General Insurance

JIET Medical College and Hospital

General insurance policies that cover medical facilities are commonly known as Medical Malpractice Insurance or Professional Liability Insurance. These policies are designed to protect medical facilities, such as hospitals, clinics, and medical practices, from financial losses that may result from lawsuits filed by patients who allege that they have suffered harm due to negligence, errors or omissions on the part of medical professionals. Policies may also include coverage for damages resulting from medical data breaches, errors in medical billing or coding, and other types of professional liability exposures that are unique to the healthcare industry.

General insurance in JIET hospital can help patients manage the cost of medical treatment and provide peace of mind knowing that they are covered in case of unexpected medical emergencies.

Health insurance covered by JIET Hospital:

  • Mukhyamantri Ayushman Arogya Yojana

Policies & Procedures:

Cashless facility is subject to the terms & conditions in the policy.

Pre Admission and Admission Requirement:

When planning a hospital admission, consult with your doctor and ensure you apply for pre-authorization of your estimated hospital expenses via your TPA at least 4-5 days prior. If unable to do so, or in cases of immediate hospitalization, assistance is available through our Corporate Help Desk. However, remember it only aids in the process and does not influence approval decisions. It's crucial to note that the TPA might not approve your request for several reasons. These can include your ailment not being covered under your policy, insufficient information in the pre-authorization form, or if the annual sum assured has been used up. For queries, contact our Corporate Help Desk at 9950059980. Remember, proper planning and understanding of your policy coverage are essential in ensuring a smooth hospitalization process.

The Pre- authorization procedure is detailed below:

When seeking pre-authorization for hospital treatment, follow these steps.

  • First, contact the Hospital's Corporate Help Desk. Here, present your original Health Insurance card provided by your Third Party Administrator (TPA).

  • Next, gather your TPA's pre-authorization forms from the Help Desk. This form comprises two sections; the general details about your insurance policy filled in by you and treatment details filled in and signed by your treating doctor.

  • Once filled, please return it to the Help Desk for verification. If there are no discrepancies, the Help Desk will fax it to your TPA. They will update you on the approval or denial of your pre-authorization.

  • Upon admission, a deposit payment of Rs.5000 is required. This will be refunded post-discharge, assuming all formalities are completed correctly. This procedure ensures your insurance covers your treatment costs.

Emergency:

In an emergency, it is crucial to receive prompt treatment. Using the Corporate Help Desk expedites your case with the Third Party Administrator (TPA), typically resulting in approvals within 6 hours on a working day.

  • Firstly, provide your health insurance card and fill out the pre-authorization form. The Corporate/TPA desk at the hospital is equipped to expedite your cashless process. However, if you cannot afford to wait for approval, pay the required deposit and commence treatment, you can later get these expenses reimbursed by the TPA.

  • Remember, while the general processing time for an emergency case is around 6 hours, this can vary depending on the insurance company or TPA. Ensure you regularly follow up with the TPA to stay updated on your request's status. Navigating through hospital procedures can be challenging, but these steps will ensure you receive the necessary care promptly.

Getting Discharged - You are required to:

To ensure your medical bills don't exceed your insurance coverage, follow these steps:

  1. Verify all medical bills and prescriptions, ensuring you weren't billed for unadministered medicines.

  2. Document the total billed amount for future reference.

  3. Before discharge, submit all medical documents to the hospital, including lab reports, claim forms, discharge summary, and final bill.

The hospital will forward these documents to the Third-Party Administrator (TPA). The TPA will verify the claim based on your policy terms and actual costs, deciding whether the payment is made directly to the hospital or reimbursed. If a deposit was initially created, in this case, Rs.5000, it will be refunded post-deductions, if any. By meticulously following these steps, you can manage your medical expenses, ensuring they align with your insurance coverage limits.