Cashless Hospitalization facility is available only at Network Hospitals. It enables the insured to obtain admission at designated hospitals subject to obtaining an Authority Letter from Medi Assist. In such cases, Medi Assist settles the hospital bills directly on your behalf.

In the case of a planned admission, you would have first consulted a doctor who in turn would have advised you on the probable date of hospitalization. In such a case, you must apply for an approval of the estimated hospital expenses directly with Medi Assist at least 72 hrs prior to the date of hospitalization. TPA desk or Hospital executive may assist you in filling up the form and the same shall be sent to Medi Assist.

Your claim would be assessed in the light of the policy issued to you by your insurance company and a letter of authorization will be issued to the hospital authorizing the patient's treatment. Once the Authority letter is sent to the hospital from Medi Assist, you need not pay to the hospital. Medi Assist will pay your hospital bills up to the amount authorized in the Authority letter.

Emergency hospitalization is a hospitalization which requires immediate admission to the hospital when an insured or covered family member meets with a sudden accident or suffers from a bout of illness.

Step 1 Approach the nearest network hospital.

Step 2 Go to the TPA desk and fill in the Pre-auth form & submit. Hospital would send the filled in pre-authorization request form to Medi Assist. Medi Assist will check the liability and send authorization letter (in case if the hospitalization is warranted and admissible under policy terms) or denial letter.

Step 3

1. If authorization for cashless transaction from Medi Assist has been received
   • At the time of discharge, pay for the services and items that are not covered under the health insurance policy/excess/co-payments/deductibles
   • Verify the bills and sign on all the bills.
   • Leave the original discharge summary and other investigations reports with the network provider. Retain a photocopy copy for your record
2. In case of non-receipt of authorization from Medi Assist or if authorization is denied by Medi Assist
   • At the time of discharge/leaving the network provider premises, please settle the bills in full and collect all the bill documents and reports.
   • Lodge your claim with Medi Assist for processing and reimbursement

In case of emergency or unplanned admission, the hospital must send the pre-authorization request to Medi Assist within 24 hours from the time of admission .In case of planned hospitalization it is prudent to send the pre-authorization request to Medi Assist at least 72 hours prior the admission date. This will ensure a hassle-free admission procedure for you at the hospital.

Yes, Mediclaim policy allows reimbursement of relevant medical expenses incurred during pre & post hospitalization towards the ailment / disease for which hospitalization was necessitated. This is subjected to the limits prescribed in the policy.