Hospital Billing

For Non-Insured Patients:

OBJECTIVES:

To ensure proper bills are produced based on charges for the procedures and investigations performed in accordance with the schedule of charges of the hospital.
To make available to the patients the details of billing.

STRUCTURE:

The Billing Department is headed by the Billing Superintendent with our staff members for indoor patients in our Account Section and other staff members at the reception for the outdoor patients.

FUNCTIONS:

Preparing outpatient cash and credit bills for all the investigations and procedures.
Preparing inpatient final bills for all the wards and rooms
Preparing credit bills and forwarding the same to the Account Office on regular basis.
Depositing cash into the bank on daily basis
Forwarding the cash collection summary, bank deposit slips and billing sheets to the Accounts Department on daily basis.

For Outpatient

All the Payments and Receipts for outpatient consultations, ultrasound, X-ray and other miscellaneous are given at the reception

For Inpatient

After the discharge of patients, full and final bill is made in our account’s department which Includes charges like:

Room Rent Charges
Nursing Charges
Operation Theatre Charges
Surgeon Charges
Assistant Surgeon Charges
Pediatrician Charges
Anaesthetic Charges
Relevant Investigation Charges

[Blood & Blood Products, Medicines & Consumables Are Excluding As They Depend Upon The Patient And His Duration Of Stay.]

Note : This information is provided to assist those without health insurance coverage. For individuals with insurance, please refer to your insurance policy for billing procedures.

For Insured Patients (Patients with Health Insurance):

If you have health insurance, here's a simple guide to understand how the billing process works:

Types of Health Insurance Claims:

Your health insurance is designed to help you financially when needed. There are two ways your insurance can assist you: Cashless Claim and Reimbursement.

Health Insurance

In today's world, Health Insurance is required for all, and by paying a standard manageable premium, you can guard yourself against exorbitant medical bills. Thanks to the rapid adaptation of internet and mobile technologies, individuals and families can now compare, access, and purchase multiple products in just a few clicks. The process of buying health insurance online has been simplified by digitization. Purchasing health insurance online is less expensive because there are no intermediaries involved and most insurers offer online discounts to their customers. It is also very convenient for customers to compare multiple insurance plans based on features and premium to choose the option that is best suited to their specific needs.

Cashless Network Hospitals

With the increasing cost of healthcare, a large number of people are vouching on health insurance policies to meet their medical bills without any financial stress. Health insurance is beneficial for those who wish to avail the best medical services without having to pay the skyrocketing hospital fees for even a minor treatment.

However, a cashless claim means that the policyholder would not be required to pay at the hospital for the medical treatment up to the sum insured limit. The health insurance company would directly pay off the hospital bill.

Cashless hospitalization makes healthcare even more accessible and affordable, as the insured person doesn’t need to fret about paying off hefty hospital admission fees and also the expenses that were incurred during the course of treatment.

And the point to note is that this facility is only available at the network hospitals/ registered hospitals/ partner hospitals/nursing homes.

Usually, the health insurance companies have a tie-up/agreement with the network hospitals and it permits the insured members to avail the best treatment in network hospitals on a deferred payment basis. For instance, if you have Care Health Insurance, then you can avail cashless treatment at any of the Care Health Insurance Network Hospital .

A cashless network hospital functions just like other non-partner hospitals work. The insured members can visit the nearest network hospital and avail medical treatment without paying at the hospital. It includes room rent, admission charges, treatment cost, ambulance cost as well as the doctor/specialist fees.

The hospital bills would be settled as per the Sum insured limit opted by you at the time of health insurance policy purchase. All the expenses that were mentioned-above would be paid by the health insurance provider (except particular treatments that are not covered by your insurance company).

The insured person only needs to intimate the network hospital that your health insurance policy covers cashless treatment and you would prefer to go ahead with that. To start with it, you would need to furnish your identification proofs, including policy documents or health card issued by your health insurance provider.

With cashless hospitalization facility, all the medical bills will be borne by your health insurance company upon completion of the treatment or before getting discharged.

In case the insured person is to be treated in a hospital away from home, then also you can avail the treatment. As most of the health insurance companies provide the facility to avail cashless treatment in network hospitals across the country without having to pay the bills.

In case of an emergency hospitalization or if the insured person is facing financial problems, then network hospitals work as a saving grace. The insured members are assured of quality treatment without any financial burden. The cashless hospitalization process may be done in the following two ways:

Planned hospitalization

In this method if you are unable to plan and determine about the list of network hospitals, then check your policy document or call the toll-free number to know the network hospitals. Here are the steps you must follow.

Procure pre-authorization form from the insurance desk at the hospital or download through the TPA website. The form must be duly filled by the patient and the physician.
The completed form must be submitted to the insurance desk where it is thoroughly reviewed for authenticity.
The form is then submitted to the TPA and the TPA then approves the same.
After that, an authorization is sent giving the sanctioned amount details.

Emergency hospitalization

In case you need to be admitted in an emergency, you need to follow the below mentioned steps:

Show your HEALTH INSURANCE card that includes the policy number and details of the type of coverage you have.
Duly fill the authorization form available at the insurance desk to expedite the process.
In case you are unable to wait for the approval from the TPA, you may settle the hospital bill and later file a reimbursement claim.

