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Health Insurance

Good Health Insurance TPA (Features, Downloads, and More)

TPA

Learn about Good Health Insurance TPA (A Simple Guide)

Good Health Insurance TPA is an Indian Third-Party Administrator (TPA), which was incorporated in 2003. Good Health Insurance TPA is headed by Mr. Srikanth Charan Mudigonda, who serves as the company Managing Director. The company has settled over 1.5 Lac claims, which has won it numerous awards including “India’s Most Promising TPA of the year- 2016.”

Let us now look at some of the most important topics concerning Good Health Insurance TPA, including:

  • Role of the company
  • How to submit a claim?
  • How to login and register under their website
  • Downloads
  • Network Hospitals
  • Customer Care

Role of the company

As a TPA company, Good Health Insurance TPA has to fulfil the following important roles:

Acts as a link: The company acts as a link between the insurance company and the policyholder. The TPA company will have to act as a mediator between both parties and will have to act in the best interest of both parties.

Claim Management: All claim related logistics will have to be handled by the TPA company, from customer guidance to submission of documents. Once all of the documents are submitted to the TPA company, the company will then forward the same to the insurance company. Once this is done, the TPA company will correspond with the policyholder on behalf of the insurance company pertaining to the claim.

Customer Support: This is a very important function of any TPA company, they are mandated to provided customer support to policyholders. Most TPA companies also provide a 24×7 Customer Support Helpline that policyholders can avail of.

How to submit a claim?

If you are a Good Health Insurance TPA customer and are wondering about how to submit a claim, then please follow through. You can submit two type of claims, cashless claim, and reimbursement claim. Let us go through with the claim submission steps for both.

How to submit a cashless claim?

Step 1) Inform your insurance agent / TPA Company

The first thing you need to do is to inform your agent or TPA Company about the hospitalization. It is vital the company be informed as soon as possible about the hospitalization.

Step 2) Submit the policy bond or Health Card to the hospital

Now, upon admission, the policyholder’s family must submit the policyholder’s policy bond or Health Card to the hospital. Once submitted, the hospital will enter into correspondence with the TPA Company and verify the policy bond. Once verified, all hospital bills will be directly paid by the insurance company to the hospital, the policyholder will not need to spend out of pocket.

Note: Cashless hospitalizations can only be availed at network hospitals.

How to submit a reimbursement claim?

A reimbursement claim can be applied in the following steps:

Step 1) Inform your insurance agent / TPA Company

Here again, the first thing you need to do is to inform your agent or TPA Company about the hospitalization.

Step 2) Keep all original medical documents

Now, you will need to meticulously keep a record of all medical documents, including admission summary, doctor’s certificates, diagnosis reports, hospital bills, receipts, discharge summary, etc. You will have to submit all of the original copies to the TPA company upon discharge.

Step 3) Submit all documents to the TPA Company

All medical documents must be submitted to the company within 15 days of discharge, it is extremely important that there is no delay here. You will have to submit the following forms along with the medical documents:

  • Filled-up claim form
  • Copy of your policy bond or E-Card
  • ID and address proof

Once submitted, your claim will be registered.

How to login and register under their website

The various benefits and features of Good Health Insurance TPA can be accessed by registering and logging into their official online portal.

How to login?

Step 1) Visit the official website

You can access the official Good Health Insurance TPA Website here.

Step 2) Navigate to the ‘Logins’ section

Now, you will need to navigate to the ‘Logins’ section on the top of the website. Once there, click on the type of login. There are a variety of logins such as:

  • Corporate Employee Login
  • Insurer Login
  • Provider Login
  • Retail Policies Login
  • Retail Agent Login

And more.

Downloads

You can also download important documents through the official website of Good Health. How?

Step 1) Visit the official website

Step 2) Navigate to the ‘Downloads’ section on top of the page

Here, you can download the following documents/forms:

  • Pre-Auth Form
  • Reimbursement Form
  • Cashless Form
  • CKYC Form
  • PPN Declaration Form

Network Hospitals

It is pivotal that all hospital admissions be done in a network hospital if you wish to avail cashless hospitalization. You can check out a list of all network hospitals navigating to the ‘Network Hospital Search’ button on the far right side of the official home page of Good Health TPA. Once on this page, you will have to enter the following:

  • Insurance company name
  • State and City

Click on ‘Submit’ once done. You will now get a list of all network hospitals in your area.

Customer Care

Department

Phone Number / Email ID

Customer Care

1860-425-3232

customer.care@ghpltpa.com

Senior Citizens Helpline

1800-102-9919

Hyderabad Branch

1860-425-3232

Bengaluru Branch

080-41521384 & 25202113

Chennai Branch

044-28150765

Mumbai Branch

1860-425-3232

Delhi Branch

 

Cochin Branch

1860-425-3232

Madurai Branch

0452–4379765 & 4231115

Visakhapatnam Branch

9515668775

Coimbatore Branch

0422–6450322 & 4362030 & 2306898

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Genins India Insurance TPA (Services, Customer Support and more)

TPA

Learn about Genins India Insurance TPA (A Simple Guide)

Genins India Insurance TPA is an Indian Third Party Administrator (TPA) that acts as a bridge between insurance companies and their policyholders. The TPA company was founded in 1996 and currently operates in 250+ Indian Cities, and has over 30+ offices across the nation.

