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#9C, IV Avenue, Shanthi Colony, Anna Nagar, Chennai – 600 040

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Sundaram Medical Foundation - List of Empanelled Insurance Companies

SMF Insurance Department staff will assist you and guide you in the process of obtaining the cashless facility from the TPA / Insurance company. However it is patient's or attender's responsibility for obtaining the approvals.SMF Insurance Department staff will assist you and guide you in the process of obtaining the cashless facility.

Private Insurance company ( Individual and Corporate card Holders)

# Insurance Company
1 APOLLO MUNICH HEALTH INSURANCE CO. LTD.,
2 BAJAJ ALLIANZ GENERAL INSURANCE CO. LTD.,
3 HDFC ERGO GENERAL INSURANCE COMPANY LTD.,
4 ICICI LOMBARD GENERAL INSURANCE CO. LTD.,
5 ROYAL SUNDARAM ALLIANCE INSURANCE COMPANY LTD.,
6 PARAMOUNT HEALTH SERVICES AND INSURANCE TPA PVT. LTD.,
7 RELIANCE GENERAL INSURANCE COMPANY LTD.,
8 STAR HEALTH AND ALLIED INSURANCE CO. LTD.,
9 ADITYA BRILA HEALTH INSURANCE CO. LTD.,
10 KOTAK MAHINDRA GENERAL INSURANCE CO.,

Third Party Administator's ( Only for Corporate card Holder's)

# List of TPA's
1 FAMILY HEALTH PLAN INSURANCE TPA PVT Ltd.,
2 GOOD HEALTH PLAN INSURANCE TPA SERVICES PVT. LTD.,
3 HERITAGE HEALTH INSURANCE TPA PVT. LTD.,
4 MDINDIA HEALTH INSURANCE TPA PVT.LTD.,
5 MEDI ASSIST INDIA INSURANCE TPA PVT. LTD.,
6 RAKSHA INSURANCE TPA PVT. LTD.,
7 VIDAL HEALTHCARE INSURANCE TPA PVT. LTD.,
8 VIPUL MEDCORP INSURANCE TPA PVT. LTD.,

Note : Please submit Patient - Insurance ID, Aadhar, PAN card & previous Relevant Investigation Reports and Insurer Employee ID (In case of Corporate Policy)

SMF reserves the right to deny the Cashless Facility to any of the Card Holders of the above mentioned TPA's.

FAQ

Hospitalization Benefit for TPA Patients

Patients can avail the benefit of Cashless hospitalization at Sundaram Medical Foundation if the patient TPA is covered by our hospital.

1) How to identify my TPA?

  • The Insurance Company will issue you an identity card which will indicate the name of your TPA.
  • Can check with your Insurance agent.

2) Where to get TPA Pre Authorization Forms ?

The Pre authorization forms of TPA tied up with the hospital can be collected from our Insurance Department located in our Main Hospital.

3) What are all the processes for Admission ?

  • For all Elective / Planned Admissions, Cashless approval should be obtained from the TPA atleast 3-4 working days prior to the date of admission.
  • The patient must give a proper and true medical history to the doctor at the time of filling in the pre authorization form, since any discrepancy may result in the denial of the claim and cancellation of the approval.
  • SMF Insurance Department will assist you in faxing the duly filled pre authorization form of the TPA. (along with the latest policy copy and investigation reports)
  • Incase your eligibility regarding the room tariff or bed type specified in the authorization letter is not available, the patient will be admitted in the higher or lower class room as per choice of patient. In case of higher class admission, patient will have to pay the difference in the bed charges from the date of admission till they gets transferred to the specified room or discharge.

4) What is the process during hospitalization ?

  • If the claim is denied for any reason by the insurance company during hospitalization, patient will be responsible for payment of total bills.
  • If the patient bill exceeds the sanctioned amount, an estimate for the additional amount will be sent to the TPA by our Insurance Staff. However it is the responsibility of the patient / attenders to keep track of the bills.
  • If the exceeded amount has not been sanctioned by the TPA, patients have to pay the balance which is above the sanctioned amount.

5) What is the Discharge Process ?

  • The hospital will retain refundable caution deposit until the hospital receives complete payment from the TPA. The patient should contact our Insurance Department regarding the procedure for the refund of deposit.
  • The hospital shall collect payment for all exclusions / non-medical expenses, if it is not covered by your TPA at the time of discharge.
  • No original investigations reports / discharge summary will be given to patient, since it has to be sent to your TPA along with your bills. Xerox copies of the same can be taken by the attender at their own cost.
  • No original investigations reports / discharge summary will be given to patient, since it has to be sent to your TPA along with your bills. Xerox copies of the same can be taken by the attender at their own cost.
  • At the time of Discharge, patient can collect a copy of the summary bill / discharge summary from the billing department / Ward Secretary.
  • If there is any pending reports after discharge, it should be collected (or) handed over to insurance department. (viz versa).

6) What shall I do, if my TPA denied my Cashless hospitalization ?

As per hospital policy, if your TPA has denied your Cashless hospitalization, you will be treated as a cash paying patient. Please make necessary arrangements to pay the final bill at the time of discharge.

7) What is the procedure for Reimbursement ?

You can go for reimbursement :-

  • If your case has been denied and asked by the TPA to come for the reimbursement or
  • If your TPA is not covered under our approved list, you can go for reimbursement.

In the above two cases you can approach our Medical Records Department with the downloaded claim form for assistance in filling the Hospital details and get it signed from our Medical Practitioner.

With this completed form, please contact your respective TPA along with the Patient Discharge Summary, all hospital bills and all original reports

For more details kindly contact our Medical Records Department in the main hospital.


Communication Address

Sundaram Medical Foundation (Main Hospital)

# 9c, 4th Avenue, Shanthi Colony,

Anna Nagar, Chennai – 40.

Ph: 26144208.

Email : Insurance@smfhospital.org

In-Patient Service : 9.00 A.M to 6.00 P.M

Out-Patient Help Desk : 10.00 A.M to 6.00 P.M

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