Facilities

Insurance (TPA) or Cashless Hospitalization

insurance SOTC

INSURANCE (TPA) OR CASHLESS HOSPITALIZATION


Shree Ortho & Trauma Centre doing many surgeries – Brain Surgeries (Neuro), Spine Surgeries, Key hole Surgeries, Joint Replacement Surgeries, Arthroscopy Surgery, PolyTrauma, Pediatric Surgeries, Laparoscopy Surgery, Renal Stones & Urology cases successfully under Ayushman Bharat Scheme completely free. Shree Ortho & Trauma Centre is empanelled with government schemes- SAST, Ayushman Bharat- Arogya Karnataka Scheme for APL & BPL Card Holders, Government Employees with KGID Total Hip & Knee Replacement, Spine surgeries (Neuro) are performed under Ayushman Bharat & Jyoti Sanjeevani Scheme completely free.

Today, most Health Insurance policies do offer cashless hospitalization facility and route your policy through a Third party Administrator (TPA). However you should be familiar with the terms- Network Hospital and Non-network Hospital.

Network Hospitals are those hospitals that your TPA has an agreement with. In case of hospitalization, if you get 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. In case you are admitted to a Non-network Hospital, you will have to settle the bills directly to the hospital and then seek re-imbursement through your TPA.


DOES CASHLESS HOSPITALIZATION COVER ALL MEDICAL EXPENSES?


  • Registration / Admission Fee
  • Telephone Charges
  • Visitors / Attenders Charges
  • Ambulance Charges.
  • Document Charges.
  • Toiletries.
  • Non-medical Expenses.
  • Service Charges
Procedure For Cashless Hospitalization
  • Establish contact with the Corporate Help Desk at the Hospital
  • At the Corporate Help Desk, you need to present the original health Insurance card issued to you by your TPA. And also produce a photocopy of ID proof issued by Govt. Authorities (PAN card/ Driving Licence/Voter ID card etc). Addition to this please produce your photocopy of employee ID card if it is a corporate group insurance policy.
  • Collect the pre-authorization forms pertaining to your TPA
  • Your pre-authorization will have two sections – general details on the health Insurance policy – to be filled in by you (the Corporate desk will assist you in case you have any difficulty)
  • Return the completed form to the Corporate Help Desk. The personnel at the desk will verify the form for its completeness and let you know in case of any discrepancy
  • Once the form is complete in all respects, the Corporate Help Desk will fax the form to the office of your TPA.
  • The Corporate Help Desk will revert to you on the approval status.
Emergency Hospitalization

In case of emergency hospitalization, the corporate help desk will take up your case on a fast track basis with your TPA and is likely to receive approvals 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 medical urgency you can undertake 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.

Who Is The TPA’s With Whom Shree Ortho & Trauma Centre Has A Tie-Up?

Deccan Hospital has a tie-up with several TPA’s. (Current list is given below). However this is dynamic and will change from time to time. Kindly contact the Corporate Help Desk for an updated list.

cashless or insurance schemes


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Shree Ortho & Trauma Centre hospital located behind Sanman Hotel, College Road, Belgaum started catering their service in October 2015. It is a 50 bedded super specialty hospital and Accredited by National Accreditation board for hospital & healthcare providers (NABH- pre entry level).

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