INSURANCE
Private Health Insurance Matters
No Co-pay | No Out-of-pocket Expenses (T&C Apply) | Life-saving & Compassionate Care
Cashless Healthcare at SMSIMSR
If you hold a private health insurance policy, our dedicated Insurance team is here to handle everything — from verifying your coverage before you arrive, to coordinating directly with your insurer or Third-Party Administrator (TPA) so you walk out without unexpected bills.
We accept most major private insurance policies and work with a wide network of TPA partners. No upfront deposits. No mandatory co-payments. No last-minute surprises at discharge. Just the care you need, covered the way your policy intended.
Whether you’re planning a procedure or arriving for urgent care, our on-site Insurance Help Desk and dedicated insurance counsellors are ready to guide you through every step.
Restoring Your Health is Our Priority
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Zero Upfront Cost Guarantee
No advanced deposits or mandatory co-payments required at admission. Complete peace of mind for your family
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No Out-of-pocket Expenses*
Direct liaison with your Third Party Administrator (TPA) and private insurance partners to ensure zero-expense exit
*Terms and conditions may apply
Instant Eligibility Check
Digital verification of a health card via email or phone to confirm exact TPA network approval parameters before booking appointment
On-Site Insurance Desk
Immediate, private eligibility assessment offered right at our dedicated lobby desk
Dedicated Insurance Counsellors
Dedicated insurance counsellors ensuring paperwork approvals while you recover
Our Partners
Our Empannelled Private Insurance & TPA Partners
Didn’t find your private insurance or TPA partner listed? Please talk to our insurance counsellor.
Private Insurance Partners
- Acko
- Aditya Birla Capital
- Bajaj General Insurance Limited
- Care Health Insurance
- Chola Insurance
- Digit Insurance
- Galaxy Health Insurance Company Limited
- General Central Insurance
- HDFC ERGO GIC
- ICICI Lombard GIC
- IFFCO TOKIO
- IndusInd General Insurance
- Kshema General Insurance
- Liberty General Insurance
- Magma General Insurance Limited
- ManipalCigna Health Insurance
- Narayana Health Insurance
- National Insurance COmpany
- Navi UPI
- New India Assurance
- NivaBupa
- Oriental Insurance
- Raheja QBE General Insurance Company
- Royal Sundaram
- SBI General Insurance
- Star Health Insurance
- Tata AIG GIC
- United India Insurance Company
- Universal Sompo General Insurance Company Limited
- Zuno General Insurance Limited
- Zurich Kotak General Insurance
Third Party Administrators (TPAs)
- FHPL TPA
- Health India TPA
- Link K TPA
- MD India TPA
- MediAssist TPA
- Vidal Health TPA
- Volo TPA
Before we get started
Essential Document Checklist
To speed up the initial approval process, please prepare the following required items:
- Patient ID (Aadhar/Voter ID)
- PAN Card
- Valid Insurance E-card/Policy Copy
- Any previous medical documents and referrals, if any
*Once we receive all this information, based on eligibility, we will download the pre-authorisation form and fill it. You will have to sign it once you visit the hospital.
The Patient Journey
Navigating hospital procedures and insurance policies can feel overwhelming. At SMSIMSR, we have structured our entire process flow to protect your time and peace of mind. Follow our step-by-step journey map below to see exactly how your care unfolds.
Step 1: Setting an appointment
Your journey begins before you even step inside our hospital.
- New Patients: Request your appointment via phone or email. Our team collects your details and creates a permanent hospital registration profile with a Unique Hospital Identification (UHID).
- Patients (Revisiting): Share your existing Unique Hospital Identification (UHID) via phone or email. We will locate your records and schedule your appointment directly.
Step 2: Welcome & Immediate Reception
Upon arrival, our dedicated Security and Sevadal staff greet you and instantly direct you past the standard queues straight to our specialised Insurance Help Desk.
Step 3: Clinical Evaluation
You will meet with your treating consultant at the Special OPD for an in-depth medical evaluation. During your consultation, your doctor/medical team will assess your immediate clinical needs and recommend treatment either through Outpatient Care (OPD) or Inpatient Admission (IPD).
Outpatient care will involve localised investigations and/or procedures followed by a medical prescription if necessary. A follow-up plan will also be provided to you if required, and you are welcome to return home directly thereafter.
If however, the treating doctor recommends admission, you will be transitioned to a pre-admission desk. Here, our team will discuss your options with you before your formal ward check-in.
