Mediassist is deducting extra 3 lakh amount in cashless claim
I have opted for cashless claim for my father and now mediassit is asking me to pay around 3 lakh extra and reason is reasonable cost i do not understand why this deductible component has been added is this something new in policy?
This is big amount for me and my hospital bill is close to 8.5 lakhs and off which Mediassist is saying i have to pay 3 lakhs
Does any one know any solution to this i have already asked them on email to reconsider this and not getting proper response is there any way to escalate this.
Standard of tcs health insurance has gone down from this year this was the only good thing here.
You would need to get the breakup details from medi assist as to what was not considered in that 300k expense. Once you get the details, see what all they are considering as non medical expense and accordingly you can raise the grievance with them if you found the expenses of 300k are indeed genuine. Do not wait for any response over email. Get over call and clear it out asap. Might want to connect this number and get your queries answered.
+91 70220 56000. Hope this helps.
Thanks yes this is Mediassist document
Mediassist is saying this is Usual, Customary, and Reasonable (UCR) - Reasonable and customary clause means the charges for services or supplies, which are the standard charges for the specific provider and consistent with the prevailing charges in the geographical area for identical or similar services, taking into account
This amount seems to be apart from co-pay. But if they have decided not to pay, probably they will not pay. Now a days there are contracts for treatment packages between mediassist and hospital. They will not pay outside the package limit. You can ask for the breakup from the hospital and see if there are unnecessary expenses billed.
Alternatively you can contact Isaac. He is the TCS HR for mediassist. Very helpful guy. See if he can help. You can also try to approach your highest HR you can get hold of and can ask for help.
I will give the contact number of Isaac in a while.
Isaac Lawrence - +91 98414 19251
Thanks for the help, I checked with hospital they said this is as per agreed package with Mediassist and they have some mou with Mediassist this is ongoing i am I contact with Mediassist
Tcs insurance has gotten to lowest level so far. I am facing difficulties in smaller claim amounts too.
Is this a medi assist document ? Usually, they give break ups for the deductibles. Please get the same and contact the helpdesk team if found invalid.
If nothing works out, try Tata Trust option as well
Yes this is Mediassist document
This is resolved now Mediassist agreed to pay the amount which was requested
Co pay and all amount will be depending upon the category of your insurance, if gold plus then co pay 10% lesser than that is 5% .. Now have a look your profile in mediassist, also check your hospital bill and ask mediassist to brekaup of this amount