If you are a customer of Genis India Insurance TPA, there are certain important topics that you would wish to know about, we will talk about the following important aspects of the company:

  • Role of Genins India Insurance TPA
  • How to file a claim?
  • How to login?
  • Health Card
  • Downloads
  • Network Hospitals
  • Customer Care
  • Mobile App

Role of Genins India Insurance TPA

As a TPA Company, Geninis India has the following roles:

  • Customer Enrollment: Potential customers are enrolled to their service after their sales team explains the benefits and features of their chosen insurance policy.
  • Claim Management: Once a customer is enrolled, it is the job of the TPA company to ensure that any claims initiated by the policyholder is managed by the TPA company.
  • Customer Support: The TPA company should act as a single point of contact for the policyholder as the customer has taken the insurance policy through the TPA company. All queries and grievances should be handled by the TPA company.
  • Issuance of Health Card: The TPA company handles the issuance of Health E-Cards. The policyholder can present this card to the hospital and avail treatment.

How to file a claim?

You can file a claim either online or offline. Let us talk about both methods below:

Offline claim submission

Step 1) Intimate your insurance agent or Genins TPA

The first thing you should do is immediately inform your agent or TPA company about the hospitalization.

Step 2) Decide on whether the claim will be a cashless claim or not

Now, you will have to take a call whether your claim will be a cashless claim or a reimbursement claim. If your claim is a cashless claim, then the entire claim will be directly handled by the insurance company and the hospital. If it is a reimbursement claim, then you will have to meticulously keep a record of all medical documents and store them safely.

Step 3) Submission of documents

If you opt for a reimbursement claim, you will have to submit all of the requested documents such as medical reports, diagnostic reports, admission summary, discharge summary, doctor’s reports, etc to the TPA company. All originals must be submitted. Keep a Xerox copy of all submitted documents for your personal record. Once all documents are submitted, the insurance company will assess the claim.

Online claim submission

You can also submit your claim online through the official website. Here’s how:

Step 1) Visit the official Genins TPA website

Step 2) Navigate to ‘Online Intimation’ button

Step 3) Enter your details

Here, you will need to enter the following details:

  • Card Number
  • Policy Number
  • Employee Code

Once entered, click on next and progress, your claim will be intimated to the company. Next, you will have to physically submit the documents to the TPA company to finish your claim submission process.

How to login?

  • In order to login you will need to visit the official Genins India TPA Website and navigate to the ‘Login’ section on the top bar.
  • Once you click on the ‘Login’ button, you will get a selection of logins, Agent login, Insured login, Corporate login, Hospital login, etc.
  • You will need to select your preferred login and enter your username policy number and click on ‘login.

Health Card

How can you download your Health E-Card?

Step 1) Visit the official website

Step 2) Navigate to the ‘Print E-Card’ button

Step 3) Download E-Card

Now, enter your policy number and employee number, and press on ‘Download E-Card.’

Downloads

There are a host of important documents and forms that you can download from the Genins India TPA Download Section, they are:

  • Authorization Request Form
  • Reimbursement Claim Form
  • Claim Intimation Form
  • PPN Declaration Form
  • KYC Guidelines
  • Cashless Claim Form
  • Claim Submission Checklist

Just navigate to the ‘Downloads’ section on the top bar of the home page and click on it. You will now be able to download all of the above forms and documents.

Network Hospitals

Why is it important to check out if your preferred hospital is a network hospital? Well, you can only avail cashless hospitalization through a network hospital. If you get admitted to a non-network hospital, you will have to opt for a reimbursement claim. Therefore, it is extremely important to check if your preferred hospital is an empaneled or network hospital.

Check if your hospital is a network hospital with Genins TPA by following the steps below:

Step 1) Visit the official Genins TPA Website

Step 2) Click on ‘Network Hospitals’

Step 3) Check your hospital

Now, enter the following details:

  • Insurance company
  • State
  • City

Now, click on ‘Search.’ You will now be presented a list of all empaneled hospitals for your selected city/state.

Customer Care

Department

Contact Details

Customer Support

18008902359 / +91-120-4144100

gil@geninsindia.com

Senior Citizens Helpline

+91-120-4144100

seniorcitizens@geninsindia.com

Source: Geninsindia.com

You can also reach out to them using their online form.

Mobile App

You can also access the various services and features of the company through their official mobile app (Android) here. The company, as of today does not have an IOS App for Apple users.

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East West Assist Insurance TPA (Services, Customer Support and more)

TPA

Learn about East West Assist Insurance TPA

East West Assist Insurance TPA is an Indian TPA company registered with IRDA, it is based out of New Delhi. The Company operates across 29+ Indian states and has a presence across 500+ offices nationwide. East West Assist Insurance TPA has also handled over 10 Lakh claims, having a claim settlement record of 97%.

Let’s talk about the most important aspects of East West Assist Insurance TPA, such as:

  • Role of East West Assist TPA
  • Claim submission
  • Download Health Card
  • Customer Support
  • Empaneled Hospitals

Role of East West Assist TPA

Mentioned within are some of the most important roles of the company, they are:

  • Enrolling and on-boarding customers to their platform after educating them about the various types of insurance products, and helping them in choosing the best insurance product for their needs.
  • Issuance of Health Cards to policyholders that they can present to hospitals during treatment.
  • Provide customer support to policyholders during hospitalization and even post hospitalization.
  • Deciding on the merit of claims and thereby assist in the disbursement of claims to policyholders.

