What procedures should I follow to avail the facility of cashless hospitalisation at M.G.M Hospital?
Hospitalisation happens under two circumstances - Planned and Emergency. Pre-authorisation of the estimated hospital expense is a must to avail this facility.
Planned Hospitalisation : In the case of a planned admission, you would have first consulted a doctor who in turn would have advised you on the probable date of hospitalisation. In such a case, you must have applied for an approval of the estimated hospital expenses directly with your TPA at least 4-5 days prior to the date of hospitalisation.
In case you have not applied for a pre-authorisation sufficiently in advance or if the doctor treating you advises you to get hospitalised immediately after the consultation, our Corporate Help Desk will assist you through the pre-authorisation procedure.
However, you will need to bear in mind that the Corporate Help Desk is only a facilitator and can in no way influence the decision on the approval. The approval can be turned down.
The pre-authorisation procedure is detailed below :
Step 1 : Establish contact with the Corporate Help Desk at the Hospital.
Step 2 : At the Corporate Help Desk, you need to present the original health Insurance card issued to you by your TPA.
Step 3 : Collect the pre-authorisation will forms pertaining to your TPA.
Step 4 :
Your pre-authorisation will have two sections -
Step 5 : Return the completed form to the Corporate Help Desk. The personnel at the desk will verify the form for its completeness and let you know in case of any discrepancy.
Step 6 : Once the form is complete in all respects, the Corporate Help Desk will fax the form to the office of your TPA.
Step 7 : The Corporate Help Desk will revert to you on the approval status
Emergency Hospitalisation : In case of emergency hospitalisation, the corporate help desk will take up your case on a fast track basis with your TPA and is likely to receive approvals within 3 hours during any working day.
For cashless treatment it is mandatory for the hospital to have an approval from your TPA. In case of delay in receiving the approval or when you cannot wait for receiving the approval owing to medical urgency you can undertake the treatment by paying the necessary cash deposit.
If you receive approval from your TPA after paying the cash deposit, you are entitled for refund of the cash deposit.