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ö What is Third Party Administrator (TPA)?

Third Party Administrators (TPA) is an important link between Insurance companies, Policyholders & healthcare providers (Hospitals and nursing homes).TPA’s role is to provide administrative support to the insurance companies for servicing their insurance Policies.

ö Check the following details if you are Medically Insured.

Have you received the insurance cards from Third Party Administrator? If not
contact your agent or TPA.

If you have received the Insurance ID cards check the name of the TPA before
getting Hospitalized.

If you have fresh policy / first year policy or recently got your policy renewed
check with your TPA about your policy enrollment, failure of which can result in
rejection of your cashless authorization request.

Medical insurance do not cover your OPD consultation / procedure / investigation
done before being hospitalized.

All claims of the discharge from the hospitals will be processed by the TPA
directly / or for reimbursements of all your post discharge expanses directly file
all originals documents, bill, prescription in TPA.

ö Corporate Desk at Paras.

PARAS Corporate desk is in the atrium near main gate ground floor, which is
open from Monday to Friday – 9 AM to 6 PM

Only policy holder’s (Those who have medical insurance) can avail the cashless
service from TPA.

PARAS Corporate desk only helps the policyholders in getting cashless approval
from TPA.

TPA will issue an authorization letter for the coverage as per the policy to Paras
Hospitals. The answer will come from TPA in the form of authorization letter.

Policy holder can directly approach the hospital Admission Counter for admission
with the ID Card and one copy of the authorization letter will be given to the
Admission / IP billing counter.

Hospital will extend cashless treatment to the policyholder up to the authorized
amount.

In case the authorized limit get exhausted get in touch with “PARAS Corporate
desk”.

At the time of discharge, policyholder has to inform the “PARAS Corporate desk”
and is supposed to sign the claim form and a copy of final bill.

NOTE : “PARAS Corporate desk” is only helping you to get your claim processed by TPA. In the event of the cashless authorization request being rejected by TPA, the patient has to pay the bill to the hospital and try to claim the expenses subsequently from the Insurance company or TPA.

ö Admission Process for TPA Card holders

ö Do’s and Don’ts for availing cashless services from Third Party
Administrators (TPA)

Do’s

Obtain pre – authorization form from “PARAS Corporate desk” 3 – 4 days prior to the admission for planned hospitalization.
Pre – authorisation form is to be filled in by treating doctor.
Check about the pre – authorisation approval at the “PARAS Corporate desk” within next 24hrs.
You can avail cashless treatment at the hospital after receipt of written authorisation from TPA for the covered ailment.
Leave back all the original documents and signed claim form with the hospital at the time of discharge.
Contact local TPA office in case of any query.
The policy holder has to bear the expenses which is not covered under the terms and condition of the policy.

Don’ts

Don’t insist upon admission at the hospital merely for investigation, evaluation or Health check – up as these are not approved by TPAs.
Don’t insist on admission on cashless basis at the Hospital without obtaining the pre- authorization approval from TPA.
Don’t carry back any original documents at the time of discharge from the hospital, if your cashless is approved by the TPA.
Don’t forget to sign the claim form.