Claim submission

If you are a customer of East West Assist Insurance TPA and are looking to find out how you can submit your claim to the company, look no further. You can submit an online claim by following the below mentioned steps:

Step 1) Visit the official website of the company

https://www.eastwestassist.com

Step 2) Navigate to the ‘Register Claim’ section on the homepage

Step 3) Click on ‘Register Claim’ and fill-up the details

Here, you will be asked the following details:

  • Claim Type
  • CCN Number
  • Policy Number
  • Full Name and Registered Contact Number
  • PAN Number
  • Hospital Name
  • Claim File (You will have to upload it)

Once done, click on ‘Submit.’

Download Health Card

Having your health card or policy bond is extremely important. Let us see how you can download your of East West Assist Insurance TPA Health Card:

Step 1) Visit the official website

Step 2) Navigate to the ‘Login’ button and login to the portal

Here, you will need to click on ‘Individual Login.’ Enter your username and password and click on ‘Login.’

If you do not have your login credentials, you will need to contact the support team or your insurance agent for the same.

Step 3) Request Health Card

Once logged in, you can now request for your Health Card. You can also check the status of your Health Card by clicking on the ‘Card Status’ button on the home page.

Customer Support

You can reach out to East West Assist Insurance TPA’s customer support through the following contact details:

Department

Contact Details

Support

+91-9711779711 / assistance@eastwestassist.com

Senior Citizen Support

011-47222647

Cashless Department

011-4722260/615/626 | 7838807980

Grievance

011-47222620

Health Card

011-47222631|9711779711

Hospital Enrollment

011-47222628|011-47222602

Reimbursement

011-47222666/634/638/6113 | 9711779711

Empaneled Hospitals

Find out a list of all of the Empaneled Hospitals associated with East West Assist Insurance TPA here.

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What are Consequential Damages in Insurance (With Examples)

damage

What are Consequential Damages in Insurance? (With Examples)

There are 6 types of damages in insurance, they are incidental, compensatory, nominal, liquidated, punitive, and consequential damages. Today, we will discuss about the meaning of consequential damages in insurance and its examples.

What are Consequential Damages in Insurance?

A consequential loss or damage is a collateral damage occurring due to loss or damage to the insured object. Here, even though the insured object is covered, the policyholder will not be protected against the collateral damage as the insurance company did not provide coverage towards any collateral damage.

This concept can be slightly confusing but we will attempt to explain to you using simple examples so you understand the concept of consequential loss or damages.

Examples of consequential damages

Example of consequential damages in motor insurance

Let us assume that Mr. Sam bought a bike insurance policy for his motorbike. Now, Mr. Sam parked his bike in a no parking zone, causing it to be towed by the authorities. During the towing process, the tow truck driver was not careful while driving and caused damages to Mr. Sam’s bike. 

Now, even though Mr. Sam has a bike insurance policy that covers physical damages, he will not be covered by the insurance company as Mr. Sam parked in a no parking zone. It will be deemed as a consequential loss to Mr. Sam.

Example of consequential damages in travel insurance

Let us assume that Mr. Ricky is a businessman and travels often to other parts of the world for business deals. Mr. Ricky is a smart individual and always opts for travel insurance.

Let us further assume that one of Mr. Ricky’s flights got cancelled due to whatsoever reason, causing him financial loss due to him missing a business opportunity. Now, the insurance company will compensate Mr. Ricky for his air ticket cost, but it will not compensate him for the loss caused due to his missed business opportunity as it was consequential loss.

Example of consequential damages in property insurance

Let us assume that Mr. Jagmohan is a businessman having a factory. He has insured his factory against damages caused due to fire. Now, a few months after he bought his insurance policy, his factory met with a fire, causing the total loss of all of his machinery and inventory.

As his factory was covered against damages due to fire, Mr. Jagmohan will be compensated for the loss of his machinery and inventory. However, the collateral damage of this event will have fare reaching consequences, as Mr. Jagmohan will have to keep his factory closed for many months, halting production and thereby resulting in financial loss to his business. This consequential loss will not be covered by the insurance company.

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Heritage Health Insurance TPA (Services, Customer Care, and more)

TPA

Learn about Heritage Health Insurance TPA

Heritage Health Insurance TPA is an Indian TPA company that was founded in 1998 and is currently headed by CEO, Mr. Sunil Parakh. The company currently has over 19 offices across the nation. Heritage TPA is part of The S K Bajoria Group of companies.

Let us talk about the most important aspects of Heritage TPA, such as:

  • Role of Heritage TPA
  • Login and Registration
  • Claim Submission
  • Empaneled Hospitals
  • Customer Care
  • Health E-Card
  • Download Forms

Role of Heritage TPA

As a TPA company, Heritage TPA acts as a bridge between the insurance company and policyholders. The company’s primary role includes the following:

  • Providing customer support to policyholders during hospitalizations.
  • Assisting customers during the enrolment and on boarding process.
  • Issuance of health cards to policyholders.
  • Claims management services.

Login and Registration

How can you Register / login to the official Heritage TPA website? Here’s how:

Step 1) Visit the official website

Step 2) Navigate to the Login / Registration section

Step 3) Enter your details and login or register

Claim Submission

You can also submit your claims to Heritage TPA through their online portal. Here’s how:

Step 1) Visit the official website

Step 2) Navigate to the ‘Claim Submission’ button

Step 3) Enter your details

Here, you will need to mention the following details:

  • Claim type
  • Insurance company name
  • Email ID
  • Mobile number
  • CCN / Card No

You will also need to upload all of the relevant medical documents to the portal.

Empaneled Hospitals

It is extremely important that you find out whether a hospital is a network or empaneled hospital before you decide on getting admitted to the hospital. The reason for this is rather straight forward, cashless claims will only be provided in hospitals that are empaneled with the insurance company. Always be sure to check out if your preferred hospital is a network hospital.

