Corporates & Insurance


CARE Hospitals provides various health management plans designed to suit various kinds and sizes of organisations. With a firm focus on disease prevention and wellness check-ups, CARE Hospitals has emerged as a key player in the corporate health care sector. Over 500 leading corporate organisations, across all segments of industry, have tied up with CARE Hospitals. The corporate services initiative of CARE Hospitals is not merely providing world standard health care but, more importantly, bringing it within the reach of every individual.

Corporate Services
  • Customized preventive health check-ups
  • Wide range of outpatient facilities
  • Consultation across all specialties
  • Inpatient facility
  • Priority admission
  • Choice of rooms
  • Multi-cuisine service
Emergency & Trauma
  • Fully-equipped ambulance, designed to handle all kinds of emergencies
  • Telemedicine services
  • On-site doctor
  • Medical manpower assistance
  • Management of medical centre — designing, equipment & maintenance, providing & training manpower, medicine supplies, day-to-day operations
Other services
  • Screening camps
  • Health talks
  • Health and Wellness Workshops

Interested in knowing more about our Corporate Partnership? Please fill in the following form and our executive shall get in touch with you soon.


Company Details

Contact Person

For more information please contact:

Mr. K. Anand
Tel: +91 8008801018, +91 40 3911 6000
Email: anand.k@carehospitals.com

While most health insurance policies offer cashless hospitalization facility and route your policy through a Third Party Administrator (TPA), it is advisable to be familiar with various terms, as well as processes.

What are network and non-network hospitals?

Network hospitals are those hospitals that your TPA has an agreement with. If you are hospitalized and admitted to a network hospital you will be eligible for cashless hospitalization, subject to the other terms and conditions mentioned in your policy being fulfilled. If you are admitted to a non-network hospital, you will have to pay the bills directly to the hospital and then seek re-imbursement through your TPA.

What does cashless hospitalization mean? Can I just walk into a hospital and get admitted for treatment free of cost?

Please be clear that there is no ‘free’ treatment. Rather, in case of cashless hospitalization, the insurance company bears the cost of treatment — either fully or partially on your behalf.

Cashless hospitalization is a facility provided by most health insurance policies. It enables an insured customer to be admitted to select hospitals and undergo the required treatment without making any direct payment. The assigned TPA mediates between the healthcare service provider (the hospital) and the insurance company and settles the bills on behalf of the insured customer.

What is the process for planned hospitalization?

In the case of a planned or scheduled procedure, you would have already consulted a doctor. The doctor may have conducted some tests and suggested a mutually convenient date for hospitalization. In such a case, you need to apply for approval of the estimated hospital expenses directly with your TPA, at least 4-5 days before the scheduled hospitalization.

If you have not applied for a pre-authorization well in advance, or if the doctor treating you advises you to get hospitalized immediately after the consultation and tests, our Corporate & Insurance Help Desk will assist you through the pre-authorization procedure.

However, please bear in mind that the Corporate & Insurance Help Desk is only a facilitator and can, in no way, influence the decision of the insurance company or the TPA regarding the approval of the likely expenses. The approval can be turned down.

What is the pre-authorization procedure for planned hospitalization?

The pre-authorization procedure involves the following steps:

  • Establish contact with the Corporate & Insurance Help Desk at the hospital.
  • At the Corporate & Insurance Help Desk, show the original health Insurance card issued to you by your TPA. You will also need to show a photocopy of the ID proof issued by a government authority, such as a PAN card, driving license, voter ID card, etc. In addition to this, you will need to hand over a photocopy of your employee ID card, in case of a corporate group insurance policy.
  • Next, collect the pre-authorization forms pertaining to your TPA.
  • Your pre-authorization form will have two sections:

General details on the health Insurance policy — to be filled in by you (the Corporate & Insurance help Desk will help you, in case you have any difficulty)

This section pertains to the treatment recommended for you — it needs to be filled in and duly signed by the doctor who is treating you. Please do not fill this section without contacting the Corporate & Insurance Help Desk.

