IRDAI License No. 010, Period of Certification : 21/03/2017 to 20/03/2020

Comprehensive Claim management services

Focus Health Insurance TPA Private Limited had empanelled more than 2500 hospitals in its networks comprising of tertiary care .secondary care multi hospitals and nursing home across the country.

These networks of hospital provide cashless treatment to the patients who are a need of availing medical services. These hospitals provide cashless treatment facility. The Insured has to select one of the empanelled hospitals and provide his the photo ID card issued by us .The hospital would send the prescribed preauthorization form after filling all the necessary details. Thus the insured has not to worry about the arrangement of money for getting the treatment

Cashless claim procedure

  • Receipt of Pre-Admonition Authorization form along with focus photo id card from the networking hospital duly filled in signed.
  • Checking of member enrollment record and data.
  • Base on the Ailment and the estimate send by the hospital. It can be approved, queries can be raised.
  • Keeping in view the policy terms and conditions packages if any initial grant is sent.
  • At the time of discharge ,After looking into the discharge summary bill and other details ,final approval of the amount is sent to the hospital
  • The insured only case for non payble other excess amount not cover under the policy.

Reimbursement claim procedure

When cash less facility is not availed or insured goes to a Non network/Non GIPSA .

Hospital the following documents are required in original.

  • Claim form dully fill and signed
  • Discharge Summary
  • Hospital Bill with breakup
  • Investigation report and films
  • First consultation prescription
  • Pharmacy Bills
  • Any other bill or receipts of payment

Based on above document the claim settlement take place within seven working days