Step 4: Dedicated Insurance Counselling
You will be escorted into a private, comfortable workspace. A dedicated Insurance Counsellor will perform an interactive policy review—verifying your active network coverage parameters, explaining room rent sub-limits, and mapping out your exact sum insured benefits.
Step 5: Pre-authorisation Submission
Our processing assistants compile your doctor-recommended treatment chart and insurance credentials. We download, populate, and manage the official pre-authorisation request packet, submitting it directly to your Insurer or Third-Party Administrator (TPA) for initial verification.
Step 6: Approval & Formal Ward Entry
The moment your insurance provider issues a formal initial or conditional approval notice to our desk, your cashless billing profile locks into place. You are immediately transferred into your clinical ward for treatment with zero upfront deposit requested.
Step 7: Documentation Compilation and Electronic TPA Submission
When your treating medical team officially declares you clinically fit for discharge, our medical and billing units compile your finalised discharge summary, build the complete line-item billing log, and aggregate all supporting clinical diagnostic charts. Our Insurance Help Desk then transmits the finalised billing and clinical dossier directly to your insurer or TPA for final payment clearance.
Step 8: Insurer Review & Final Approval
The insurance company evaluates the medical files and issues a final authorised payment waiver directly back to our billing desk. The authorised payment amounts are posted smoothly against your patient profile, resolving your medical dues.
Step 9: Sign and Exit Comfortably
You review and sign the final clearance sheet, collect your take-home medications alongside specific aftercare instructions, and exit the hospital comfortably.
Frequently asked questions (FAQs)
If you need further clarification on any terms or points mentioned above, please go through the following questions or contact us directly using the contact details below.
Yes. We accept most major private health insurance policies, subject to policy terms, eligibility, and approval from the insurance company or Third Party Administrator (TPA).
Yes. Cashless hospitalisation may be available for eligible policies. Approval is subject to the insurer’s authorisation and policy coverage.
Our Insurance Help Desk will verify your policy details and guide you regarding eligibility, coverage, and the available treatment process.
The hospital directly coordinates with the insurer for approved expenses.
Approval timelines vary depending on the insurer and the completeness of the submitted documents. Our team will coordinate with the insurer to facilitate the process.
If a claim is denied due to policy limitations, exclusions, or insurer decisions, the patient will be informed accordingly. Our team will provide all necessary documents and clarification available from the insurer.
For planned admissions and procedures, prior authorisation is generally recommended and may be required by your insurer.
Yes. Dedicated insurance coordinators are available to assist patients with appointments, admission processes, documentation, approvals, and discharge coordination.
You may contact our Insurance Help Desk or the designated insurance counsellor for support regarding appointments, approvals, billing, and claim-related queries.
Yes. Our team will keep you informed regarding the status of pre-authorisation requests, approvals, and any additional requirements from the insurer.
Traditional hospital visits may incur hidden admin charges, non-medical expenses, or mandatory “co-payments” (where your policy forces you to pay a fixed percentage of the bill yourself). At SMSIMSR, “No Out-of-Pocket” means that for all authorised, policy-covered treatments, we structurally eliminate these unexpected upfront fees. If your private insurance policy covers the procedure, the billing will be zero. However, this out-of-pocket expense will amount to 10% excess of the total amount of your coverage. We coordinate directly with your provider to protect you from out-of-pocket friction.
The timeline for initial pre-authorisation during admission varies based on your insurance company’s specific verification speed, usually taking anywhere from a few hours to a day. We at SMSIMSR operate under a strict priority 3-hour window for discharge documents. Our insurance team uploads your completed medical files and final bill to your insurer or Third Party Administrator (TPA), and ends the moment we receive final clearance for your swift, cashless exit.
The primary difference comes down to when your insurance approval is secured.
Planned Admissions: This is for scheduled surgeries or procedures recommended during your OPD consultation. It gives you the ultimate advantage, as our team can submit your paperwork and secure pre-authorisation from your insurer days before you check in, ensuring a zero-delay entry straight to your ward.
Ongoing/Emergency Admissions: This occurs when a patient requires immediate medical stabilisation or unexpected hospitalisation. We never let paperwork delay critical care. Your medical treatment starts instantly, and our Insurance Counsellors will handle the pre-authorisation workflow directly from your bedside while you are being treated.
Contact Us
Insurance Helpdesk Number: 82174 16049
Email: insurance.info@smsimsr.org