dsiidc.org Insurance Backed Cashless Medical Scheme Renewal 2014-15 : Delhi State Industrial & Infrastructure Development Corporation Ltd
Name of the Organization : Delhi State Industrial & Infrastructure Development Corporation Ltd
Name of the Scheme : Insurance Backed Cashless Medical Scheme Renewal 2014-15
Location: Delhi
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Official Website : http://dsiidc.org/
Insurance Backed Cashless Medical Scheme Renewal 2014-15:
Reference is invited to this Division’s circular of even no dated 18.07.14 regarding renewal of Insurance Backed Cashless Medical scheme of the Corporation effective from 18.07.2014 to 17.07.2015. It is retreated that the scheme will now be operated thro M/s. United India Insurance Company ltd., with M/s. Paramount Health Services Pvt. Ltd.(PHS) being the TPA,
All the employees may refer to the below listed details/procedures to make themselves conversant with the services available with the service provider and process for the settlement of their claims.
Please browse through various sections in the Home page of M/s. Paramount Health Services Pvt. Ltd. (TPA) for downloading e–cards, list of Hospitals/ Nursing Homes for indoor treatment, forms for reimbursement/ claim settlement list of services available
For Pre- Authorization/ Cashless Hospitalization:
In case of planned hospitalisation i.e. for pre authorisation it is essential that the Insured employee intimates the TPA about planned hospitalization in an admission request form 48 hours prior to hospitalization.
In case the hospital is in the panel with the TPA, the claim is registered by the TPA and the TPA thereafter intimates the hospital/Insured employee within 3 hours of registration & issues an authorization letter for planned hospitalization to the hospital
Steps to access the Pre Authorization Form:
1. Go to : www.paramounttpa.com
2. Select : Download Forms
3. Download and print Paramount Health Cashless Request form
In case of normal hospitalization, to the hospital in the panel of the TPA, the Insured employee will intimate the Hospital Helpdesk within 24 hrs of Hospitalization providing details of the Paramount Medical ID Card to avail himself of the cashless facility. The concerned hospital will be under obligation to accept the request of the employee
Non-Empanelled/ Non-Network hospitalization Procedure:
If treatment is taken by an Insured employee at a Non-Empanelled hospital, the Insured employee will intimate the TPA/ Insurance Company about the factum of hospitalization within 24 hrs of such hospitalization. He may apply to the TPA for reimbursement in the prescribed format
Steps to access the Reimbursement:
1. Go to : www.paramounttpa.com
2. Select : Download Forms
3. Download and print Mediclaim Insurance Policy Claim Form
Insured employee shall ensure submission of hospitalization claim within 30 days from the date of discharge from the hospital, with complete documents, as detailed below:
** Self Signed Claim Form of Insurance Co.
** Original Final Hospital Bill along with Payment Receipt.
** Original Discharge Summary / Card.
** All Original Investigation Reports.
** Original Bills & Receipts for investigations done outside hospital. Doctors Prescription.
** Original Bills of medicines and surgical appliances if purchased by you.
** Investigation reports in original with the prescriptions prior to hospitalization
** Cancelled cheque for electronic transfer of reimbursed amount
For any further information with regard to claim the following employees of M/s. Paramount Health Services may be contacted
Bhagat Singh 09310143739
bhagat.singh@paramounttpa.com
Rajeev Kumar – 09311136513
rajeev.kumar@paramounttpa.com
Toll free number – 1800226655
Cashless queries – 011-41637594/95/96
Address:
D-39, Okhla Phase -1, New Delhi
Download Notification : https://www.indianjobtalks.in/uploads/42307-17102014circular-insurancebakedmedical.pdf