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Paramount Health Services & Insurance TPA Pvt. Ltd.
IRDA License No: 006
Validity : From 21-03-2023 To 20-03-2026
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Comprehensive Claims Management |
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| A step-by-step guide for a successful claim settlement
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| This facility is available only at the network hospitals of PHS. The list of the network hospitals is available on the website. |
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| 1. |
Fill in the Authority Letter form available with the hospital and at our office.The form should be filled in by the treating doctor and sent/faxed to the PHS office. |
| 2. |
After considering the validity of the request, PHS issues an Authority Letter to the hospital to undertake treatment of the insured. |
| 3. |
PHS pays all medical expenses and all non-medical expenses are borne by the insured. |
| 4. |
The cashless facility may be denied in certain cases. The policy holder can then send the claim for reimbursement, which will be considered based on the merits of the policy features. |
| 5. |
Your PHS ID card does not automatically entitle you to cashless treatment as this facility depends on the terms and |
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conditions of the policy in force. The cashless treatment begins only after the hospital receives the Authority Letter from the PHS office. |
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The policy holder should notify the PHS office about the hospitalization with the following details |
| 1. |
PHS ID card no |
| 2. |
Policy no |
| 3. |
Name of hospital |
| 4. |
Name of the attending doctor |
| 5. |
Nature of illness/injury |
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Successful reimbursement of your claim requires you to submit all relevant documents related to your treatment. |
| 1. |
Original discharge card from the hospital |
| 2. |
Original hospital bill with break up and receipt |
| 3. |
Doctor's prescriptions and medical bills |
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Original Investigation reports with Doctor's authorization |
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Surgeon/Consultant's bills in original |
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Other documents connected to hospitalization/treatment.The above documents should be submitted to the PHS office along with a signed claim form.The claim form can be obtained from our office or downloaded from here. |
| 7. |
All medical expenses will be reimbursed as per the policy features. Non-medical expenses will not be reimbursed. |
| 8. |
It is advisable to keep a photocopy of all documents that you have submitted for future reference. |
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