  • Return the completed form to the Corporate & Insurance Help Desk. The personnel will verify the form and let you know in case of any discrepancy.
  • Once the form is complete in all respects, the Corporate & Insurance Help Desk will fax the form to the office of your TPA.
  • The Corporate & Insurance Help Desk will revert to you once they know about the status of the approval.
What is the process for emergency hospitalization?

In case of emergency hospitalization, the Corporate & Insurance Help Desk will take up the case on a fast track basis with your TPA. In such cases, approvals are expected to be given 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 a medical urgency, you can proceed to undergo 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.

Does cashless hospitalization cover all medical expenses?

For complete details on the medical expenses that are covered by the policy, and those that are not covered, you need to read your health insurance policy and talk to your agent, in case of any doubts. However, in general, the expenses listed below are not reimbursable under cashless hospitalization.

  • Registration/admission fee
  • Telephone charges
  • Visitors 'attendants' charges
  • Ambulance charges
  • Charges for diet, which is not part of the administered treatment
  • Documentation charges
  • Toiletries
  • Non-medical expenses
  • Service charges

These need to be settled by you directly to the hospital at the time of discharge

In case of cashless hospitalization, what documents do I need to submit at the time of discharge?

All the original documents, including bills, lab reports, discharge summary and claim form, should be submitted to the hospital at the time of discharge. All these should be original documents, duly signed by you.

SOME OTHER TERMS

Cashless Access

This is a special benefit extended by an insurer or the assigned TPA to avail of medical treatment as an in-patient, without the need to pay the treatment costs upfront to the hospital. Under this procedure the payment due to the hospital will be met out either by the insurer or by the assigned TPA. After discharge from the hospital, the bills pertaining to medical expenses incurred at the hospital are sent to the insurer or the TPA for reimbursement by the hospital, subject to insurance policy and conditions. The hospital can claim a refund in accordance with the preauthorized limit and additional cost, as envisaged by the enhancement. In any case, the upper limit of this facility cannot exceed the sum insured under the contract of insurance.

Denial

This means repudiation of a pre-authorization request, admission liability or cashless facility and or settlement of a claim under the insurance contract.

Discrepancies

This refers to a difference between the amount claimed and the admissible amount and also any violation of the terms and conditions of the insurance policy or agreement.

Domiciliary hospitalization

Medical treatment for a period exceeding 3 days for such illness, diseases or injury which, in the normal course, would require care and treatment at a hospital but is actually given at home, under certain circumstances. For eg., where the patient cannot be moved to the hospital or there is no room available at the hospital — as per the definition of the insurance policy.

Enhancement

This is a situation when the insurer seeks to increase the limit of the authorized claim amount, resulting from extension of hospitalization.

Exclusions

This refers to items that are specifically and expressly removed from the scope of the insurance contract and, hence, are not payable.

Hospitalization

Medical treatment after getting admitted in a hospital

Insured amount

The maximum limit up to which the insured can seek medical treatment under the specific Mediclaim policy

Insured/policy-holder

The individual who, by paying a premium, secures himself to receive medical treatment up to a fixed sum of money, in the event of injury, loss or damage to his body

Insurer

A corporate body licensed by the IRDA for underwriting various insurable risks against any or all insurable perils with an assurance to make good the loss in an unforeseen eventuality

Mediclaim policy

An insurance policy that covers the hospitalisation expenses incurred during an in-patient hospitalization. Insured persons should check the terms and conditions of the policy to understand the nature and the scope of risk covered.

Medico-legal case

A situation arising out of treatment at the hospital for any bodily injuries sustained in an accident or an attempt of suicide, which needs to be intimated to the police and other concerned authorities for any investigation and procedures. For eg., burns, suicide, assault, road traffic accidents, etc

Network hospital

A network hospital is a hospital which has entered into an agreement or MOU with an insurer or a TPA to request pre-authorization, extend the cashless facility and accept payment at a later date on submission of bills, complying with the policy requirements. Hospitals that do not have a prior agreement for cashless hospitalization with your insurer or TPA are called non-network hospitals.

