Empanelled Insurance Co. & TPA's


We have a tie-up with the leading health insurance companies which help in providing you with cashless and hassle free hospitalization. These companies have been our long time partners and trust us to provide the best of service.


Planned admission

  • Cashless approval has to be taken in advance, i.e. before admission, max 7 days before admission.

Emergency Admission

  • In case of emergency admission if patient requires Intensive Care Unit (ICU) / accident case then patient can get admitted by showing their concern TPA ID card and paying deposit of Rs.10,000/-and then complete the cashless process with 24 hours failing which patient relative need to pay balance deposit amount as per hospital policy. 
  • If the patient is in ward then the patient has to pay the prescribed hospital deposit and then complete the cashless process finalization within 24 hours of admission.
  • In case of emergency / walk in admission, if patient requires Intensive Care Unit (ICU) / ward patient is admitted as self-payee as the relative do not have patient’s TPA information, in such case to avail TPA cashless facility the relative need to provide TPA information within 48 working hours of admission /before discharge / before any surgical procedure is performed whichever is earlier. 
  • In all the cases deposit amount paid at the time of admission / interim will be refunded after deducting Security Deposit amount within 48 working hours from the time of discharge.

Security Deposit

  • A security deposit of Rs.10,000/- (towards deduction if any, at the time of bill settlement by TPA / Insurance Company) is collected from patients / patient relative for availing TPA cashless facility at the time of admission or before discharge. The security deposit is refunded to patient after the payment is received from TPA / Insurance Company and after deduction of short payments if any.
  • In case of HDFC Ergo the Security deposit amount is Rs. 10000/- or 10% of final Authorisation amount (received at the time of patient’s discharge) whichever is more.

Steps to avail TPA cashless facility

  • Pre authorization form has to be filled by the patient / relative (patient details, policy details and next of kin contact details and email address) TPA cashless forms are available at our TPA desk.
  • Admitting doctor / dedicate RMO / admitting doctor’s RMO / TPA doctor need to fill up medical history, medical complaint and patient’s line of treatment to be given. The hospital TPA staff will facilitate the patient /relative for the TPA cashless process.
  • The patient / relative must give a proper and true medical history and details to the doctor while filling the pre authorization form if the claim is denied due to inconsistent information in pre authorization and history or treatment papers, the patient has to settle the hospital bill.
  • Hospital TPA staffs need to fill class of admission& give estimate as per line of treatment mentioned by doctor.

List of documents to be submitted along with pre authorization form

  • Insurance / TPA ID card or Policy copy.
  • PAN card & Aadhar Card of the patient and Proposer.
  • PPN Network – Declaration by Patient / Patient’s attendant (This form has to be filled by the patients who have policy of PSU’s New India Assurance, National Insurance and United India Insurance).
  • KYC Form (This form has to be filled by the patient and proposer. It is required by some private insurance company as mentioned in the table).
  • Passport size photo of the patient and Proposer.
  • Positive Investigation reports.
  • Treating Doctor’s consulting paper.
  • Discharge card of previous hospitalization (Chemotherapy, PTCA, CABG, D J Stent Removal procedure & Transfer from other hospital).
  • If MLC case (MLC / FIR copy).
  • In case of surgery, grade of surgery and approximate estimate of OT Materials & OT Pharmacy to be provided by the admitting doctor.
  • Consent Form to Avail Cashless Facility form (This form has to be filled by the patient / relative).
  • NEFT / RTGS Refund Form (The bank detail of the patient / patient relative is to be provided with cancelled cheque,  this can be provided before the discharge of patient).

After the patient / relative has submitted cashless pre-authorization form along with the required documents, need to be scanned and uploaded on the portal (Remedi Net) and sent to the concern TPA. An auto SMS goes to patient relative mobile (on the number which is provided at the time of filling the cashless pre authorization) this SMS goes from Remedi Net portal.

The concern TPA response after sending cashless pre-authorization form can be as below:

  • Authorization Letter (AL)
  • Query Letter
  • Additional document requirement
  • Denial Letter

The AL will have the authorized amount.

  • Once the AL received, hospital TPA staff need to check patient’s details, date of admission, class of admission, AL amount, and any special remarks for example co-payment, etc.

Query Letter has to be replied to get the AL processed

  • In case query related to patient, the hospital TPA staff need to inform patient relative.
  • Incase medical query the hospital TPA staff need to inform RMO/ patient relative.
  • Incase query related to hospital the hospital TPA staff need to be replied the same.

Additional document requirement if any has to be provided to get the AL processed

  • The hospital TPA staff may need to collect additional document from patient relative / nursing counter / concern department and sent it to concern TPA.

Denial Letter means denied cashless facility

  • The hospital TPA staff need to inform the patient relative that their TPA has rejected the cashless and they need to do payment.

At the time of admission

  • Based on the AL the patient is admitted as per their entitled class mentioned in their AL. 

During the hospitalization following documents need to be sent by hospital TPA staff to the concern TPA

  • History sheet (Initial assessment sheet).
  • Progress notes.
  • Treatment sheet.
  • If surgery done than the OT/ Cath lab / Endoscopy notes.
  • Case summary as and when requested by concern TPAs.
  • If the bill exceeds the AL then billing statement need to be sent for additional cashless enhancement.
  • Letter from primary doctor incase change in line of treatment.