You can check out if your hospital is an empaneled hospital in 3 simple steps:

Step 1) Visit the official Heritage TPA website

Step 2) Navigate to the ‘Hospitals’ section

Once here, click on ‘Empaneled Hospitals’

Step 3) Fill up the details

Now, you will need to select your state, city, and insurance company. Once done, you will get a list of all the network hospitals associated with your insurance company.

Customer Care

City

Phone Number

Email ID

Kolkata

(033) 2248 2411

(033) 4014 5100 / 4033 4141

(033) 4014 5200

(033) 4033 4141

heritage_health@bajoria.in

Mumbai

(022) 61273891/3892/3893

(022) 69062500

heritagehealth@vsnl.net

Hyderabad

(040) 2324 4264

heritagehyd@bajoria.in

Vizag

(0891) 2713917

hhsplvizag@bajoria.in

Chennai

(044) 4260 4135/ 2829 0400 /10/30

hhsplchennai@bajoria.in

Delhi

(011) 4300 9540/41/42/43/44

hhspldelhi@bajoria.in

Surat

(0261) 400 0046/403 1544-46

hhsplsurat@bajoria.in

Ahmedabad

(079) 4027 2801-04

heritageahmd@bajoria.in

Bangalore

080-26423736, 080-26423746

hhtplbangalore@bajoria.in

Uttar Pradesh (UP)

(0522)424-8870

suhasismaity@bajoria.in

Pune

08421787005

hhtplpune@bajoria.in

Jaipur

0141-294 4765

hhtpljaipur@bajoria.in

Health E-Card

How can you download The Heritage TPA Health Card? Here’s how:

Step 1) Visit the official website

Step 2) Click on ‘E-Card Download’

Step 3) Enter your details

Here, you will need to enter the following details:

  • Insurance company name
  • Your name
  • Policy year
  • Emp ID

Once entered, click on ‘Submit.’

Download Forms

You can download the required forms by doing the following:

Step 1) Visit the official website and navigate to the ‘Download Forms’ section

Step 2) Select the form and download

Available forms include:

  • Claim Forms (Cashless and Reimbursement)
  • PPN Declaration Forms
  • Pre Authorization Form

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Medi Assist TPA (Complete Details)

TPA

Learn about Medi Assist TPA (Complete Details)

Medi Assist TPA acts as a Third-Party Administrator between insurance companies and policyholders. A TPA basically acts as a link between the insurance policyholder and the insurance company. Medi Assist TPA was founded in 2000 by Mr. NS Raghavan.
The company currently has around 3000 employees, has a presence in over 45 cities in India, and has its registered office in Bengaluru, India.

Let us now talk about some of the most important points about Medi Assist TPA, they are:

  • Products and services
  • Customer support
  • Submission of claims
  • Download E-Card
  • Claim intimation
  • Medi Assist TPA Hospital list
  • Company management
  • Notable accomplishments

Products and services

Services

The company provides the following services:

  • Enrolment and on boarding: Medi Assist TPA’s marketing and on boarding team looks after customer acquisition and enrolment. They guide potential customers about the types and kinds of insurance policies available, and the most suitable policy for their needs and requirements.
  • Providing customer support: Providing customer support is one of the most important function of any TPA company. It is the TPA company’s duty to ensure that all customer queries, questions and grievances are catered to and the best possible support is extended to the policyholder.
  • Management of claims: During a claim, the claimant will submit the claim to his/her TPA company and the TPA company will look after the claim management process thereafter. They will act as a link between the policyholder and the insurance company. It is the role of the TPA company and the agent to smoothen things out for the policyholder.

Products

The company provides the following products to its customers:

  • Member platform: The member platform provides policyholders with all of the important details pertaining to their insurance policy. Once logged in, all important insurance related reports can be accessed and downloaded.
  • Outpatient platform: The Outpatient platform can be used by policyholders to get access to important outpatient related details.
  • Claims management platform: Policyholder claims can be accessed and managed through this platform.

Their customers can leverage these technologies in order to get better results for themselves and their families.

Notable accomplishments

Details

Stats

Claims settled

60 Lacs+

Active members

4.5 Cr+

Offices

27

Insurance partners

30

Customer support

Department

Phone Number

Helpline

080 22069449

Helpline

1800 425 9449

Senior Citizen Helpline

1800 419 9493

Email

info@mediassist.in

SMS Facility (to know claim status)

SMS “CLAIMS ” to +91 96631 49992

Submission of claims

You can submit your claim to Medi Assist TPA using the following method:

Step 1) Visit the official Medi Assist TPA website

Step 2) Navigate to the ‘Intimate Claim’ section at the bottom of the website

Step 3) Enter your details

  • Here, you will need to enter either your Medi Assist ID / Employee ID / Policy No. Once entered, click on ‘Identify.’
  • Follow the next guided steps and submit your claim online.

Download E-Card

This is how you can download your Medi Assist TPA E-Card:

Step 1) Visit the official Medi Assist TPA website

Step 2) Navigate to the ‘Download eCard’ section at the bottom of the website

Step 3) Enter your details

Here, you will need to enter either your Medi Assist ID / Employee ID / Policy No. Once entered, click on ‘Identify.’

Medi Assist TPA Hospital list

Check out all of the affiliated hospitals here.

You will simply need to enter your city location and insurance company and the system will show you a list of all empaneled hospitals within your city.

