Welcome Your Bundle of Joy with eCashless

pregnancy-792742_640The first eCashless request comes from Kashmir. Sunny and Aditi, a young couple from Kashmir, are looking forward to welcoming their little one into this world. Sunny is a member of the Medi Assist family. Being well-informed about Medi Assist services, he decides to opt for the eCashless service for planning his wife’s hospitalization.

Sunny wants to make this moment special for both of them by staying with her while their child comes into this world. With the eCashless option, he can also request for a preferred hospital room type. So, he logs on to his MediBuddy app, provides the necessary details, selects a preferred room type and sends the request.

Within a few hours of sending a request, Sunny gets a provisional pre-authorization from Medi Assist, which he can track on his MediBuddy app. He also receives a secure passcode. On the day of admission to the hospital, he takes his wife to the hospital, along with a photo-ID and his Medi Assist e-card, and presents the secure passcode at the insurance desk. He instantly receives his pre-authorization approval letter. In a few minutes, as per his previous request, Aditi and Sunny are green-channeled into his preferred type of room.

Sunny is absolutely delighted about the way cashless hospitalization is changing. Be part of this change. In the case of a need for planned hospitalization, think eCashless and nothing else.

3 Easy Steps to Access Your New MediBuddy Agent Portal

Healthcare - Folder Name in Directory.If you are an insurance agent, you may have already experienced our MediBuddy Agent portal. Let us make the experience more refreshing for you. Medi Assist welcomes you to the transforming world of MediBuddy with exciting new features. The new portal has features that are aimed at helping you, the insurance agent, take control of your customers’ health benefits and empower you with all the information you need to serve them better.

What are the features available to you?

The following are some of the features available to you:
– You can now create your own preferred login to access your MediBuddy’s features.
– You can gain visibility into your customers and their policies. Now, you can also know when your customers’ policies are due for renewal.
– You can get real-time status of your customers’ claims.
– You can instantly download e-cards for any of your customers anytime from anywhere.
– You can use our map-based search to locate a preferred network hospital in your vicinity or filter network hospitals by insurers.

In order to access these new features, you must first activate your account in the new portal.

How do you activate your account?

Activating your account is simple and secure. You need to just follow three simple steps:

1. Identify yourself

You need to identify yourself using your Agent ID & policy details of two of your customers. The policy details that are to be provided include their policy numbers and the policy holders’ name.

2. Update your contact details

Enter your contact details in the given fields. Make sure that you have entered your correct email ID and mobile number to which a secure one-time password (OTP), which is mandatory to confirm your login, will be sent.

3. Choose your preferred login

You can now select your own username and password to create your preferred login. Use the OTP you have received to confirm your profile.

You are now ready to use the portal. Click Login on the top of the page and use the credentials you have used for logging into your account. You can see all the policies for all your customers, download e-cards for them, see when their policies are due for renewal, and do much more.

So, what are you waiting for? Get started today!

Cashless Hospitalization – What You Should Know

Cashless hospitalization is a facility provided by the insurance company where the policy holder can get admitted and undergo necessary treatment without paying the hospital directly for the medical expenses. The eligible medical expenditure which is incurred is settled by the insurance company directly with the hospital. You can avail cashless hospitalization only in the hospitals that are part of your TPA’s network.

At Medi Assist, you can avail cashless and eCashless hospitalization at our network of hospitals. Following is a step-by-step procedure of availing the facility from Medi Assist.

1. Intimate us about your hospitalization at least 72 hours before hospitalization:
• MediBuddy: Intimate Cashless tile (or)
• SMS: CLAIM INT to +91 96641 72929 (or)
• Email: claimintimation@mediassistindia.com (or)
• Toll-free number: 1800 425 9449

2. Present your Medi Assist E-Card at the hospital during admission along with any other legally accepted identity card.

Note: You can log into your Medi Assist online portal and click Generate E-Card to instantly generate and print out an E-Card for any beneficiary.

