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Admission Procedures

Procedure for Inpatient Admissions

You will require an ‘Admit Instruction Slip’ from a doctor of Zion Hospitals to register for admission.


Procedure for Medical Insurance Card Holder

The following procedure is adopted for Admission :

  • All planned admissions for hospitalization/surgical procedures will be made only after the receipt of Pre-Authorization approval from the concerned TPA/Insurance Company.
  • Pre-Authorization form for all Mediclaim policyholders shall be issued from Admission Counter to the patients requiring admissions.
  • Admission Counter will validate the identity of the patient prior to giving a request form of the concerned TPA/ Insurance Company.
  • The request form consists of 3 parts:
  • Part A: To be filled in by the insured Patient/Attender.
  • Part B: The patients shall then get Pre-Authorization form filled in by the treating Doctor.
  • Part C: Billing counter shall enter the estimated cost of the treatment.
  • Filled in forms shall be submitted to Insurance Cell at Reception counter along with photo ID for processing with the concerned Insurance company/TPA.
  • During the off duty hours of Insurance Cell, the filled in form shall be submitted at Billing for processing.
  • The request will be submitted to the concerned TPA/ Insurance Company, the Turnaround time for authorization is approx 6-10 working hours.
  • The TPA/ Insurance Company will send Approval/ Denial Letter and the print out of the same will be available at the Insurance Desk.
  • If approved the Approval letter will also indicate the amount upto which the TPA will settle the bill directly with hospital.
  • After receiving Pre-Authorization approval from the concerned TPA/ Insurance Company, the patient can get admitted.
  • If the patient wants to get admitted prior to the receipt of Pre-Authorization approval, deposit has to be made as per the existing system of the Hospital, depending on the room category and 90% of the cost of surgery, if any. This applies to EMERGENCY admissions also. (Subsequently Pre-Authorization would be requested from the TPA/ Insurance Company) as above.
  • Such deposits received will be refunded in cash (if it is within 25,000/-) or by way of A/c payee cheque (in the name of the patient only) on discharge or will be adjusted against balance (if any) in the final bill on receipt of approval.
  • At the time of discharge if the final bill amount exceeds the authorized amount, the consolidated final bill will be processed with the concerned TPA for enhancement for further approval or reconfirmation of the case which will take 3-4 hrs from the time the final bill and discharge summary are processed. We request you to bear with this delay in the discharge formalities.
  • Such deposits received will be refunded in cash (if it is within 25,000/-) or by way of A/c payee cheque (in the name of the patient only) on discharge or will be adjusted against balance (if any) in the final bill on receipt of approval.
  • At the time of discharge if the final bill amount exceeds the authorized amount, the consolidated final bill will be processed with the concerned TPA for enhancement for further approval or reconfirmation of the case which will take 3-4 hrs from the time the final bill and discharge summary are processed. We request you to bear with this delay in the discharge formalities.
  • Payments are to be made in full, if Pre-Authorization is not approved under any circumstances. Similarly, difference amount in the bill (if any) not approved by TPA / Insurance along with the non-medical expenses and non-reimbursable charges shall to be paid by the patients at the time of discharge.
  • Please note that the rejection of the preauthorization request is only denial for cashless services and is no way to be treated as denial of treatment. The insured can directly settle the bill with the hospital, the insured retains the right to get treated and submit the bill directly to the TPA for subsequent reimbursement.
  • With regard to all TPA/ Insurance related issues, decision of the Zion Hospitals Management will be final and binding.