MDINDIA HEALTHCARE SERVICES (TPA) PVT. LTD.

An ISO 9001:2000 Company

Toll Free Customer Care No.: 1 800 233 11 66

Toll Free Cashless No.: 1 800 233 45 05

UAN Fax No.: 1 860 233 44 49

FAQ's - Generic / General

	If I’m hospitalised who should my family get in touch with? What is a TPA? How will they identify me? After being admitted to hospital, how soon should the insurance / TPA be informed? Do you take care of medical expenses incurred before and after hospitalisation? Will I be covered from day one of the cover? How do I avail cashless facility? What happens after that? How long does it take to get an Authorisation for cashless treatment in a hospital? Where can I get my doubts about my policy cleared? What is the TPA Company’s e-mail id? In how many days will I receive my MD India id card? I have received a cheque with wrong details, how can I get it changed? What do I do if the claim has been rejected and I want it to be re-considered? Can I collect my cheque from the MD India office directly? What happens when, in an emergency I go to a non-empanelled hospital for treatment? What is cumulative Bonus? Who will bear the cost of health check up? What should I do if there is a delay in the re-imbursement of my claim? What is Domiciliary Hospitalisation?
A1.	You can contact your Insurance company call centre or the TPA (Third party Administrator). Top
A2.	A TPA or Third Party Administrator is an organisation that processes insurance claims for an insurance company. Top
A3.	When you make a call please mention your policy number or your MDIndia card number which is on your card if you have one. On establishing your identity your queries will be answered. Top
A4.	Timelines for intimating the insurance company or the TPA are mentioned on your policy terms & conditions. Top
A5.	Yes. The expenses are called pre and post hospitalisation. This can be for a period of 30 days before and up to 60 days post hospitalisation. Top
A6.	It may be covered provided your policy says so. Usually there is a waiting of 30 days from the day the policy is issued. Top
A7.	You can avail cashless facility only in hospitals which are empanelled with Mdindia. You can get the list of empanelled hospitals on our website www.mdindaonline.com or you can contact our Customer Care Toll Free No 1800- 233-4505 or 1800-233-1166 accordingly to obtain the information of the empanelled hospital in your city. You need to submit the MDID card /current year policy copy/Government -valid Photo Identity proof of the patient at the TPA counter in the hospital to avail the Cashless facility. Top
A8.	Hospital authority fills & Faxes a request letter with the required documents to the TPA after verifying the authenticity of the patient. After verification of all the complete documents required, an Authorization Letter is issued by sending the fax from the TPA to the hospital authority sanctioning a calculated amount. On discharge from the hospital, Insured signs all bills to authenticate the amount and also pays non-medical expenses to the hospital. After the treatment the patient is discharged. Hospital sends the Mediclaim file (i.e. with discharge card, hospital bills, investigation reports & other relevant papers in originals) to the TPA to settle the Mediclaim directly with the Hospital. Top
A9.	Minimum time required to give an approval is 2 hours. Top
A10.	The Insurance company or the TPA can be contacted to clarify all your doubts regarding the policy's terms & conditions. Top
A11.	customercare@mdindia.com Top
A12.	If you have submitted all the required documents (photo copy) of the policy to the insurance company and the same data has been received to mdindia then you will get the MDID card with in 7 working days. In case of emergencies you can download the E card from our website i.e. www.mdindiaonline.com Note: In case there is a delay from our side then please contact us on toll free no.1800-233-4505 or 1800-233-1166. Top
A13.	Please submit the incorrect cheque to the nearest branch /Head office this will be sent to our Head office for corrections it can take up to 20 working days for the new cheque to be issued and dispatched to your address. Top
A14.	Once the claim has been rejected the customer has to send the request to the TPA to reconsider the claim within 15 days from the date of receiving the rejection letter. Top
A15.	On settlement of claim the cheque is issued on the name of proposer and is dispatched to the respective branch from where it will be courier to your mailing address. Top
A16.	The claim will we considered after scrutiny the admissible amount will be paid to the insured. Top
A17.	For every claim free year (where you have paid the premium but have not claimed any medical expenses) a bonus is paid to you in the form of a discount at the time of renewal of your policy. Top
A18.	The insurance company bears the cost of health checks whenever insured is eligible as per policy terms & condition. Top
A19.	The claim settlement is probably delayed due to the non availability of certain documentation please contact the TPA to know the documents required. Top
A20.	Means Medical treatment for a period exceeding three days for such illness/disease/injury which in the normal course would require care and treatment at a hospital / nursing home as in-patient but actually taken whilst confined at home in India under any of the following circumstances namely: The condition of the patient is such that he/she cannot be removed to the Hospital/Nursing Home OR The patient cannot be removed to Hospital/Nursing home due to lack of accommodation in any hospital in that city / town / village. Top

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