Insurance TPA Service

What is TPA ?

The Third Party (Claims) Administrator (TPA) insurance service is one of the facilities offered by Indira Hospital. The TPA acts as a mediator between the medical claims department and the concerned insurance company (both public and private insurance companies). The TPA issues identity cards to policy holders with and handles all post-policy issues, including claim settlements directly with the hospital and the insurance company. The TPA card entitles the policy holder to seek cashless facility from the empaneled hospitals. At the time of discharge, patients (policy holders) need to make the payment for the amount exceeding the authorization amount received from TPA. 

TPA Rules

Terms and Conditions for applying cashless treatment from Insurance Company through Indira Hospital

  1. Indira Hospital has no responsibility in getting cashless benefits from insurance company on behalf of the patients.

  2. But will help the patient for the process in order to avail such facilities from the insurance company.

  3. Applying through hospital for pre-authorization of cashless benefits never guarantees approval from the company either partially or fully.

  4. The insurance company without much explanation may deny it at any time.

  5. In case if the company disapproves the claim for cashless benefits, the patient has to pay entire hospital amount at the time of discharge.

  6. Later they may claim directly from insurance company, which again is not the responsibility of Indira Hospital.

  7. In the event if the insurance company approved part of the hospital bill only, the patient has to pay the balance amount and should leave their reports and other treatment documents with the hospital for claiming the partial amount that has been sanctioned by the Insurance Company.

  8. Otherwise they can pay the entire hospital bill and directly approach the company for reimbursement. In such case all reports and treatment document will be issued to them.

  9. Payments such as mentioned below are not covered under Mediclaim and therefore needs to be paid directly by the patient to the hospital. An advance of Rs. 2,000 has to be remitted at the time of admission which will be adjusted against such.


    •  Admission charges
    • Registration charges
    • Medico-legal charges
    • Attendant stay charges
    • Relative stay charges
    • Additional stay
    • Gate pass / Attendant pass
    • Overhead charges
    • Establishment charges
    • Incident charges
    • Waste disposal charges
    • Tax surcharge
    • Inpatient service fee


  • Private nurse charges
  • Telephone charges
  • Fax charges
  • Food/beverages
  • Diet electricity charges
  • Water charges
  • T.V. / Internet charges
  • CD Newspaper / Magazines
  • A/C charges
  • Stationery charges
  • Linen / Laundry charges
  • Mortuary / Coffin charges
  • Ambulance charges
  • Aesthetic treatment / Surgeon
  • Luxury tax preparation charges
  • Referal doctor fees
  • Dressing charges
  • Diabetic chart charges
  • IM/IV injection given charges
  • Xerox charges
  • Tubal ligation
  • Excess room
  • Rent miscellaneous charges


  • Baby expenses
  • Maternity
  • Pre existing condition
  • Expenses not pertaining to diagnosis mentioned in the pre-authorisation


    • Water bed/ Air cushion
    • Alpha bed
    • HOT water bag
    • Bed pan / Kidney tray/Sputum cup
    • Crutches/Walker /Wheel chair
    • Braces/Cervical collar
    • Slings / Splints knee cap
    • Abdominal belt / LS belt
    • Nebuliser / Steam inhaler / Humidifier
    • Thermometer
    • Chest binder
    • Spirometer
    • Spacer
    • Glasses / Lenses / Goggles / Frames
    • Dentures / Dental braces /Tooth implants
    • Hearing aids
    • Glucometer
    • BP monitoring device
    • Other monitoring device
    • Arm sling
    • Apron drape
    • Linen blanket
    • Tourniquet
    • Urometer
    • Medicine box
    • Urine can
    • Pelvic traction belt charges


  • Antiseptic / Disinfectant solutions
  • Soap powder (Talc)
  • Oil
  • Cream
  • Sanitary pads /Diapers / Tissue paper
  • Cassette / Film charges
  • Oxygen cylinder
  • Betadine
  • Scrub solution
  • Gloves /Gown
  • Toothpaste/Brush
  • Mineral water
  • Foot cover
  • Band aid
  • Cozy towel
  • Caps
  • Crepe bandage
  • Cosmetics
  • Health drinks
  • Room freshener

TPA Insurance Partners