Company management

Name

Contact Details

Dr. Vikram Jit Singh Chhatwal (Director)

https://www.linkedin.com/in/dr-vikram-chhatwal-विक्रम-छतवाल-30372082/

Srimathy Ranganathan (Director)

https://www.linkedin.com/in/srimathy-ranganathan-406b70156/?originalSubdomain=in

Satish Gidugu (CEO)

https://www.linkedin.com/in/satishgidugu/

Source: Medi Assit TPA

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Medvantage Insurance TPA (Services, Customer Care, E-Card and more)

TPA

Learn about Medvantage Insurance TPA (A Simple Guide)

Medvantage Insurance TPA is a third-party administrator that has ties with health insurance companies, and helps in providing health insurance related services to policyholders. Medvantage Insurance Tpa was founded in 2001 and currently has 8 offices across India, including offices in Mumbai, Hyderabad, Pune, Kolkata, and Bangalore. The company’s registered office is in Airoli, Navi Mumbai.

Let us talk about the most important topics concerning Medvantage, such as:

  • Services
  • Medvantage Insurance Login
  • How to download Medvantage E-Card
  • Customer Care
  • Empanelled Hospital List
  • Company Management

Services

  • Enrolment: Potential policyholders are brought aboard rather seamlessly through their online enrolment process, where customers can understand the different types of policies, their benefits and features.
  • Customer Support: This is the fundamental service offered by any TPA company, they support the policyholder during their time of need. They assist the policyholder and their family during the difficult time of hospitalization as well as post and pre-hospitalization customer support.
  • Claims Management: Medvantage TPA handles claims management where they vet the claim application and investigate the case. If all things are in alignment, they will then begin the claim disbursement process.
  • Account Management: All your communication with the TPA company is handled through experienced account managers that ensure that there isn’t a communication gap during correspondence.

Medvantage Insurance Login

  • You can login to your Medvantage TPA account by visiting the following link.
  • Once on the login page, you will need to enter your Email ID/ Mobile Number/ User ID and your password. Once entered, click on ‘Login.’

What are the benefits of logging in? Well, you can submit your insurance claim online, and you can even track your claim status online after logging in.

How to download Medvantage E-Card

You will need to download your Medvantage E-Card in order to access cashless treatment at affiliated hospitals. How can you download the E-Card?

Step 1) Visit the official website

Official website: https://medvantagetpa.com/

Step 2) Navigate to ‘Download E-Card’

Step 3) Enter your details

Now, you can download your E-Card by either entering your registered phone number or your registered Email ID. You will need to enter the following details:

  • Registered phone number/ Email ID
  • OTP number
  • Captcha details
  • Once entered, click on ‘Verify’

Customer Care

You can contact Medvantage TPA in multiple ways, let’s mention them below:

Email

Department

Contact Details

Customer Service

customerservice@medvantagetpa.com

Grievances

Grievances

General Enquiry

contactus@medvantagetpa.com

Phone Numbers

Department

Contact Details

Customer Service

1800-209-8884

Cashless Department

1800-209-8444

Senior Citizens Helpline

(022)4933-7781

You can also contact Medvantage through their online contact form. Just mention your name, email ID, query, phone number, and click on ‘Submit.’

Empanelled Hospital List

It is extremely important to find out if your desired hospital is empaneled with your insurance company, as you will only be able to take advantage of cashless hospitalizations in empaneled hospitals. You can find a list of all of the empaneled hospitals with Medvantage here.

Once on this page, you will need to enter the following details:

  • Name of your insurance company
  • City
  • Hospital name
  • Pin code
  • Captcha

Now, press on ‘Search.’ You will now get a list of all of the network hospitals in your area.

Company management

Name

Contact Details

Nimish R Parekh (Chairman)

https://sg.linkedin.com/in/nimishparekh

Prashant Nagarkar (Vice President)

https://in.linkedin.com/in/prashant-nagarkar-618ba612

Sanjay Kotkar (Claims Manager)

https://in.linkedin.com/in/sanjay-kotkar-897132217

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Dr YSR Aarogyasri Scheme (A Complete Guide)

Dr YSR Aarogyasri Scheme (A Complete Guide)

This article will explain the most important aspects of The Dr YSR Aarogyasri Scheme. This Scheme was introduced by The State Government of Andhra Pradesh in 2007, with the aim to provide quality health care services to the economically challenged people in Andhra Pradesh.

We will touch upon all of the most important aspects of these scheme, such as:

  • What is Dr YSR Aarogyasri Scheme?
  • What is Dr YSR Aarogyasri Health Care Trust?
  • Benefits and features of the scheme
  • Scheme coverage (Inclusions and Exclusions)
  • How to apply for The Aarogyasri Scheme?
  • How to login to your Aarogyasri Account?
  • Dr YSR Aarogyasri Health card
  • Aarogyasri Mobile App
  • Scheme Management

What is Dr YSR Aarogyasri Scheme?

As mentioned above, this state government initiative was launched in 2007 with the aim to provide quality health care services to the economically backward people of Andhra Pradesh. This scheme is a completely financed state government social health initiative which is managed by The Dr YSR Aarogyasri Health Care Trust. This trust handles all activities regarding the scheme.

This scheme is only available to the economically challenged people of Andhra Pradesh, no other people are eligible towards this scheme.

What is Dr YSR Aarogyasri Health Care Trust?

