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Cashless Mediclaim/Insurance for Hernia Surgery

Insurance for any type of Hernia surgery
CASHLESS MEDICLAIM FACILITY AVAILABLE AT OUR NETWORK HOSPITAL FOR ALL PATIENTS.Cashless mediclaim facility is available for all patients of Herniaclinik. We help all patients to get cashless approval before surgery so all facilities can be availed. There are few documents required for availing these facilities.All TPA, Govt. Agencies,Private mediclaim insurance companies are enlisted. with out network hospital..

Documents required for Cashless approval of Health insurance

  1. CASHLESS MEDICLAIM CARD / POLICY NUMBER
  2. ULTRASONOGRAPHY ABDOMEN, PELVIS REPORT
  3. ID PROOF
  4. ADDRESS PROOF
  5. FIRST CONSULTATION LETTER BY DR.SACHIN KUBER
  6. REFERRAL LETTER
  7. 2 PASSPORT SIZE PHOTOS

Time required for approval of Pre-Authorisation for surgery

  • 8-12 hours depending upon insurance provider

Pre-Authorisation required for:

Individual policy holders

Pre-Authorisation - Not mandatory for:

Corporate Health Insurance policy holders

Sactioned Amount Bifurcation:-

  1. Intial/Interim approval - within 12 hours
  2. Final approval- within 6 hours of discharge declaration by surgeon

Whats is covered?

If hernia dignosed and eligible for surgery after 2 years of commencement of policy for Individual policy holders and immediately for corporate policy holders.

  1. Surgery cost
  2. Hospital cost
  3. Mesh implant cost
  4. Pharmacy charges
  5. Nursing charges

What is not coverd?

  1. registration/admission service charges
  2. telefax/photocopy,
  3. food and beverages for relatives special diets,
  4. external implants,
  5. supports and accessories,
  6. dental treatment,
  7. toiletries,
  8. private nurse charges,
  9. ambulance, barber charges.

Deposit ( Refundable)

  1. Initial deposit for approval of surgery has to be made at the time of admission, which is refundable 1 month after dischrge.
  2. Non refundable administrative charges

Estimate for Hernia SUrgery

  1. During checkup , a rough idea of expenses, estimate is given to patients by surgeon or staff.
  2. Please note that there is significant variation of charges for self paying patients and mediclaim holding patients. This is due to discrimination by insurance company.
  3. Estimate may vary 5-15% as per individual patient.
  4. Patients requiring special attention for Diabetes,Asthma,Epilepsy,Hypertension may require additional resourses that may increase cost of overall surgery.

What if my claim/Authorisation is denied by TPA before admission in Hospital?

There aremany conditions put forward by TPA companies. In case of denial by TPA to honour claim, then you can get your surgery by paying all fees upfront and go for re-imbursement option.For this we advice that you get admitted in less expensive hospital in our list like MJM Hospital or Yashda hospital.

What if my claim/Authorisation is denied by TPA after admission in Hospital?

In this case, you will have to settle all payment by yourself. Take the bill-cum-receipt and submit all documents for re-imbursement after discharge.



Time required Discharge after declaration by surgeon?

It takes 8-12 hours for the formal procedures to take effect. After final approval from TPA, you will be physically allowed to leave hospitals.

What are details of upgradation to better rooms for accomodation?

  1. You will be entitled rooms as per your insurance plan.
  2. If you want to upgrade from semi-pvt room to Pvt room then you will have to pay the difference.
  3. Please note that all other allied charges for the updraded room will apply. Like surgeon fees, OT charges,Nursing charges will raise.
  4. It is not like only room charges will change. Other charges will be levied according to category.
  5. If you downgrade the room allowed, then you will not get any refund.