TPA & Insurance

At HNCII, we understand that managing medical expenses can be as stressful as the treatment itself. To make your care journey smoother and more accessible, our hospital is empanelled with various insurance providers.

Our dedicated TPA Desk assists patients and their families through every step of the insurance process — from pre-authorization to final settlement — ensuring a seamless and transparent experience.

Quick Links

Star Health Insurance

HDFC ERGO

SBI General

ICICI Lombard
(Empaneled only up to single room category)

1. Consultation and Admission Recommendation

Collect the admission note provided by your doctor for surgery, Radiotherapy or any other procedure. Contact TPA desk along with the admission note for availing cashless Hospitalization. You can download the Pre-Authorization form from here

2. Submission of Documents to TPA desk

For planned admissions, kindly submit following documents 5–7 days prior to admission. In case of emergency, ensure submission within 24 hours after admission.

Pre-authorization form duly filled
Copy of Policy Card / policy details issued by TPA or Insurance Company
Copy of ID proof – Aadhaar / PAN / Passport / Driving License
Doctor’s consultation & supportive investigation reports
Patient’s / Proposer’s recent photograph (if applicable)
Employee’s Company ID card (if available)

Our TPA Desk will verify your insurance details and prepare the Pre-Authorization Request.

3. Pre-Authorization from Insurance Company

The hospital sends the pre-authorization form, medical reports, and cost estimate to your TPA / Insurance Company.

The insurer reviews the documents and may issue approval, partial approval, or raise a query for additional information or Denial as per the policy terms and conditions.

4. Confirmation of Approval

Once approval is received from the insurer, our TPA Desk will update you about the authorization details and will share the approval letter via Email.

5. Admission and Treatment

On the day of admission, visit the Admission Desk with your ID and approval letter. Admission desk will assist you with room allocation and documentation.

6. Enhancement During Hospital Stay

If additional procedures, medicines, or extended stay are required, an enhancement request will be sent to the insurer by the TPA Desk

You will be informed about any partial approvals or exclusions.

7. Discharge and Final Settlement

At the time of discharge, the hospital submits the final bill and discharge summary to the insurer for approval. The approval from the insurer may take anywhere between 2-4 hours.

After final approval, you need to pay the unapproved amount which includes non-medical expenses (NMEs), co-pay (if any), Proportionate deductions, excluded expenses as per policy terms and conditions (if any) and the refundable security deposit (10% of final approval).

8. In Case of Denial

If the cashless request is denied, you will have to settle the entire Hospital bill and process for Reimbursement.

Our TPA Desk will assist you with all required claim documentation for the reimbursement process.

1. Contact TPA Desk

Please contact the TPA Desk for the assistance to claim reimbursement and collect reimbursement claim form and Indoor case paper application form.

2. Settle Your Bill at Discharge

Complete the payment of the final hospital bill and obtain a copy of the same and payment receipt from the cash counter.

3. Document Collection at Discharge

Ensure you collect the following original documents

Final Hospital Bill and all payment receipts
Discharge Summary
Investigation Reports
Doctor’s Prescriptions
Implant Stickers (if applicable)
Consultation Papers

4. Document Authorization by TPA Desk

Once you collect all the necessary documents, please contact TPA Desk. TPA Desk will stamp and sign documents wherever necessary.

5. Claim Submission Process

Fill out the Reimbursement Claim Form provided by your insurance company.
Attach all original hospital documents.
Submit directly to your insurance company/TPA.
Keep photocopies/scanned copies for your records.

Disclaimer

Reimbursement claims are processed solely by the respective insurance company/TPA as per policy terms and IRDAI regulations. The hospital is not responsible for claim rejection, deductions, or delays by the insurer.

Apply for cashless approval 5–7 days before admission to avoid delays.
Keep copies of all documents for your records.
Clarify your policy coverage and exclusions with your insurer beforehand.

For patients covered under Insurance or TPA, the security deposit will be refunded only after receipt of payment from the Insurance Company / TPA.
To process the refund through RTGS / NEFT, kindly submit a cancelled cheque or a copy of your bank passbook at the Admission Counter.

What is the difference between cashless and reimbursement claims?

Cashless Claim: The hospital settles bills directly with your insurance company or TPA for covered services.

Reimbursement Claim: You pay the hospital bill first and later claim reimbursement from your insurer by submitting the required documents.

How do I apply for cashless hospitalization?

Visit TPA Desk with your health insurance card and photo ID.
Our TPA Desk will send a pre-authorization request to your insurer. Once approved, you can proceed with cashless facility.