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THE NEW INDIA ASSURANCE
COMPANY LIMITED
Mount Casa Blanca Building, 2nd Floor, 260 Anna Salai, CHENNAI-600
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THIRD PARTY ADMINISTRATOR |
The Insurance Regulatory and Development Authority has granted TTK Healthcare TPA Private Limited licences to provide Third Party Administration Services. They have subsequently authorized by us to extend their services to Citibank Card members who are all covered under our Good Health Mediclaim Policy. Their services include
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Issue of identity card to all citibank card membes who are all covered under this GOOD HEALTH mediclaim policy. |
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Provide information to all policyholders about hospitals |
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Provide Cashless access in TTK network hospitals. The name of members of the network hospitals is subject to deletions and additions. |
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Provide
24 hours a day, 7days a week customer services toll free
number. The number is 1800-425-7575. Each person covered under the policy will be issued an identity card. Whenever there is a need for hospitalization, the policyholder should obtain an Authorization letter from TTK. For this authorization, the policyholder may contact his/her nearest TTK office or toll free number 1800-425-7575 and request for the same. The policyholder will have to submit this authorization letter along with the identity card given by TTK to the admission counter in the hospital. The hospital will then start treatment. This facility is called 'CASHLESS ACCESS ' facility. This request may be declined by TTK if the policyholder provides inadequate information to them or the ailment/disease for which hospitalization is required is not covered under the policy or the insured person does not have adequate insured amount left to cover the hospitalization costs. The denial of preauthorization letter shall not be construed to mean that the policyholder cannot claim under the terms and conditions of the policy. In such cases, the policyholder is advised to file your claim for reimbursement and TTK will process the claim as per the policy terms and conditions. |
There are two types of Hospitalizations TTK takes care.
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PLANNED HOSPITALIZATION |
a) A request for Authorization (Pre-Authorization) for planned treatment has to be filled up. This request form is available in all TTK offices. This form has to be filled up by the Doctor recommending Hospitalization. The form must be filled in BLOCK letters indicating the Doctor's name, Registration Number and Telephone Number. For any clarifications, TTK's medical officer may contact the policyholder's doctor before TTK initiates action on the request.
b) This request must reach TTK office at least 4 days before hospitalization.
c) Any change in the date of hospitalization, Hospital, nature of illness or surgeon who is going to perform the procedure will make the authorization invalid. A fresh authorization will have to be taken.
d) The authorization is valid only for Network Hospitals.
e) The authorization will be addressed to the hospital and sent to the patients address or faxed to the hospital as desired by the policyholder.
f) The policyholder can collect a claim form from the nearest TTK office for claiming purpose or can download from this site or from TTK website (www.ttkhealthcareservices.com)
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GETTING HOSPITALIZED |
In order to secure admission on the appointed day, the policy holder is advised to register the insured person's name with the hospital well in advance.
a) Contact the admission desk of the hospital.
b) Show the TTK identity card and Authorization letter given by TTK. The hospital will check the ID card and authorization letter. In case the policy holder does is issued a non-photo identity card, he/she may have to carry some identification documents like a driving licence/voter's ID card etc.
c) Some network hospitals may charge the policy holder registration fees/admission fees etc. These will have to be paid by the policy holder. These expenses are not reimbursable under the policy.
d) If the approved amount is less than the amount estimated by the hospital, the policy holder should make arrangements for the difference. In addition to the above, the policy holder may have to pay expenses towards telephone charges, ambulance charges etc. if incurred. For more details, please contact toll free number 1800-425-7575.
EMERGENCY HOSPITALIZATION
The insured person is advised to get admitted,
in case of admission to a Network Hospital, the hospital will admit the
patient as per the procedure of the hospital. The hospital will then
contact TTK and send us a request for authorization.
At times, the policyholder may be required to contact TTK for authorization. The card member must send the pre-authorization request completely filled. TTK will revert within 6 hours of receipt of the request. In case cashless access is declined, this is no way to be construed to be denial of treatment. The card member must obtain the treatment as per his/her treating doctor's advice. The denial of pre-authorization letter shall not be construed to mean that the card member cannot claim under the terms and conditions of the policy from TTK. In such cases the card member is advised to file his claim for reimbursement and TTK will process the claim as per the policy terms and conditions.
In case the insured person gets admitted to a
non-network hospital, then the hospitalization bills will be reimbursed by
TTK as per policy terms and conditions.
For all Mediclaim policy claims,
TTK Healthcare TPA Pvt.Ltd.,
should be contacted.
(Toll Free : 1800-425-7575 or 1800-425-8885 or cell phone users may contact
98452 48885)