Dec 12, 2003 02:24 AM
6961 Views
(Updated Dec 12, 2003 02:24 AM)
I want to share my First hand experience with the TPA.
First of all, I got this insurance/card frm my employer.
I included my parents into this policy and had to pay up some xtra money which will be picked up thru my salary once in a year.
I feel I did a gr8 thing by including my parents in this policy. Just after 2 months I got the card, my dad had to be hospitalised for a condition called cellulitis in his right foot and during the hospitalization was also diagnised for Jaundice.
First Time:
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I had to pay 1K as advance at the Hospital. The hospital first sent out a requsition for 18K and got the authorization immdiately. As soon as the bill crossed 18K one more requisiton was sent to TPA asking for 25K and the authorization given was just for 15K. The lady at the hospital asked me to pay up 10K as soon as possible. I was completely lost as I wasnt having sufficient funds to pay up to the hospital. I called up TPA and asked them what was the reason for authorizing only 15K. I was told that was a mistake from the paramount's side and I was asked to resend the requisition so that they wud authorize the complete amt. Eventually, the hospital sent out one more requsition to the TPA and got the authorization. My dad was in the hospital for almost a month and the bill went up to 73K. Luckily I didnt hv to pay more than 2K frm my pocket at the hospital. I only had to pay up for the pharmacy bills which cud be reimbursed later from the TPA.
Second Time:
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Even after a month, the wound left by the cellulitis wasnt healing up, I had to admit my dad again to the hospital. This time it was a real run from pillar to post. I was told by the Hospital that the TPA hadnt cleared the previous bills and the hospital wud not admit my dad. I had to talk to my HR and get this settled between the TPA and the Hospital. This time again the payment was done by some thing called Online mode. Hospital got the cheque frm the TPA on the day of the discharge. I was told by the hospital, ''Your dad will not be discharged untill and unless we get the cheque frm the TPA''.
Third Time(Yet to arrive):
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This time its for Skin grafting to cover the wounds left by the cellulitis. and looks like the hospital is ok with providing the cashless service. I hv arranged for the authorization upto 45K and the hospital is ready to admit my dad. I hope this wud be the last trip to the hospital and my dad recovers completely.
Ultimately in a country where everybody is made to run frm pillar to post for getting things done, it is ok untill the help is provided. I dont mind shelling out few hundreds I spent on calling the TPA and the hospital from telephone and mobile.
Over all ok.