Planned hospitalization

Taking advantage of the medical condition where one does not require immediate hospitalization (as it would not affect his/her quality of life in any way), the insured seeks pre-authorization sufficiently in advance of the actual admission to the hospital for treatment on a cashless basis.

Policy terms & conditions

This refers to the terms and conditions outlining the details and limitations of the insurance contract, indicating the requirements for fulfilling or adhering to the contract of the insurance.

Pre-authorization

This means the authorization issued by the insurer or the assigned TPA for admission and treatment up to a value, as deemed fit by the insurer, for treatment by the hospital. To receive pre-authorization one has to make a request providing the details contained in the Pre-Authorization Form.

While most health insurance policies offer cashless hospitalization facility and route your policy through a Third Party Administrator (TPA), it is advisable to be familiar with various terms, as well as processes. What are network and non-network hospitals? Network hospitals are those hospitals that your TPA has an agreement with. If you are hospitalized and admitted to a network hospital you will be eligible for cashless hospitalization, subject to the other terms and conditions mentioned in your policy being fulfilled. If you are admitted to a non-network hospital, you will have to pay the bills directly to the hospital and then seek re-imbursement through your TPA. What does cashless hospitalization mean? Can I just walk into a hospital and get admitted for treatment free of cost? Please be clear that there is no ‘free’ treatment. Rather, in case of cashless hospitalization, the insurance company bears the cost of treatment — either fully or partially on your behalf. Cashless hospitalization is a facility provided by most health insurance policies. It enables an insured customer to be admitted to select hospitals and undergo the required treatment without making any direct payment. The assigned TPA mediates between the healthcare service provider (the hospital) and the insurance company and settles the bills on behalf of the insured customer. What is the process for planned hospitalization? In the case of a planned or scheduled procedure, you would have already consulted a doctor. The doctor may have conducted some tests and suggested a mutually convenient date for hospitalization. In such a case, you need to apply for approval of the estimated hospital expenses directly with your TPA, at least 4-5 days before the scheduled hospitalization. If you have not applied for a pre-authorization well in advance, or if the doctor treating you advises you to get hospitalized immediately after the consultation and tests, our Corporate & Insurance Help Desk will assist you through the pre-authorization procedure. However, please bear in mind that the Corporate & Insurance Help Desk is only a facilitator and can, in no way, influence the decision of the insurance company or the TPA regarding the approval of the likely expenses. The approval can be turned down. What is the pre-authorization procedure for planned hospitalization? The pre-authorization procedure involves the following steps: Establish contact with the Corporate & Insurance Help Desk at the hospital. At the Corporate & Insurance Help Desk, show the original health Insurance card issued to you by your TPA. You will also need to show a photocopy of the ID proof issued by a government authority, such as a PAN card, driving license, voter ID card, etc. In addition to this, you will need to hand over a photocopy of your employee ID card, in case of a corporate group insurance policy. Next, collect the pre-authorization forms pertaining to your TPA. Your pre-authorization form will have two sections: General details on the health Insurance policy — to be filled in by you (the Corporate & Insurance help Desk will help you, in case you have any difficulty) This section pertains to the treatment recommended for you — it needs to be filled in and duly signed by the doctor who is treating you. Please do not fill this section without contacting the Corporate & Insurance Help Desk. Return the completed form to the Corporate & Insurance Help Desk. The personnel will verify the form and let you know in case of any discrepancy. Once the form is complete in all respects, the Corporate & Insurance Help Desk will fax the form to the office of your TPA. The Corporate & Insurance Help Desk will revert to you once they know about the status of the approval. What is the process for emergency hospitalization? In case of emergency hospitalization, the Corporate & Insurance Help Desk will take up the case on a fast track basis with your TPA. In such cases, approvals are expected to be given 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 a medical urgency, you can proceed to undergo 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. Does cashless hospitalization cover all medical expenses? For complete details on the medical expenses that are covered by the policy, and