3. Ensure that the hospital sends your pre-authorization form to Medi Assist:
• MediBuddy+ hospital portal: Log the request online (or)
• Email: cashless@mediassistindia.com (or)

4. Track your claim in real-time:
• Click the Claims tile on MediBuddy (or)
• Log into www.medibuddy.in and click the ‘Claims’ tab (or)
• Visit track.medibuddy.in to search claims by Claim ID, MA ID or Employee ID
• SMS “Claims (Claim Number)” to +91 96631 49992

5. Medi Assist sends the approval to the hospital. Further enhancement approvals may be issued on request, subject to terms and conditions of the policy.

6. In case, the request cannot be approved or if the expenses are not covered by your policy, you will have to settle the hospital bill in full and subsequently raise a reimbursement claim after discharge.

Note: Denial of a pre-authorization request must not be construed as denial of treatment or denial of coverage.

7. After discharge, the hospital will send all the documents related to your claim to Medi Assist for settlement.

Do Note:

• The hospital will ask you to pay for all the non-medical expenses in your bill.
• You will have to pay for all pre- and post-hospitalization expenses. These can be claimed only after the settlement of the main hospitalization claim.
• At the time of discharge, check and sign the original bills and the discharge summary. Do carry home a copy of the signed bill, discharge summary and all your investigation reports for future reference.

eCashless

You can now opt for cashless hospitalization using Medi Assist’s eCashless facility. With typical cashless hospitalization, the pre-authorization process takes time and this can be stressful especially on the day of your admission to the hospital as you have to wait for long hours at the insurance desk at the hospital. With eCashless, you can obtain a provisional pre-authorization well in advance of your hospitalization. All you need to do is carry your ID card, provisional pre-authorization on your MediBuddy app and your Medi Assist E-Card while getting admitted to the hospital.

To know more about how you can opt for eCashless, click here.

Note: In case of suppression of material facts or misrepresentation of facts by the hospital or the insured, the pre authorization issued for the cashless facility will stand cancelled. The insured will be liable to settle the hospital bill in full.

Claims Processing and Settlement: What You Should Know

Whether you have opted for cashless hospitalization or reimbursements, you are bound to make a claim if you are covered by a health insurance policy in case of hospitalization. With Medi Assist, your claim processing and settlement becomes simpler. Here is what you should know about getting your claims settled by us.

Technology at your disposal

Cashless or reimbursement; planned or emergency hospitalization; treatment at a network hospital or non-network hospital – as a holder of a Medi Assist card, you are eligible for hassle-free claims settlement. What more, we leverage technology at every step to help you raise requests easily, track claims in real-time, obtain approvals faster and receive reimbursements quicker:

Medi Assist Online Portal: The Medi Assist online portal allows you to add / modify beneficiaries to your policy, generate your e-card, raise reimbursement requests online, and also scan and upload your medical records to maintain your electronic health repository.
MediBuddy Mobile App: The MediBuddy mobile app allows you to send claims intimation, view policy details, browse network hospitals in the vicinity and importantly, track the status of your claims in real-time using your smartphone. All the functionality of the app is also available on our mobile-friendly portal, www.medibuddy.in.
MediBuddy+ Hospital Portal: This portal allows hospitals to raise and track cashless claims online. By eliminating disparate channels of communication and by moving all interactions onto an online portal, we help you obtain pre-authorization approvals faster.

Cashless Hospitalization

Following are the steps to make a claim for cashless hospitalization.

1. Intimate us about your hospitalization at least 72 hours before hospitalization.
2. Present your Medi Assist E-Card at the hospital during admission along with any other legally accepted identity card.
3. Ensure that the hospital sends your pre-authorization form to Medi Assist.
4. Track your claim in real time.
5. Medi Assist sends the approval to the hospital. Further enhancement approvals may be issued on request, subject to terms and conditions of the policy.
6. In case, the request cannot be approved or if the expenses are not covered by your policy, you will have to settle the hospital bill in full and subsequently raise a reimbursement claim after discharge.
7. After discharge, the hospital will send all the documents related to your claim to Medi Assist for settlement.

To understand in detail the cashless and Medi Assist’s eCashless process, click here.

Reimbursement

You can claim a reimbursement after discharge. Following are the steps to claim reimbursement.

