Cashless Hospitalization

What does cashless hospitalization mean ?

Cashless Hospitalization means, the insurance company from which you have taken the health insurance will bear the cost of treatment either fully or partially on your behalf.  Cashless facility is provided through health insurance policies. An Insured person can obtain admission and go through the treatment without paying. TPA (Third Party Administrator) which is a moderator between hospital and insurance company and settle the bills of the insured patient. Hospital is only the facility provider, it has no power to grant approval or disapproval for any cashless hospitalization. There are few rules and regulations decided by the IRDA (Insurance Regulatory and Development Authority) for availing the cashless hospitalization facility.

Does all the expenses of treatment & hospitalization reimburse in health insurance?

It depends on the policy of health insurance provider what they cover and not cover in their policy. Person has to go through the documentation of their policy. Few of the expenses not covered in health insurance and has to be paid by the patient are :

• Ambulance charges

• Nursing Charges / Service Charges

• Room Charges of Attenders

• Registration Fee

• Other non medical expense

Documents Required at the time of Admission or Discharge ?

• Claim Form

• Copy of Health Insurance policy

• Original Reports of - X-Ray, Pathology Lab, Doctors Prescription

• Original Bills

• All the Documents should be signed by the doctor and you.

How can we avail cashless facility of hospitalization at GBH AH?

• We at GBH-AH has a separate help desk for cashless hospitalization

• You have to show and submit a copy of Insurance ID card issued by the helth insurance company.

• Fill the pre-authorization form which relate to the TPA. This form has two section one has to be filled by you and other section by the doctor who will treat the patient.

• Submit the form at help desk.

• Help desk personnel will fax this form to the TPA for taking approval after checking the complete form, and inform you after receiving the approval from TPA.

List of TPA's with GBH American Hospital has tie-up