Health Insurance or Mediclaim Policies can be bought from private companies or government backed companies ( GIPSA companies ). Each company will have its own list of approved hospitals for cashless treatments in various cities across India. These companies also have pre-approved rates for surgeries of various types and complexities.

Patients, who have acquired health insurance cover, can avail cashless treatment facilities only at recognised or approved hospitals. If they get treated at non-recognised or non-approved hospitals, then they first have to pay their bills themselves and then submit their paperwork for re-imbursement.

Private Insurance Companies generally do all formalities themselves about cashless pre-authorisation and payments to hospitals for treatment provided. For such patients, forms provided directly by the insuring company needs to be filled up and sent with supportive documents for approval of cashless treatment. ​

Government backed insurance companies (GIPSA) and some private companies may appoint another company for providing pre-authorisation and hospital payment facilities. Such intermediary companies are called TPAs (Third Party Administrators). For all such TPA patients, application forms provided by the concerned TPA company needs to be filled up and sent with supportive documents for approval of cashless treatment.

Patients having a Mediclaim (Health Insurance) Policy need to pre- operatively complete formalities like application for cashless treatment. Normally pre-authorisation for cashless treatment is taken 5 to 7 days prior to planned surgery. The selected hospital’s Mediclaim Department team will assist patients in filling appropriate forms and submitting all relevant documents for cashless approval.

Planned surgery proceeds only after the hospital gets a written confirmation of approval for cashless treatment from the insurance company. In some cases, the insurance company may raise some concerns or have some queries about patient’s diagnosis or treatment. In such circumstances, Dr. Jadhav and the hospital team will reply and resolve these queries with the insurance company to get approval. Patients are advised prior to their surgery, that if there is any difference in the final bill and the bill amount sanctioned by their insurance company, then they will have to pay extra money to cover up this gap . In some cases, there is a clause of co-payments by the patient. This co-payment amount varies from company to company and must be settled by patients prior to their discharge.