TPA INSURANCE
 

A third-party administrator (TPA)

is an organization that processes insurance claims or certain aspects of employee benefit plans for a separate entity.[1] This can be viewed as "outsourcing" the administration of the claims processing, since the TPA is performing a task traditionally handled by the company providing the insurance or the company itself. Often, in the case of insurance claims, a TPA handles the claims processing for an employer that self-insures its employees. Thus, the employer is acting as an insurance company and underwrites the risk. The risk of loss remains with the employer, and not with the TPA. An insurance company may also use a TPA to manage its claims processing, provider networks, utilization review, or membership functions. While some third-party administrators may operate as units of insurance companies, they are often independent.

Shreeji Hospital is empanelled with most of the reputed insurance providers. We also accept employer covered insurance services Cashless facility is subject to the conditions and terms in the policy.

Planned Hospitalization
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 approval of the estimated hospital expenses directly by your TPA at least 4-5 days prior to the date of hospitalization.
In case you have not applied for pre-authorization sufficiently in advance or if the doctor treating you advises you to get hospitalized immediately after the consultation, our Corporate Help Desk (Phone: 022-29664969 / 29663104) will assist you through the pre-authorization procedure. However, the Corporate Help Desk is only a facilitator and can in no way influence the decision on the approval.

Emergency Hospitalization
In an emergency hospitalization, the important thing is to get the patient treatment at the earliest. The Corporate Help Desk will take up your case on a fast track basis with your TPA and is likely to receive approvals within 6 hours during any working day.