The Dr YSR Aarogyasri Health Care Trust manages all of the operations of The Dr YSR Aarogyasri Scheme. It manages the following activities:

  • Issuance of Aarogyasri Health Card
  • Checking eligibility of applicants
  • Disbursing payment to applicants
  • Accepting or declining claim requests

Benefits and features of the scheme

Let us now look at some of the most important benefits of The Dr YSR Aarogyasri Health Care Scheme:

  • Under this scheme, eligible people are provided health insurance coverage up to Rs.5 Lakhs / year.
  • Cashless hospitalization is also provided under this scheme. Cashless hospitalization basically means that the Trust will directly disburse the payment to the hospital, the patient will not need to make any out of pocket expenses.
  • This scheme also provides coverage for consultation and OPD.
  • One of the most important features of this scheme is that it provides coverage for pre-existing conditions and diseases. This means that if the scheme beneficiary is already suffering from any pre-existing condition, he/she will still be covered under this scheme.
  • Post hospitalization treatment is also covered under this scheme (up to certain limits.)
  • Family floater option is also available under this scheme.

Scheme coverage (Inclusions and Exclusions)

This scheme covers a total of 2434 diseases and disorders. Mentioned within are some of the notable inclusions and exclusions of the scheme.

Inclusions

Exclusions

General Surgery

Tuberculosis

Ophthalmology

HIV/AIDS

Septorhinoplasty

Infectious diseases

ENT Surgery

Leprosy & Filaria

Surgical Gastroenterology

Malaria

Paediatric Surgeries

Gastroenteritis

Neurosurgery

Knee replacement surgeries

Surgical Oncology

Gamma-knife procedures in neurosurgery

Plastic Surgery

Jaundice

Glaucoma Surgery

Cardiac and liver transplant

Cardiology

Bone marrow treatment

Nephrology

 

Pulmonology

 

Dermatology

 

Rheumatology

 

Psychiatry

 

Myringoplasty

 

Open radical Prostatectomy

 

The neck of bladder reconstruction for incontinence

 

Lumbar hernia repair in a pediatric patient

 

Polytrauma

 

Prostheses

 

Genitourinary surgeries

 

If you want to find out all of the diseases covered under this scheme, you can check it out here.
Further, there is another list of additional diseases covered which can be accessed here.

Empaneled hospitals of The Aarogyasri Scheme

Here are the notable hospitals affiliated with the scheme:

Hospital Name

City

Sunshine Heart Institute

Hyderabad

Olive Hospital

Hyderabad

Yashoda Hospital

Hyderabad

Sentini Hospital

Vijayawada

Care Hospital

Vizag

Sevenhills Hospital

Vizag

Lotus Childrens Hospital

Hyderabad

Get a complete list of all empaneled hospitals here.

How to apply for The Aarogyasri Scheme?

Applicants can apply for the scheme in two ways, either online or offline. Let us discuss about both the online and the offline method below:

Online method

Step 1) Visit the official website of the scheme

You can access the official website from here: https://navasakam2.apcfss.in

Step 2) Register on the website then login

Login button

Step 3) Enter your login details

login box
Login box

Step 4) Fill-up the Aarogyasri application form

Step 5) Upload all requested documents along with the fill-up form

Step 6) Check application status

Offline method

Step 1) Visit the official website of the scheme

You can access the official website from here: https://navasakam2.apcfss.in

Step 2) Click on the ‘Downloads’ button on the top bar

download button
Download button

Step 3) Select ‘YSR Aarogyasri Health Card Performa’

download Performa
Download Performa

Step 4) Download the form

Step 5) Fill-up the form and attach the requested supporting documents

Step 6) Submit the fill-up form along with all documents to the Aarogyasri Health Care Trust Office

How to login to your Aarogyasri Account?

Step 1) Visit the official website

Official website: https://navasakam2.apcfss.in

Step 2) Navigate to the ‘Login’ button

Login button

Step 3) Fill-up the details and login

login box
Login box

Dr YSR Aarogyasri Health card

Step 1) Visit the official website 

Official website: https://www.ysraarogyasri.ap.gov.in/

Step 2) Click on ‘EHS’

EHS button
EHS button

Step 3) Click on ‘Download Health Card’

download health card
Download health card

Step 4) Enter your user ID

enter your user ID
Enter your user ID

Aarogyasri Mobile App

The scheme benefits and features can also be accessed through the official scheme app. The app is currently only available on the Google Play Store. You can access it from here.

Scheme Management

You can find out the name of the management employees, their designation, and their contact numbers here.

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Frequently asked questions

Categories
Health Insurance

Swasthya Sathi Scheme of West Bengal (A Complete Guide)

Swasthya Sathi Scheme of West Bengal (A Complete Guide)

Launched in 2016, The Swasthya Sathi Scheme is a health insurance scheme introduced in West Bengal, under the governance of Mamata Banerjee. This scheme is one of largest health schemes in India with over 2.4 crore+ families covered.

In addition to this, there have been over 39.5 Lakhs + hospitalizations (as of 2022) which are covered under this scheme. Lastly, this scheme has a very high claim settlement ratio of 95.1%. Let us understand the most important aspects of this scheme, such as:

  • What is The Swasthya Sathi health Scheme?
  • What are the features and benefits of Swasthya Sathi?
  • How to login to your Swasthya Sathi account?
  • What is Swasthya Sathi Card and how to get it?
  • How to check your Swasthya Sathi Card status?
  • How to check your claim status?
  • The Swasthya Sathi App
  • Swasthya Sathi Package list
  • Swasthya Sathi find your name
  • Contact details and helpline numbers
  • Hospital list

What is The Swasthya Sathi health Scheme?

