Pre Authorisation /Request for Cashless Hospitalisation -

All planned (non-emergency) hospitalization must be pre-authorized with the Helpline, by filling in Pre-Authorisation Form to ensure that the hospitalization is co-ordinated properly and the patient/employee is not inconvenienced while getting admitted into a Hospital. This is possible only in the Network Hospitals tied up with Vidal Health TPA Services

In emergencies, the relatives must contact the Help Desk by showing the Vidal Health TPA ID Card or contacting the hospital administration/billing dept. The hospital authorities will help complete the cashless request procedure.

For all issues, please get in touch with the Help Desk for assistance.

Note: Before discharge, please ensure the patient pays for all the non-medical expenses.

Reimbursement -

This applies to hospitalisation in hospitals that are not covered in Vidal Health TPA Service's network -

• Settle the Bills.
• Send the Documents for Reimbursement with duly filled Claim Form
• The claim documents will be scrutinized and settled.
• If there are any docutments pending,Vidal Health TPA Services will intimate to the employees or to the HR in case the Email ID of the employee is not available.
• In 12 working days, the claims will be settled barring delays due to audit, shortage of funds etc. In case of claims exceeding Rs.1 Lakh, the same will get settled in about a month after getting sanction from their Divisional Office.
• Claims arising out of hospitalization in non networked hospitals has to be forwarded to the HR for onward reimbursement.

Documentation -

List of Documents (ORIGINALS) required for submission of the claim:

1) Discharge Summary / Treatment summary

# DISCHARGE SUMMARY SHOULD BE IN THE HOSPITAL LETTER- HEAD, DULY SIGNED, CONTAINING ALL THE DETAILS MENTIONS IN THE DISCHARGE SUMMARY FORMAT.

# FOR DAY CARE SURGERIES, SUMMARY SHOULD BE OBTAINED GIVING ALL THE DETAILS WHICH ARE GIVEN IN A DISCHARGE SUMMARY. THE ONLY DIFFERENCE WILL BE THE DATE OF ADMISSION AND THE DATE OF DISCHARGE WILL BE THE SAME DAY

2) Hospitalization bills and receipt.

# SOME HOSPITALS GIVE THE SUMMARY OF EXPENSES AGAINST EACH HEAD SUCH AS ROOM RENT, DOCTORS' FEES, INVESTIGATIONS, AND MEDICINES ETC. IN SUCH CASES OBTAIN THE BREAK UPS FOR THE ABOVE AND IT IS CALLED "BILLING DETAILS"
PLEASE ENSURE THAT IT IS NOT PROVISIONAL BILL.

3) Reports & bills of the Investigations carried out in the hospital

# REPORTS FOR INVESTIGATIONS ARE ALSO NECESSARY. X'RAY, CT SCAN FILMS ARE NOT NEEDED.

# FOR ALL THE INVESTIGATION BILLS, EITHER CHARGED THROUGH THE MAIN BILL OR SEPARATE BILL, REPORTS SHOULD BE THERE.

# IF INVESTIGATIONS ARE DONE OUTSIDE THE HOSPITAL AND SEPARATE BILLS ARE SUBMITTED, PRESCRIPTION AND ALSO THE REPORT IS NECESSARY.

4) Bills of the medicines purchased along with the prescriptions. Prescriptions are needed for medicines consumed if the medicines are purchased in the hospital Pharmacy and not included in the main bill AND Breakup of Operation Theatre Medicines

# PLEASE TAKE CARE TO SEE THAT THE PRESCRIPTION FOR MEDICINES TALLY WITH THE MEDICINE PURCHASED. SUPPOSE YOU HAVE PURCHASED ANY ALTERNATIVE BRAND, DUE TO THE NON-AVAILABILITY OF THE PRESCRIBED MEDICINES, HAVE THE PRESCRIPTION CHANGED.

# QTY PRESCRIBED AND BOUGHT SHOULD ALSO TALLY. IF THERE IS REPEAT DOSAGE, GET THE PRESCRIPTION FOR THAT ALSO.

# PRESCRIPTION ARE NEEDED FOR MEDICINES PURCHASED FROM HOSPITAL PHARMACY ALSO, IF IT IS NOT INCLUDED IN THE MAIN BILL. SOME TIMES THE HOSPITAL PHARMACY DOES NOT RETURN THE PRESCRIPTIONS IN WHICH CASE THESE BILLS CAN BE AUTHENTICATED BY MARKING "INDENTED AT THE HOSPITAL" ON THE REVERSE OF THE BILL AND IT SHOULD BE SEALED WITH HOSPITAL SEAL AND SIGNED.

# IF HOSPITAL HAS SUPPLIED MEDICINES, ENSURE THAT THERE IS BREAK UP FOR MEDICINES SUPPLIED AT THE HOSPITAL AND BILLED IN THE MAIN BILL IS ALSO AVAILABLE

# IF THE DOCTOR'S FEE IS BILLED SEPARATELY IN HIS LETTER HEAD / RECEIPT, PLEASE GET A CERTIFICATE FROM THE HOSPITAL IN THE HOSPITAL LETTER HEAD STATING THAT HE IS THE CONSULTANT WHO HAS TREATED THE PATIENT AT THAT HOSPITAL. OR
# ALTERNATIVELY TREATING DOCTORS' NAME SHOULD APPEAR IN THE DISCHARGE SUMMARY. (THIS HAS BECOME NECESSARY SINCE THERE HAS BEEN FALSE BILLS PRODUCED FROM DOCTOR'S)