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Guidelines for patients under Insurance Coverage

Contact Information:

Email: insurance@mmm.org.in
Phone: 044-26568225/26568235/26568245

Planned Admission:

· As per Insurance / TPA – Planned Admission document can be submitted before 7 days.
· We will accept all below document before 5 days.

Admission:

· Patients are requested to approach the Insurance desk
· Provide the following documents as per the Insurance / TPA

Identification proofs:

Private/Corporate Insurance - Mandatory documents:

· Insurance card /E card, Employee ID Card
· Patient ID Proof (Pan Card/Driving License/Voter ID/Passport)
· Address Proof (Aadhar card/Bills of any Govt schemers-LPG,TNEB Bill, Bank Pass Book)

TN Government Employee Scheme (Through MD India & Mediassist TPA):

· Insurance card /E card, Employee ID Card
       o If insurance card is not available -Annexure –VII for serving employees & Annexure –IV & Option form for pensioners
· Patient ID Proof (Pan Card/Driving License/Voter ID/Passport)
· Address Proof (Aadhar card/Bills of any Govt schemers-LPG,TNEB Bill, Bank Pass book)

Medical Proofs:

Planned Admission:

· Treating doctors OPD Report-For Planned admissions or Certificate mentioning the plan for treatment
· Investigation reports supporting the diagnosis like ECG, ECHO, Doppler, USG, other scan reports etc.
· Surgery/PTCA-CAG report, Images, Discharge summary from other hospital.
· Estimation for treatment.

Emergency:

· Hospital will take responsible to collect all report from Emergency / CCU/ICU.

Process followed in MMM Insurance desk:

On Admission

· On receiving Identification proofs and Medical Proofs the insurance desk will apply for preauthorization.
· The patient should be aware that the room rent eligibility per day, if the patients opt for higher room category; he needs to pay proportionate deductions made by the insurance company on the total bill.
· Insurance Rule – 1% of sum Insured For Eg. If sum insured is 2 Lakhs, then patient is eligible to opt for Rs.2000/- per day as room rent.
· Patient should be ready to pay the difference in the estimated amount and the Insurance/TPA approval at the time of admission to carry out the surgery/procedure in the hospital.
· Minimum time to receive the preauthorization from Insurance Company will be between 2 to 4 hours.

On Discharge

· Medical documents from Nurses station & Final Bill from Billing counter is mandatory to apply final enhancement with insurance /TPA
· Insurance desk will apply for enhancement. If the advance amount is found to be not sufficient after adjusting insurance coverage it is mandatory to keep a minimum deposit with the hospital towards caution deposit.
· Patients are requested to approach the billing counter and settle the bill.
· Settlement of refund is subject to the actual realization of the mentioned amount by the insurance Company/TPA.
· Minimum time to receive the enhancement from insurance Company will be between 4 to 6 hours on office timings i.e. between 9 to 6 hours.

INSURANCE AND TPA TIEUPS

INSURANCE COMPANIES (BOTH CORPORATE AND INDIVIDUAL POLICY HOLDERS)

  1. 1.STAR HEALTH AND ALLIED INSURANCE COMPANY LTD
  2. 2.BAJAJ ALLIANZ GENERAL INSURANCE COMPANY LTD
  3. 3.FUTURE GENERALI INDIA INSURANCE COMPANY LTD
  4. 4.CHOLAMANDALAM MS GENERAL INSURANCE COMPANY LTD
  5. 5.MAX BUPA HEALTH INSURANCE COMPANY LTD
  6. 6.IFFCO – TOKIO GENERAL INSURANCE COMPANY LTD
  7. 7.RELIANCE GENERAL INSURANCE COMPANY LTD
  8. 8.UNIVERSAL SOMPO GENERAL INSURANCE COMPANY LTD
  9. 9.ADITYA BIRLA HEALTH INSURANCE COMPANY LTD
  10. 10.RELIGARE HEALTH INSURANCE COMPANY LTD
  11. 11.RELIANCE HEALTH INSURANCE LTD
  12. 12.LIBERTY GENERAL INSURANCE LTD
  13. 13.MAGMA HDI GENERAL INSURANCE CO LTD
  14. 14.NAVI GENERAL INSURANCE LTD
  15. 15.SBI GENERAL INSURANCE COMPANY LIMITED LTD

TPA’s (ONLY CORPORATE POLICY HOLDERS)

  1. 1.HERITAGE HEALTH INSURANCE TPA PVT LTD
  2. 2.MD INDIA HEALTH INSURANCES TPA PVT LTD
  3. 3.MEDSAVE HEALTH INSURANCE TPA LTD
  4. 4.PARAMOUNT HEALTH SERVICES & INSURANCE TPA PVT LTD
  5. 5.GENINS INDIAINSURANCE TPA LTD
  6. 6.ALANKIT INSURANCE TPA LTD
  7. 7.RAKSHA HEALTH INSURANCE TPA PVT LTD
  8. 8.GOOD HEALTH INSURANCE TPA LTD
  9. 9.MEDI ASSIST INSURANCE TPA PVT LTD
  10. 10.FAMILY HEALTH PLAN INSURANCE TPA LTD
  11. 11.DEDICATED HEALTHCARE SERVICES TPA (INDIA) PVT LTD
  12. 12.UNITEDHEALTHCARE PAREKH INSURANCE TPA PVT LTD
  13. 13.VIPUL MEDCORP INSURANCE TPA PVT LTD
  14. 14.VIDAL HEALTH INSURANCE TPA PVT LTD
  15. 15.HEALTH INDIA INSURANCE TPA SERVICES PVT LTD
  16. 16.HEALTH INSURANCE TPA OF INDIA LTD
  17. 17.ERICSON INSURANCE TPA PVT LTD
  18. 18.UTI ASSET MANAGEMENT - Senior Citizen Units Plan
  19. 19.EAST WEST ASSIST INSURANCE TPA PRIVATE LIMITED

LIST OF EMPANELLED ORGANIZATIONS

  1. 1.BHARAT PETROLEUM CORPORATION LTD (BPCL)
  2. 2.LARSEN & TOUBRO LTD (CONSTRUCTION DIVISION)
  3. 3.LUCAS TVS LTD
  4. 4.OIL & NATURAL GAS CORPORATION LTD (ONGC)
  5. 5.NEYVELI LIGNITE CORPORATION LTD (NLC)
  6. 6.MRF
  7. 7.INDIAN OIL CORPORATION LTD (IOCL)
  8. 8.METALS & MINERALS TRADING CORPORATION (MMTC)
  9. 9.CHENNAI PETROLEUM CORPORATION LTD (CPCL)
  10. 10.TUBE PRODUCTS OF INDIA
  11. 11.MAHINDRA AND MAHINDRA
  12. 12.STATE BANK OF INDIA.
  13. 13.NATIONAL BANK FOR AGRICULTURE AND RURAL DEVELOPMENT (NABARD)
  14. 14.RESERVE BANK OF INDIA (RBI)
  15. 15.THE RAMCO CEMENTS LTD
  16. 16.RITES LTD

HEALTH INSURANCE SCHEME

  • 1.TAMIL NADU CHIEF MINISTER’S COMPREHENSIVE HEALTH INSURANCE SCHEME - *For Cardiology & Cardiothoracic Surgeries only
  • 2.TAMIL NADU NEW HEALTH INSURANCE SCHEME (TNNHIS) Employees & Pensioners Scheme & Co-Operative Society Employees) - * For Cardiology & Cardiothoracic Surgeries only