Payment follow up during hospitalisation

  • If the bill amount exceeds more than Rs. 1.0 lac of initial authorization then the hospital TPA staff need to send the billing statement to the concern TPA with current treatment detail for additional cashless enhancement and inform the patient relative to do follow up with their TPA for additional AL. If the AL not received within 24 hours, inform the patient relative that they need to do additional payment (same will be refunded at the time of discharge as per hospital refund policy).
  • If the AL limit is exhausted then the patient relative need to do payment as and when asked by the hospital

Queries raised by TPA during hospitalisation

  • If TPA needs any clarification / documents from hospital, in such case the hospital TPA staff need to contact the concern department / primary doctor to reply the query / provide the document.
  • If query is related to patient, in such cases the hospital TPA staff informs patient relative in order to address the TPA query.

TPA cashless discharge process

  • Discharge Timing: 10:00 am, discharge requisition should be prepared by the ward /ICUs on or before 10:00 am and discharge paper should come to billing department on or before 10:30 am.
  • If the discharge request is prepared after 10:00 by the ward / IUCs in such case accommodation charges for the day of discharge will be applicable.
  • Once the final bill is ready the hospital TPA staff send the same along with discharge card, pharmacy & material break-up to the concern TPA.
  • Once the bill is sent to the concern TPA, patient relative need to do follow up with their TPA for final cashless approval.
  • If any query is raised then the hospital TPA staff need to reply the query in order to get the AL.
  • If AL amount is lesser than patient bill amount than the difference amount need to be paid by the patient relative.
  • For discharges before 10:00 am once the bill is sent for final cashless approval – The accommodation charges is applicable, if their TPA takes more than 3 hours to send final cashless AL.
  • On an average, time taken for getting cashless approval from TPA / Insurance Company on all working days is 3 hours and 4 – 6 hours on Sundays / Public Holidays & after TPAs working hours.
  • If any patient / patient relative do not want to wait for final AL from their concern TPA and want to leave the hospital, in such case the patient relative need pay the difference amount (bill amount & initial AL amount). 
  • Once the final AL is received from the TPA the excess amount paid by patient relative will be refunded to them within 48 working hours.
  • If due to any reason if initial AL amount is reduce / rejected, in such case the hospital TPA staff will intimate the patient / relative and they have to settle their due within 48 working hour from the time they are informed.
  • The right to approve or deny the claim remains with your TPA Company. Any disputes about claim will need to be addressed to your TPA Company/ insurance agent. The hospital is not liable for any denials.
  • However you are requested to note that this is a value added service, and the final responsibility to obtain the authorization for cashless service, will rest with the customer. The role of the hospital TPA desk will be purely to assist the customer in the authorization process.


  • Patient’s settlement type can be changed from self-payee to TPA / from One TPA to other TPA within 48hours of the patient admission time.
  • In case of any surgical / cathlab / endoscopy procedure done need the operating / primary doctor’s approval.


  • The TPA staff checks the approval letter’s terms & conditions, i.e. Non-payable / co-payment / pay class differences amount (if any) and accordingly updates in the LHMS / IPB software.
  • The discharge counter staff need to check the TPA staffs instructions (which is updated is IPB software) as need to collects the payment from the patient relative.
  • The staff takes patient’s relatives acknowledgement on original set of bill and handovers the duplicate copy of bill.
  • If required collects the balance payment (difference of bill & AL amount, co-payment & non-medical charges) from the patience relative and issue the receipt voucher for the same.
  • The staff also checks that the patient has paid Security deposit, if not than collect the same.


On working days                      :  8:00 AM TO 8:00 PM

On Sundays / Public holidays    :  8:00 AM TO 3:00 PM

After TPA working hours please contact our IP Billing department


Kindly cooperate & assist us to provide you the hassle free cashless service.

For any further query please contact TPA Desk during TPA desk working hours.

TPA Desk ‐ Mr. Khan – (Contact No‐022 ‐ 69318089)

Email Idtpa@lilavatihospital.com

Billing Department: 022‐69318000- extn. 1560



List of Insurance companies and TPA's

  • Aditya Birla Capital
  • Bajaj Allianz General Insurance
  • Bharti Assist Global Pvt Ltd
  • digit
  • Ericson TPA Insurance Pvt Ltd
  • Falck India Pvt Ltd
  • Family Health Plan Insurance (TPA) LTD
  • Future Generali India Insurance Company Ltd
  • Good Health Insurance
  • HDFC Ergo
  • Health India Insurance TPA Services Pvt Ltd
  • Health Insurance TPA of India Ltd
  • ICICI Lombard Gen Insurance Co Ltd.
  • Kotak Mahindra General Insurance
  • Liberty general Insurance
  • Magma HDI General Insurance Company Ltd
  • Medi Assist India Private Limited
  • Niva Bupa Health Insurance
  • Paramount Healthcare Services (TPA) Pvt Limited)
  • Raksha Health Insurance TPA Pvt. Ltd.
  • Reliance General Insurance Co Ltd.
  • Safeway Insurance TPA Pvt Ltd
  • SBI general Insurance
  • United Healthcare (Parekh) India Private Limited
  • Vidal Health Insurance TPA Pvt Ltd
  • Vipul Medcorp TPA Pvt Ltd
  • Volo By your side