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  Standard Guide Book
WELCOME TO PARAMOUNT HEALTH SERVICES – YOUR LINK TO GOOD HEALTH
 
        Dear Insured,
 
        Paramount welcomes you and your family to a brand new experience in Insurance healthcare services.
 
        PHS in alliance with your insurance company would initiate a vibrant new dimension to health insurance servicing in
 India.
 
        Paramount Health Services (PHS) a premier Third Party Administrator ( TPA ) is happy to manage your health care policy
 and will be your LINK TO GOOD HEALTH .
        PHS is a TPA, licensed by The Insurance Regulatory and Development Authority of India (IRDA). PHS is a German joint
venture, established in the year 2001 by a group of Indian professionals and a German MNC with several years of experience in health care management.
        PHS has strived over the years to provide hassle free service with the assurance and security that you need in times of
 difficulty. We wish you a HAPPY HEALTH, should you require any further assistance do write to us at: contact.phs@paramounttpa.com
        Wishing you the best
 
        Paramount Health Services
IMPORTANT INSTRUCTIONS
1.  When you first receive your card, check the information carefully. If there are any errors write to us at:
contact.phs@paramounttpa.com, or contact us immediately.
2.  Please quote your PHS Identity Card Number in all your correspondence and Claims forwarded to us.
3.  Identity Card along with Authorization letter issued by PHS will allow you access in network hospitals for cashless
treatment as per the terms and conditions of your Insurance Policy. Always contact PHS 24 x 7 helpline to assist you prior to arranging any healthcare services.
4.  PHS shall not be responsible for availability, quality and clinical outcome of the treatment, selection of network
or non network hospital is a prerogative of the Insured.
5.  In case of loss of PHS I.D. Card, duplicate will be issued at an additional charge of Rs. 50/- per card.
SCOPE OF SERVICES
1.  Issuance of Identity Card for every insured.
2.  Answering queries pertaining to your policy.
3.  Arrangement for cashless access to PHS network hospitals.
4.  Processing and payment for Insured paid claims.
YOUR ID CARD
        It is not a Credit Card but an Identity Card which will identify you as the Insured and will give access to the Network
Hospitals of PHS across INDIA.
        Secure your ID card and carry it with you at all times. Quote your ID Card Number and the Insurance Company name
when you call PHS 24 Hours Toll Free Help Line.
Information about PHS Hospitals Network
        PHS has created a Network of Healthcare Providers consisting of reputed Hospitals, Nursing Homes, and Healthcare ).
Centers across the country wherein cashless hospitalisation can be availed in times of need (subject to terms and conditions of your Policy
        A comprehensive list of the Provider Network has been provided in this booklet. The Provider Network is subject to
addition / deletion, we request you to refer to our website www.phmhealth.com under utilities section - provider network for the latest provider network in your state / city.
        If you still have any queries, contact PHS Helpline. PHS urges you to choose a Network Provider for maximum benefit
and hassle free service.
        Intimation to PHS and obtaining pre authorization for medical treatment is mandatory in Network as well as Non-Network
Hospitals.
How to avail cashless facility
The Four Golden Steps
Step One: Obtain the Medical details of your aliment from treating doctor
        For all hospitalisation, insured has to give prior intimation (before admission) in the prescribed format to PHS 24-hours
helpdesk. In case of any elective hospitalization, intimation should be preferably 48-72 hours before hospitalization. This form can also be downloaded from our website www.phmhealth.com.
Step Two: Call-up and Fax
        CALL US and FAX a request form for cashless admission in the network hospital to PHS along with all necessary medical 
details like investigation reports / tests, which can confirm the diagnosis and enable PHS to verify your coverage eligibility as per the policy terms and conditions.
Step Three: Get the Pre-Authorization
        PHS will issue an Authorization Letter (AL) post verification of your documents. AL is a payment guarantee for cashless
services to be rendered by the network hospital for your medical treatment
        For all hospitalization (Elective or Emergency) it is mandatory for the insured to obtain prior approval from PHS in the 
form of Authorization Letter to enjoy cashless facility.
Step Four: Avail of the Cashless Hospitalization
        Insured are requested to approach the Admission / Reception Counter of the hospital on the day of admission with the
Authorization Letter and your ID Card.(PHS will also arrange to send Authorization Letter to the Hospital.)
When Cashless Access to Hospital can be denied
 
1.  In case of admission to network hospital without prior intimation to PHS helpdesk
2.  In case sufficient information in the prescribed format is not given.
3.  In case of vague symptoms when medical team of PHS is not sure of eligibility under the coverage due to inadequate medical information, pre-authorization for cashless can be denied
 
        The denial of cashless facility does not mean denial of treatment and does not in any way prevent you from seeking
necessary medical attention or hospitalization
However insured’s are requested to take note of:
 
1.  Register/reserve your admission as per the selected hospital's procedure for admission.
2.  Admission at network hospital is subject to availability of bed.
3.  Cashless facility is always subject to your policy terms and conditions.
4.  The policy does not cover the following expenses
  • Telephone/Fax
  • Food and Beverages for relatives
 
  • Toiletries etc.
 
  • And any other charges not covered in you policy
Cost of such services has to be borne by you and paid directly to the Hospital before discharge.
Download Standard Guide Book (English version)
Download Standard Guide Book (Hindi version)
Download Standard Guide Book (Marathi version)
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Download Standard Guide Book (Kannada version)
Download Standard Guide Book (Punjabi version)
Download Standard Guide Book (Bengali version)
Download Standard Guide Book (Tamil version)
Download Standard Guide Book (Telugu version)
 
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