Navigating Healthcare Expenses with Cashless Insurance

Health Insurance at Sri Ramachandra Medical Centre

Health Insurance at Sri Ramachandra Medical Centre (SRMC) provides financial support for hospitalisation due to illness, injury, or accidents. Understanding the terms of your policy is important to ensure a smooth admission, treatment, and discharge process.

Key Points to Note:

• Most policies require a minimum hospital stay of 24 hours for coverage.
• Certain day care procedures may be covered without this requirement. Please check your policy or contact your company’s HR for details.
• Preliminary tests or diagnostic evaluations are usually not included under standard coverage.

Exclusions and Non-Medical Expenses

Health insurance does not cover non-medical items or consumables. These may include:

• Toiletries, cosmetic products, earbuds, masks
• Housekeeping and admission charges
• Attendant or registration charges
• Medical certificates, MLC charges, attender room fees, etc.

For the full list of non-payable items, please check your insurance policy or speak with the Insurance Helpdesk at SRMC.

Room Rent and Insurance Limits

Most health insurance plans cover room charges only up to a set limit:

• Regular room: Covered up to 1% of the total insured amount
• ICU room: Covered up to 2% of the total insured amount (including nursing)
• If the room you choose costs more than the set limit, the insurance company may reduce the entire claim - not just the room rent. In such cases, the remaining amount must be paid by the patient.

Cashless Claim Denial - Common Reasons

Cashless claims may be denied due to:

• Treatment for pre-existing conditions not covered in the policy
• Specific exclusions mentioned in the policy
• Hospitalisation under the influence of alcohol
• HIV/AIDS-related treatment
• Full use of the insured amount
• Psychiatric care, if not included in the plan

For help with claim issues, please contact your Third Party Administrator (TPA) or visit the Insurance Helpdesk at SRMC.

For inquiries, please contact

Extension: Pre-Authorization - 8499, Admission - 410, Discharge - 3499

Insurance Dept.: 044-4592 8500/044-24768403

Direct Number: 044-24765629/24761550/24761541