TCS insurance cashless query
Hello, I have raised a cashless claim today of Rs. 225000 for my wife's surgery but only 144625 were approved out of which Rs. 10000 I have to pay. So all in all 134000 rs are approved. My question is that will this approved / settlement amount change at the time of final bill / discharge or this is what will be paid only?
The approved amount will definitely be changed during discharge. Stay assured.
It is not final until the last settlement. Ask your hospital to take care of the correct submission along with documentation. I have done this multiple times and have received full claims except for co-pay.
At the moment I am just going with my guts and assuming that I will have to bear 10-20% anyways. So far hospital has taken utmost care while submitting the information.
Remaining will be approved after surgery , be assured , they do not settle entire amount in one go , also since it is cashless it will be managed by hospital insurance department.But We have to pay either 10 or 12 percent (not sure) if we do not intimate them at least 72 hrs before surgery as per the policy.
Co-pay will be 5-20 percent.. Based on grade
Full bill not approved at first.At the time of discharge Company will settle final bill.
Wait for the final bill settlement..
Similarly thing has happened to me i raised for 65000 but the approval was give 32000 only and remaining amt i have to pay when asking to tpa they had given standard reply it is as per policy
It depends on the policy. So whatever approved will be settled and rest you have to pay from your pocket.
I think this may be copay amount . They have introduced from last year . Check on the helpline line provided on HIS link