We are delighted to inform you that, Krishna Medical Centre has now been empanelled with SBI General Health Insurance, Care Health Insurance & Ericson Insurance TPA Pvt. Ltd and patients insured with these companies can avail cashless facilities in the hospital for IPD admissions

For searching our hospital, kindly log into their official website:-

For SBI General Health Insurance log into www.sbigeneral.in
For Care Health Insurance log into www.careinsurance.com
For Ericson TPA Pvt.Ltd log into www.ericsontpa.com

You can log into their vast network of hospitals and search for our hospital's name by entering the city Lucknow and the area pin code 226001

Cashless Facility Available

Here/TPA List:

Welcome To Ericson Insurance TPA Pvt Ltd

We have developed our own state-of-art claims IT system, and we are in process to build up tone of the largest direct billing hospital (Cashless) network hospitals across the India. We are in better position to provides full-range comprehensive health insurance services, including, enrolment, claims processing, pre-authorization, case management, emergency assistance, network maintenance and other customer services right in all over India. Innovation, flexibility, speed, and superior service are the hallmarks of our commitment to our valued clients. We are ready to provide you with the best customer service for now and in the future.

Network List For Swasthya Ratna Policy Holders

The New India Assurance Co. Ltd.

United India Insurance Co. Ltd.

National Insurance Co. Ltd.

The Oriental Insurance Co. Ltd.

Bajaj Allianz General Insurance Co. Ltd.

ICICI Lombard General Insurance Company Limited

Chola Mandalam Ms General Insurance Co. Ltd

Liberty Videocon General Insurance Co. Ltd.

Magma Hdi General Insurance Co. Ltd.

Tata Aig General Insurance Co. Ltd.

Universal Sompo General Insurance Co. Ltd.

Iffco-tokio General Insurance Co. Ltd.

Niva Bupa Health Insurance Company Limited

Aditya Birla Health Insurance Co. Ltd.

Royal Sundaram General Insurance Co Limited.

SBI General Insurance

SBI General Insurance, are committed to carry forward the legacy of trust and security; and have a vision to become the most trusted general insurer for a transforming India. Ever since the establishment in 2009, their growth has been exponential in various aspects. They have expanded their presence from 17 branches in 2011 to over 141 branches pan-India. Till date, they have served over 55.55 crores customers. They have been awarded ‘Insurer of the Year’ in the non-life category at FICCI Insurance Industry Awards, for two consecutive years in 2020 & 2021. In 2022, recognized as the 'Best General Insurance Company of the Year' at the 'Third Emerging Asia Insurance Awards' organized by the 'Indian Chamber of Commerce'.

SBI General is one of the fastest growing private general insurance companies, with the strong parentage of SBI.

Get high-quality medical care swiftly with the help of cashless claim facility at any of our network hospitals.

These Network hospitals of SBI General Insurance are for cashless facility for inpatient hospitalization only (as per the applicable product terms and conditions). The network list is dynamic and subject to change. Please refer respective TPA website for the updated list of hospitals. You may also call the hospital before visiting to ensure that they are providing the relevant services.

Care Health Insurance

Care Health Insurance Limited (formerly Religare Health Insurance Company Limited) is an Indian health insurance company established in July 2012. It is part of the Religare Group and a direct subsidiary of Religare Enterprises.

Care Health Insurance is headquartered in Gurgaon, Haryana, and operates out of 158 offices across India with 8500+ employees.

Key Benefits of Care Health Insurance

At CHI, we ensure our valuable customers get access to affordable healthcare from a wide range of hospitals. As the world is going digital, and when you can shop for things at the comfort of your home, you can even buy health insurance online without any hassle. Buying an insurance policy online minimizes paperwork and manual efforts to an extent. The online mode is highly convenient since you get the choice of comparing policies and opting for the most affordable health plan for you and your family. You can buy a policy, pay for the premium, and initiate a claim, all through a few clicks.

The key benefits offered by Care Health Insurance are as follows:

In-Patient Care
Pre and Post Medical Hospitalization expenses
Ambulance Cover
Day Care Treatments
No Claim Bonus
Tax Benefits u/s 80D
Cashless treatment in network hospitals

Cashless Claim:

Show your health insurance card at the hospital during admission.
Treatment expenses will be settled directly by the insurance company.
No need to pay anything at the hospital.
Most insurance companies approve cashless treatment within 4 hours.

Cashless Procedure for Planned Admission:

Choose a hospital from the network (as mentioned in your insurance document).
Inform the third-party administrator (TPA) 3 days before admission.
Fill the cashless request form at the hospital.
Submit the form and medical records to TPA.
If approved, the insurance company settles hospital bills directly.

Cashless Procedure for Emergency Admission:

Inform TPA in case of emergency admission.
Fill the cashless form at the hospital, certified by a doctor.
Send the form with medical records to TPA.
If approved, hospital bills are settled directly.

Reimbursement:

If your cashless claim is rejected or you're at a non-network hospital, you can apply for reimbursement.
Start the reimbursement process within seven days of discharge.

Reimbursement Procedure:

Contact your insurance company through the toll-free number, provide the membership number.
Settle hospital bills yourself.
Provide bills, prescriptions, discharge summary, and other necessary documents.
Download and fill the reimbursement form from the insurance website.
Submit the form with medical records to the insurance company.
A cheque will be disbursed upon claim approval within 20 days.

Important Points for Claims:

Fill reimbursement forms accurately to avoid denial.
Raise a claim request within 7 days of discharge.
Some items may not be reimbursed.

Follow these steps carefully to get your insurance claim approved. Keep your documents ready, as the insurance company may request them at any time.

For more information on tax benefits, contact with your health insurance provider on our website.