Reimbursement Procedure

  • A. Cashless facility is offered by the Hospital to the Insured
  • B. Insurance Company Settles the Claims by Banking Instruments like RTGS directly
  • C. Anyuta Insurance TPA in Health Care,
    • a. Issues the Authorization Letter (AL) to treat the Policyholder,
    • b. Process the claims as per the Insurer`s Policy conditions and guidelines
    • c. Generates Claim Settlement Float and submits to the Insurer to Settle Claims
    • d. Submits all Claim Documents with it to the Insurer with the Claim Settlement Float

In the case of reimbursement,

  • a. The Policyholder may not be entitled for the total amount claimedin case the claimant is not aware of the deductibles in the Policy.
  • b. It is always better for the Policyholder to discuss with the TPA to know about the reimbursable amount before getting admitted for treatment
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