those that are not covered, you need to read your health insurance policy and talk to your agent, in case of any doubts. However, in general, the expenses listed below are not reimbursable under cashless hospitalization. Registration/admission fee Telephone charges Visitors 'attendants' charges Ambulance charges Charges for diet, which is not part of the administered treatment Documentation charges Toiletries Non-medical expenses Service charges These need to be settled by you directly to the hospital at the time of discharge In case of cashless hospitalization, what documents do I need to submit at the time of discharge? All the original documents, including bills, lab reports, discharge summary and claim form, should be submitted to the hospital at the time of discharge. All these should be original documents, duly signed by you. SOME OTHER TERMS Cashless Access This is a special benefit extended by an insurer or the assigned TPA to avail of medical treatment as an in-patient, without the need to pay the treatment costs upfront to the hospital. Under this procedure the payment due to the hospital will be met out either by the insurer or by the assigned TPA. After discharge from the hospital, the bills pertaining to medical expenses incurred at the hospital are sent to the insurer or the TPA for reimbursement by the hospital, subject to insurance policy and conditions. The hospital can claim a refund in accordance with the preauthorized limit and additional cost, as envisaged by the enhancement. In any case, the upper limit of this facility cannot exceed the sum insured under the contract of insurance. Denial This means repudiation of a pre-authorization request, admission liability or cashless facility and or settlement of a claim under the insurance contract. Discrepancies This refers to a difference between the amount claimed and the admissible amount and also any violation of the terms and conditions of the insurance policy or agreement. Domiciliary hospitalization Medical treatment for a period exceeding 3 days for such illness, diseases or injury which, in the normal course, would require care and treatment at a hospital but is actually given at home, under certain circumstances. For eg., where the patient cannot be moved to the hospital or there is no room available at the hospital — as per the definition of the insurance policy. Enhancement This is a situation when the insurer seeks to increase the limit of the authorized claim amount, resulting from extension of hospitalization. Exclusions This refers to items that are specifically and expressly removed from the scope of the insurance contract and, hence, are not payable. Hospitalization Medical treatment after getting admitted in a hospital Insured amount The maximum limit up to which the insured can seek medical treatment under the specific Mediclaim policy Insured/policy-holder The individual who, by paying a premium, secures himself to receive medical treatment up to a fixed sum of money, in the event of injury, loss or damage to his body Insurer A corporate body licensed by the IRDA for underwriting various insurable risks against any or all insurable perils with an assurance to make good the loss in an unforeseen eventuality Mediclaim policy An insurance policy that covers the hospitalisation expenses incurred during an in-patient hospitalization. Insured persons should check the terms and conditions of the policy to understand the nature and the scope of risk covered. Medico-legal case A situation arising out of treatment at the hospital for any bodily injuries sustained in an accident or an attempt of suicide, which needs to be intimated to the police and other concerned authorities for any investigation and procedures. For eg., burns, suicide, assault, road traffic accidents, etc Network hospital A network hospital is a hospital which has entered into an agreement or MOU with an insurer or a TPA to request pre-authorization, extend the cashless facility and accept payment at a later date on submission of bills, complying with the policy requirements. Hospitals that do not have a prior agreement for cashless hospitalization with your insurer or TPA are called non-network hospitals. Planned hospitalization Taking advantage of the medical condition where one does not require immediate hospitalization (as it would not affect his/her quality of life in any way), the insured seeks pre-authorization sufficiently in advance of the actual admission to the hospital for treatment on a cashless basis. Policy terms & conditions This refers to the terms and conditions outlining the details and limitations of the insurance contract, indicating the requirements for fulfilling or adhering to the contract of the insurance. Pre-authorization This means the authorization issued by the insurer or the assigned TPA for admission and treatment up to a value, as deemed fit by the insurer, for treatment by the hospital. To receive pre-authorization one has to make a request providing the details contained in the Pre-Authorization Form.




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