Cashless Facility

  • A. Cashless facility is offered by the Hospital to the Insured
  • B. Insurer offers to settle the claims on behalf of its policyholder as per the Policy conditions
  • C. Anyuta TPA in Health Care,
    • a. Issues the Authorization Letter to treat the Policyholder
    • b. Process the claims as per the Insurer`s Policy conditions and guidelines

Procedure for Cashless Facility

  1. The Hospital identifies the Policyholder, verifies the Policy details, Covered period / validity, Covered amount, Amount Claimed and the Balance in the Policy for usage and then sends the Preauthorization request to Anyuta TPA
  2. Anyuta TPA issues the Authorization letter to the Hospital to commence treatment
  3. Hospital treats the patient and sends the Original Claim file with the Discharge Summary containing the Differential Diagnosis / Final Diagnosis / Investigations done / Medications given / Procedures done / Bills of Investigations / Procedures / Medical and Surgical Sundries / Implants, etc., to Anyuta TPA office by hand delivery / post / courier
  4. The Hospital Files the documents in order as listed in Anyuta Check List and sends it to Anyuta TPA Office along with a covering letter listing all documents in the file and the date of submission of the file.
  5. The Hospital takes an acknowledgement from Anyuta TPA for having submitted the file.
  6. Hospital gives an identical File to the Policyholder
  7. Anyuta TPA processes the Claims and settles it directly or sends the process sheet along with the Original Claim File, to the Insurer for Claim Settlement
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