Patient is directed to Insurance department from the registration while admission time Insurance Department staff is confirm that whether the patient is cashless or reimbursement.
Collect the ID Proof and policy paper and sign the pre- authorization form from patient or relative.
Counseling giving to patient/bystander about consumable items (non medical expenses), cutting amount and discharge medicines are not payable in cashless In-case of Rejection at the time of discharge or before, patient liable to pay the whole bills.
Pre authorization form should be filled by treating doctor and the Insurance Department.
Pre-authorization form, ID proof, insurance document should be mailed to the concerned insurance company with in 24hours from the admission time.
Then insurance company gives query mail to the hospital.
Query should check and reply to send by the treating doctor to insurance company.
Then insurance company will send a reply about insurance may be approval letter or rejection letter through mail and website.
Insurance Department staff should update the patient insurance status and communicate with patient/relative.
At the time of discharge, Scanned copies of Discharge summary, final bill and breakups, investigation reports are send to insurance company for the final approval.
At the time of discharge insurance staff informed the patient/bystander that 4hrs minimum processing time for final approval.
After whole process Insurance department send the softcopies of (preauth forms. Approval letter, patient id and kyc, discharge summary, investigation reports, final bill) claim for claim submission.
In final approved cases of cashless patients all documents such as Discharge Summary, investigation reports etc. of hard copies should courier to the insurance company. In rejection cases, these bills are reimbursed.