GTK Hospital: Cashless Care, Peace of Mind
GTK Hospital: Cashless Care, Peace of Mind
At GTK Hospital in Adarsh Nagar Delhi, we are dedicated to giving our patients the top-class health-care they deserve. When it comes to health, money should never be a barrier. We are here to make your healthcare experience as smooth as possible. One of the great benefits we offer is cashless hospitalisation. This ensures that the burden of arranging large cash sums upfront for your or your loved one's treatment will be the last thing you need to worry about.
We've partnered with some of the best insurance providers, including Niva Bupa, ICICI Lombard, Bajaj Allianz, GIPSA, National, and SBI, to help you in your hard times.
How To Get Cashless Empanelments: Claims Procedure
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1. Patients’ Arrival At The Hospital
For the procedure to start, the patient needs to be physically present at the hospital. It beings when the patient comes for admission at the hospital.
2. Pre-authorisation Form Fill UpThe doctor consulting with the patient will fill out a pre-authorisation form, estimate the treatment costs, and send it to your insurance company or TPA (Third-Party Administrator) for their initial approval.
3. Handling QueriesSometimes, the insurance company or TPA might have questions and queries before approving the insurance. Don't worry; we'll respond to them.
4. Getting Provisional ApprovalBased on your policy details, the insurance company or TPA will give you provisional approval.
5. Undergoing TreatmentWith approval in hand, the treatment for the patient gets started.
6. Final Billing and Discharge SummaryBefore the patient leaves, we'll send the final bill, treatment details, and your discharge summary to the insurance company or TPA for final approval.
7. Resolving QueriesIf the insurance company or TPA has any more questions, we'll handle those, too, to ensure everything is clear.
8. Cleared for DischargeOnce we get the final approval, the patient will be all set and ready to be discharged.
Remember These Points ALWAYS
Confirm Registration
Before admission, check with our Admission Desk or Medical Insurance Desk to see if your insurance company or TPA is registered with us.
Required Documents
At the time of admission, make sure all the documents are handy.
You need to provide the following documents:- • Valid TPA/Insurance card
- • Proof of identity
- • Policy documents
When You Might Have to Pay Despite Cashless Insurance?
Claim Denial
If the insurance company/TPA denies the claim, the patient must clear the hospital dues before discharge.
Partial Payment
If the insurance company/TPA pays only part of the total bill, the patient must settle the rest before discharge.
Bed Charge Limits
If the policy caps bed charges at 1% of the policy amount and the patient avails facilities beyond that, they must pay the difference before discharge.
Non-admissible Expenses
Some expenses, such as service charges, diapers, gloves, extra food, telephone bills, and nutritional supplements, are not covered by the insurance and must be paid by the patient. Refer to the annexure and your policy document for a detailed list of exclusions.
Final Sanction
The final approval from the insurance company/TPA is usually sent only after the discharge summary and final bill are reviewed. Hence, the patient may need to stay in the hospital for a few hours after receiving discharge advice from the doctor.
Pre-Approval for Planned Treatments
For planned treatments or surgeries, it is advisable to obtain cashless benefit approval from the insurance company/TPA before admission. Contact our Medical Insurance/TPA Desk for assistance.
Need Help?
If you need assistance or have questions about your claims, please visit our Insurance/TPA Desk on the [mention the floor] floor from [insert time].
Quick Instructions
- 1. The Admission Desk will keep a photocopy of your TPA ID card or insurance policy while the patient begins with receiving treatment.
- 2. Patient relatives must complete the necessary formalities, such as consent forms, during admission.
- 3. The hospital's TPA desk coordinator fills out the pre-authorisation form, signed by the patient or their relatives. Then, this form is sent to the relevant TPA within 24 to 48 hours of your hospitalization.
- 4. The coordinator will regularly follow up with the TPA for initial approval and address any queries or requests for additional information.
- 5. Once the authorisation or denial letter is received, the coordinator informs the patient's relatives.
- 6. If the TPA denies the claim before discharge, the patient or their relatives must pay the full bill amount for the treatment.
- 7. If authorised, the patient or their relatives only need to pay charges for any unsanctioned part.
- 8. At discharge, patient relatives receive photocopies of all reports while the original reports and bills are sent to the TPA.
If they have any questions, patient relatives may contact the executive at the Front Office or the Head of Corporate Relations at [CONTACT DETAILS] during regular office hours.
We've teamed up with top insurance providers. These are as follows:
- • Niva Bupa
- • ICICI Lombard
- • Bajaj Allianz
- • GIPSA
- • National
- • SBI
We want to offer our patients the best care without any financial stress during their hard times. These partnerships help us provide cashless treatment, making healthcare more accessible and convenient for all of our patients.
Our goal is to simplify the claims process and ensure that you receive timely medical attention and the best services and care.
If you need more information or assistance, don't hesitate to reach out to our supportive staff, who are always there for you. We're here to help and provide the best facilities.