list of our network hospitals and medical facilities. These facilities have tie-ups with us and are authorised to provide you with cashless treatment. This means that you or your family do not have to be burdened with paying any of the treatment bills at the hospital. However, the cashless hospitalisation amount is subject to your policy coverage and fulfilment of other terms.
How to avail of the cashless hospitalisation facility?
Cashless hospitalisation works in two ways. It can either be planned (an ongoing treatment or as per the advice of the doctor) or unplanned (due to a medical emergency or an accident).
Planned hospitalisation: In the case of planned hospitalisation, follow these steps to get a cashless claim:
- Check if the hospital of your choice is on the empanelled list of networks.
- Submit the pre-authorisation forms (available on the Tata AIG website/network hospital website/TPA office) along with relevant documents to the insurer. This must be done at least 48 hours prior to the treatment.
- Fill in the relevant details in the form and get it authenticated by the physician concerned.
- Obtain the authorisation letter from the TPA. This will indicate the name of the insured, hospital, the nature of illness and the approved cashless claim amount.
Unplanned hospitalisation: The steps of unplanned hospitalisation are similar, but the requirement for prior intimation and approval is waived. However, after hospitalisation, Tata AIG or the TPA should be informed within 24 hours of the hospitalisation or emergency treatment.
The cashless claim process during hospitalisation differs as per the type of hospitalisation.
- Before taking admission into the network hospital for the treatment, inform the TPA or Tata AIG, at least 48 hours prior, about the intended procedure/treatment and request for a pre-authorisation.
- In case of emergency treatment, Tata AIG or the TPA should be informed at least 24 hours after the procedure is done.
- You need to submit your authorised policy-issued ID card and other relevant documents to the network hospital.
- The designated TPA will check the policy details, nature and extent of coverage, and based on the policy, send the authorisation to the network hospital.
- If proper documents are not submitted, the application will be rejected by the TPA. This does not equal claim rejection. You simply have to re-submit the forms with the correct documents.
- The application can also be rejected if the intended treatment/procedure is not covered under your policy. This equals claim rejection.
- If the cashless claim is approved, the original bills and claim documents will be retained by the network hospital. You can take a copy of the documents for your record.
- Just because a claim is pre-authorised does not mean the entire claim is sanctioned. Tata AIG reserves the right to analyse every claim and entry, and final reimbursement will be paid based on the policy coverage.
- In the case of co-payment, the relevant proportion of the final bill as per your co-payment terms will have to be borne by you.
Documents required for cashless claim settlement
- Claim Form – Download the health insurance claim form for our website and submit it duly filled and signed.
- Original Bills – Consultation, Treatment, Procedure, Hospital-administered medication, Pharmacy bills, Prescriptions, etc.
- Medical Reports – Investigation reports, case history, treatment papers, indoor case papers, etc.
- Diagnosis Report by the Physician/Hospital.
- Detailed Report of all the individual medical procedures done and services provided with separate costs for each.
- Detailed Drug Prescriptions – Prescriptions should be in the insured’s name with clear medications prescribed and their unit costs.
- Pre and Post Hospitalisation Expenses – A list of all pre and post-hospitalisation treatments, tests, follow-ups, etc., done.
- Details of Implants – Invoices or stickers of implants used during the procedure.
- Settlement Letter – Copy of settlement letter if another TPA/insurer is involved.
- Legal Papers – Medico-legal certificates or FIRs if registered for accident-based cases.
- Identity Proof – Aadhar Card, Pan Card, Passport, etc.
- ID Card issued with the Health Policy.
- Details of legal heir, if needed.
Key benefits of cashless hospitalisation
Here are the top benefits of availing of a cashless hospital facility:
- You and your family do not have to worry about arranging the finances and can focus on your treatment.
- You have the freedom to get the best treatment possible without worrying about the present financial situation or hospital bills.
- You get easy discharge as your bills are directly cleared by us.
Today, the growing incidence of cashless hospitalisation has made healthcare more affordable and accessible in the country. However, when you apply for a cashless claim facility, be sure to read all policy-related documents thoroughly. Understand all exclusions and upper limits, if any, to avoid any unpleasant surprises later.