Swasthya Sathi is a universal health care scheme launched by the Government of West Bengal. Under this scheme, all permanently residing families of West Bengal are eligible to enroll under the scheme. This scheme provides health coverage of up to Rs.5 Lakhs / family per year. That being said, individuals who are covered under any other state sponsored health care scheme cannot enroll under this scheme.

What are the features and benefits of Swasthya Sathi?

  • Under this scheme, beneficiaries will receive a health care coverage of Rs.5 Lakhs/family per year.
  • All pre-existing diseases and disorders will be covered under this scheme.
  • Cashless hospitalization feature is available under this scheme.
  • This scheme is completely financed by The State Government of West Bengal. The beneficiary is not required to pay charges.
  • Pre hospitalization and post-hospitalization expenses are covered (up to a certain limit.)
  • Reimbursement claims are disbursed to the policyholder within 30 days.
  • There is a special 24×7 call center that is always at hand for providing assistance to claim beneficiaries.
  • Beneficiaries can also submit their complaints, queries, or questions to the online portal of the scheme and expect a prompt reply.

How to login to your Swasthya Sathi account?

You can login to your Swasthya Sathi account by following the steps below:

Step 1) Visit the official Swasthy Sathi website

Swasthya Sathi website
Swasthya Sathi website

https://swasthyasathi.gov.in/

Step 2) Click on the ‘Login’ button on the top right hand side

Click on Login

Step 2) Enter your username and password and click on ‘Submit’

Login box
Login box

What is Swasthya Sathi Card and how to get it?

All of the scheme benefits can only be accessed if you have a Swasthya Sathi Card. Therefor it is extremely important that you know how to get this card. We will show you how you can get the card in the following simple steps:

Offline method

Step 1) Download the Swasthya Sathi application form

apply online button
Apply online button

Hover over the ‘Apply Online’ tab on the top of the website and navigate to the Download Application Form’ section.

Step 2) Download the relevant form, take a print and fill-it

Step 3) Submit to your nearest scheme affiliated medical center

You will have to submit your form along with the request documents like Aadhar Card, BPL Certificate, Domicile Certificate, etc. Once the submission is done, your card will be disbursed to you within 7 days.

Online Method

You can also apply for the card via the online method. Let us understand how:

Step 1) Visit the official scheme website and navigate to the ‘Apply Online’ section

apply online button
Apply online button

Step 2) Click on ‘Online Application for Swasthya Sathi Card’

Step 3) Enter your mobile number and OTP

Online Application
Online Application

Once entered, click on ‘Submit.’ You will now be redirected to the online page where you can apply for the Swasthya Sathi Card.

How to check your Swasthya Sathi Card status?

You can check the status of your card in the following steps:

Step 1) Visit the official website

Step 2) Click on ‘Find Your Name’

find your name button
Find Your Name Button

Step 3) Enter your registered mobile number and click on ‘Submit’

find your name box
Find Your Name Box

Your status will reflect on the next page.

How to check your claim status?

You can check your claim status by logging into your Swasthya Sathi account on the official scheme portal.

The Swasthya Sathi App

You can also avail the benefits and features of this scheme through the official Swasthya Sathi App, which is available on the Android Play Store. The app is currently not available on the Apple App Store.

Swasthya Sathi Package list

You can access the complete Swasthya Sathi Package list here. Here, you can check out all of the medical conditions, disease, and disorders covered under the scheme, and the maximum amount covered per disease. You will simply have to select the Grade of the procedure and click on ‘Show Data.’

 

Swasthya Sathi Package list
Swasthya Sathi Package list

All of the covered procedures and their maximum coverage amount will be visible on the next page.

Swasthya Sathi find your name

What if you want to check the status of your Swasthya Sathi application? You can do so by visiting the Swasthya Sathi find your name page. You can access this page from the homepage.

Click on ‘Find Your Name’ from the top bar of the home page.

find your name button
Find Your Name Button

Once on the page, enter your registered mobile number and click on ‘Submit.’

find your name box
Find Your Name Box

Contact details and helpline numbers

Helpline Number

18003455384 (Toll-Free)

You can also access the entire contact details of the entire Swasthya Sathi team here. You can easily contact the relevant person or the department easily through the contact details mentioned there.

Swasthya Sathi Hospital List

You can find out all of the empaneled hospitals under the scheme by navigating to the ‘Hospital Information’ tab and clicking on ‘Active Hospital List.’
Once on this page, enter the following details:

  • State
  • District
  • Hospital Type
  • Hospital Grade

Now press ‘Submit’ and get a list of all the network hospitals for that area.

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Frequently asked questions

  • In which hospitals can the beneficiary receive treatment?

    The beneficiary will be eligible to get covered only if he/she receives treatment in an empaneled hospital.

  • Which grade hospitals are empaneled under this scheme?
    • Grade A
    • Grade B
    • Grade C
    • Grade R
  • When was this scheme launched?

    2016

  • Is Swasthya Sathi completely sponsored by The State Government?

    Yes, this scheme is completely sponsored by The State Government of West Bengal.

  • Does Swasthya Sathi have an online portal?

    https://swasthyasathi.gov.in/

     

  • Are OPD consultations covered?

    They are covered if the consultation leads to hospitalization.

  • Does this scheme provide pre and post hospitalization?

    Yes, up to specified limits.