1. Intimate us about your impending claim.
2. Present your Medi Assist e-card at the hospital during admission along with any other legally accepted identity card.
3. Submit your reimbursement claim online within 7 days from the date of discharge.
4. Send the original documents to Medi Assist Insurance TPA Private Limited within 30 days from the date of discharge from the hospital. You can either request your HR team to forward your documents on your behalf, or submit them at the Medi Assist Onsite Kiosk if applicable or courier them to the Medi Assist branch servicing your account. Visit our website, www.mediassistindia.com, for branch addresses.
5. Track your claim in real-time.
6. The medical team at Medi Assist processes the claim.

Following are the documents that you should submit while claiming a reimbursement:

• Original hospital final bill
• Original numbered receipts for payments made to the hospital
• Complete breakup of the hospital bill
• Original discharge summary
• All original investigation reports along with prescriptions
• All original medicine bills with relevant prescriptions
• Original signed claim form
• Copy of the Medi Assist ID card or current policy copy and previous years’ policy copies (if any)
• Covering letter stating your complete address, contact numbers, and email address (if available).

To know more about reimbursement claims, click here

Hospitalization, Claims and Expenses: Things You Should Know

As humans, we are bound to fall sick and get treated. We may even get hospitalized at some point of time. As a person who may be covered under a health insurance policy and opting for hospitalization, these are some basic things you should know about hospitalization, claims, and expenses.

Read on to know some of the basics of hospitalization.

Hospitalization

Hospitalization can be of two types:

  • Planned hospitalization
  • Emergency hospitalization.

Planned hospitalization happens when you have ample time to plan your admission to the hospital. For example, if your doctor advises a surgery for hernia anytime within a couple of weeks, you have time to plan your hospitalization. Emergency hospitalization happens typically in case of emergencies such as domestic accident or a road accident. One cannot plan such a hospitalization.

Benefits of planned hospitalizations

If you are aware of the fact that you or your family members require hospitalization in the near future, you can send prior intimation to Medi Assist to plan your hospitalization. Not only does this ease the admission and pre-authorization process, but it also helps reduce your overall cost of treatment wherever possible.

Once Medi Assist receives the intimation, we will help you plan everything including choosing a network hospital, opting for discounted packages, if available, and planning for cashless hospitalization. Here are the advantages of a planned hospitalization:

• You get a green-channel hospitalization which means that the hospital is aware of your impending admission and your wait time on the date of admission is significantly lesser.
• The Medi Assist executive helps you compare tariffs and facilities at various network hospitals so you can make an informed choice.
• You have the benefit of opting for discounted packages, negotiated by Medi Assist exclusively for our members, along with the benefit of cashless admission, wherever applicable.
• Even if your policy places a cap on your hospitalization expenses you can reduce your out-of-pocket expenses by choosing the discounted price available to you as a Medi Assist member.

Hospitalization expenses

Expenses associated with hospitalization can be classified as follows:

Pre-hospitalization expenses: When you’re unwell, you will most likely consult a physician first, who gets relevant investigations done before advising hospitalization. Such medical expenses incurred before hospitalization are called pre-hospitalization expenses.
Hospitalization expenses: All expenses incurred as part of your hospital stay as an in-patient can be termed as hospitalization expenses.
Post-hospitalization expenses: Some part of your treatment may extend beyond your hospitalization. It may involve follow-up visits to the doctor, prescription medication, further investigations, etc. Such medical expenses are called post-hospitalization expenses.
Domiciliary hospitalization expenses: This typically includes expenses related to domiciliary hospitalization – at-home medical treatment for more than three days for cases which in the normal course would require hospitalization. The exact circumstances / terms / exclusions related to domiciliary hospitalization would be spelled out in your policy document.

Apart from hospitalization expenses, your health insurance policy may also cover pre- and post-hospitalization expenses, and offer a cap for domiciliary expenses.

