HI TPA shall process reimbursement claims of its members for the medical treatment availed by them in Non-Network Hospitals or for cases where cashless is not availed or denied.
The process for settling reimbursement claims is:
Member undergoes Hospitalisation
Collect & send the Discharge summary, claim form & bills to HI TPA
HI TPA receives the documents & reviews it
On Approval the member is reimbursed
Reimbursement claim process
- The insured member undergoes treatment at a hospital meeting the policy criteria.
- Insured member informs the HI TPA/Insurer within 24 hours of hospitalisation.
- Insured member makes the payment to hospital & collects all original bills & reports and gets claim form filled and counter signed by treating doctor.
- Insured member Submits the copy of Member id card, original Claim form, original bills, reports Etc. to HI TPA as per documents check list provided in the claim form/website/FAQ’s.
- Claim is processed as per policy T&C and payment is made to the Insured through NEFT.