  • Categories
    Health Insurance

    Paramount TPA (Claim Status, Customer Care, Hospital List, and more)

    TPA

    Learn about Paramount TPA (Simple Guide)

    Paramount Health Services & Insurance TPA Pvt. Ltd. (PHS) is a Third-Party Administrator that currently operates in over 160+ locations across India. Paramount TPA was founded in 1996 and is a notable player in the Indian Health Insurance sector, and is one of the largest TPA providers in India.

    Paramount TPA was founded by Dr. Nayan Shah, and he currently serves as the company’s Managing Director. The company provides the following services:

    • Health insurance claim management
    • Customer handling and support
    • Policyholder assistance
    • Health portfolio management
    • Handling of medical check ups

    This article aims to provide a complete understanding of Paramount TPA and all of its benefits, features, services, and more. We will touch upon the following topics:

    • How to check your Paramount TPA claim status
    • How to download claim form
    • Paramount TPA customer care
    • Paramount TPA login
    • How to download E-card?
    • Paramount TPA hospital list
    • Paramount TPA management

    How to check your Paramount TPA claim status

    This is how you can check your claim status:

    Step 1) Visit the official Paramount TPA website

    Step 2) Navigate to the claim status page

    Step 3) Enter your claim details

    Once on this page, you will need to enter the following details:

    • Insurance company
    • Policy type
    • PHS ID
    • IPD/OPD

    Once selected, click on ‘Submit.’ You will now be redirected to a page that will show your claim status.

    How to download your claim form

    You can download the claim form using these simple steps:

    Step 1) Visit the official Paramount TPA website

    You can access the website here.

    Step 2) Navigate to the ‘Downloads’ section

    The ‘Downloads’ section is on the top bar of the homepage. Hover over it and then click on ‘Download Forms.’

    Step 3) Download Forms

    Now, you will need to select the relevant claim form and download it to your PC or mobile phone.

    Paramount TPA Customer Care

    Contact

    Phone Number

    Landline

    +91 22 666 20 808

    WhatsApp

    +91 91369 72004

    Branch address and phone number

    Location

    Address

    Phone Number

    Email ID

    Andheri (East) – Mumbai (Corporate Office)

    401, Sumer Plaza, 4th Floor, Marol Maroshi Road, Andheri (E) 400 059.        

    +91 22 40004200

     

    Thane (Head Office)

    Plot No. A-442, Road No. 28, Ram Nagar, M.I.D.C. Industrial Area, Wagle Estate, Thane West Pin Code – 400604.

    022-68342424

    contact.phs@paramounttpa.com

    Bangalore

    Janardhana Towers, No. 133/2, 3rd floor Residency Road, Bangalore – 560025         

    080-41990100

     

    Chennai

    2nd Floor, “Ampa Manor”, No. 107/3, Nelson Manickam Road, Aminjikarai, Chennai – 600 029. (Landmark – Opposite to MGM Healthcare)     

    (044)- 43435959 / 43435933 / 43435944

     

    Delhi

    Building No. D-39, Okhla Industrial Area, Phase-I, New Delhi – 110 020.

    41637594 / 95 / 96               

     

    Kolkata

    ICMARD Building, 4th Floor & 8th floor, Block 14/2, C.I.T. Scheme VIII (M) Ultadanga, Kolkata – 700 067.            

    (033)-23567005 / 23567008 / 9836561300 / 9331457647

     

    Ahmedabad      

    Office No. 304,Meera Manan Arcade, Near Krupa Petrol Pump, Parimal Cross Road, Ellisbridge, Ahmedabad-380006.                

    (079)-40399287/40399288 Fax No:(079)-26401545

     

    Chandigarh

    SCO-46, Cabin No.-106-107, First Floor, Sector -11,(Landmark Canon Plaza) Panchkula(Chandigarh).134109               

    9316111218

     

    Hyderabad

    No. 1-8-303/48/9, 1st Floor, Tirumala Chambers, PG Road, Behind Chutneys Restaurant, Begumpet, Hyderabad – 500 016

    (040) – 66758271 / 66759271 Fax No:(040) – 66366271

     

    Pune

    Office no 403-404, Mayfair Tower I C.T.S. no 28, Wakadewadi Shivaji Nagar, Pune – 411005.  

    020-25541100 / 020- 25541111

     

    Cochin

    H No.Cc662946, Kanakathuparambu, Near Nariamparambil Court, Kacherippady, Kochi – 682018.               

    (0484) – 2393709/(0484)-2392610/(0484)-4011962

     

    Get a complete list of all branches here.

    Paramount TPA Login

    You can login to your Paramount TPA account by visiting the link here
    You will need to enter the following details while logging in:

    • Username
    • Password
    • Group Code

    Once entered, kindly click on ‘Log in.’

    If you don’t have an account, you will have to register for an account first. Once have registered for an account, then you can login to your account using your credentials.

    How to download E-card?

    You can download your Paramount TPA E-card by visiting the link here

    Once, you are on this page, you will need to enter the following details:

    • Insurance company
    • PHS ID/Employee ID/Policy No
    • Once entered, please click on ‘Submit.’

    Your E-card will be downloaded.

    Paramount TPA Hospital List

    You can check out all of the empaneled network hospitals of Paramount TPA here. You will simply need to enter your state, city, Insurance company. Once your details are entered, click on ‘Submit.’

    Paramount TPA Management

    Name

    Designation

    Contact Details

    Dr. Nayan Shah

    Founder and Managing Director

    https://www.linkedin.com/in/nayan-shah-4655767/

    Mr. Atman Shah

    Vice President Operations & Customer Relations

    https://www.linkedin.com/in/atmans/

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