Claims

Depending on the situation and your policy coverage, you can make two types of health insurance claims:

Cashless: The essence of cashless hospitalization is that the insured need not make an upfront payment to the hospital at the time of admission. You may not have any out-of-pocket expenses towards hospitalization in this scenario. Cashless hospitalization can be availed only at a Medi Assist network hospital and upon approval of your pre-authorization application.
Reimbursement: A reimbursement claim is one where you pay all the expenses related to the hospitalization of the insured and claim a reimbursement of your expenses after discharge. Reimbursement claims may be filed in the following circumstances:
– Hospitalization at a non-network hospital
– Post-hospitalization and pre-hospitalization expenses
– Denial of pre-authorization for cashless facility at a network hospital.

Visit our website, www.mediassistindia.com, for the updated list of network hospitals.

Your Third Party Administrator: What You Should Know

If you are covered by a health insurance policy, you will be allocated a third party administrator or TPA by your insurance company. However, most people are unaware of who a TPA is or what a TPA does. Here is what you should know about the third party administrator.

• If you are reading this, this means that you have probably been assigned Medi Assist as your TPA for health insurance benefits managed by your organization. As a member of Medi Assist family, you are eligible for hassle-free health care insurance claims administration.

• What this really means for you is that, if you or any of your family members is covered under the insurance policy, we handle all the paperwork related to your claims. Wherever possible, we give you the benefit of cashless hospitalization; and we ensure that your claim is settled at the earliest.

• As a member of Medi Assist, you are not only entitled to hassle-free claims, but also several other health benefits.

• However, you should understand that TPAs are not the same as insurance companies.

What a third party administrator (TPA) does

A TPA is appointed by your insurance company to process your claims. This means that whenever you raise a claim for hospitalization for yourself or any of your family members covered under the policy, a TPA processes these claims.

What a TPA does not do

• Decide who is covered and what ailments/procedures are covered under your policy. Your insurance plan dictates these.

• Control your policy terms and conditions. Your insurance policy is developed by your insurance company.

• Decide admissible/non-admissible expenses. Your insurance policy dictates that.

• Approve/disapprove claim without reason. TPAs process claims strictly based on your policy terms and conditions.

6 Steps to Enjoy Host of Wellness Services

wellness checkHealthcare goes beyond in-patient hospitalization. It includes eating healthy and living a healthy life. An important part of maintaining good health is getting a periodic health check, regular lab tests and scans done. But running around in search of these services may be quite confusing and time-consuming.

How would it be if you could access a world of healthcare and wellness services on your palm? And how would it be if you can obtain them as a personalized package? Now, obtain access to a host of health and wellness services including annual health checks, specialist OPD appointments, lab tests and investigations, and much more through just a click.

Here is how you can obtain these services

1. Go to your MediBuddy app or the MediBuddy online portal

2. Click the ‘Wellness’ tile

3. Select the type of wellness program and package you want

4. Select your preferred network medical center

5. Select your preferred date and time

6. Book your appointment.

It is as easy as that. So, just pick up your phone or laptop and opt for your required health service today.

E-Card: An Efficient Way of Identifying Beneficiaries

ID cardDid you know that carrying a Medi Assist card is mandatory during your hospitalization? A Medi Assist card gives the hospital a confirmation that your insurance company has appointed Medi Assist as your TPA. However, carrying a physical card is often a challenge. A physical card gives confirmation of only one beneficiary in the family who is covered by Medi Assist. There is no guarantee that the beneficiary will carry a copy of the card while getting admitted to the hospital. Another challenge is that the card can either get lost or deteriorate due to wear and tear. Moreover, why do you want to carry around a physical card when you can carry an E-Card?

The Medi Assist E-Card helps you in carrying the details of all the beneficiaries of the insurance policy on your phone, instead of carrying individual physical cards. All you need to do is to flash the E-Card on your MediBuddy app upon request at the insurance desk in the hospital at the time of admission.

How can you do this?

Obtaining a Medi Assist E-Card is very simple. You can do it in two ways.

1. Logon to ecard.medibuddy.in and click ‘Download E-Card’.

2. Enter your Medi Assist ID/Employee ID/policy number or your claim ID.

3. Fill the other mandatory fields and click ‘View’ to verify and confirm your details.

4. You can now download the E-Card.

5. Alternately, go to your MediBuddy app. Click the ‘E-Card’ tile and enter your details. You can now view the E-Card on your app.

So, switch to a more efficient way. Download your E-Card today.