Adani GMC Policy- Cashless process

 Name of Insurance Company : HDFC ERGO General Insurance Company Limited

• Employee Policy No: 2999204409302500000

• Parent Critical illness Policy No: 2999204407817800000

• Employee TOP-UP Policy No: 2999204432266600000

• Parents Optional Mediclaim Policy No. 2999204452751300000

 Policy Period : 11-11-2021 to 10-11-2022

 TPA for claim servicing: Paramount Health Services & Insurance TPA Pvt. Ltd

 Note: Following policy details will also appear on PHS Portal very soon.

• Employee Additional (TOP-UP) Hospitalization / Mediclaim Insurance 2021-22

• Optional Hospitalisation Policy For Employees’ Parents 2021-22

Cashless Facility
Cashless facility can be availed for both planned and emergency hospitalisation in
network hospitals only.

1 2

Planned
Emergency
Hospitalisation
Hospitalisation

Apply for cashless Apply for cashless

at least 3 days within 24 hrs
prior to admission from time of
admission
Cashless Claim process

Admitted in Visit Cashless

Network department in
hospital hospital

Below minimum documents have to be submitted to cashless department

in Hospital.

Current Cashless card of Need to fill up Photo id proof of

Treatment file Patient the cashless Patient:
and Dr advise request form & Aadhar card,
letter submit Driving licence etc
Hospital will send cashless request forms along with estimate of expense
and supporting documents to Insurance company.

Insurance Co. will

check and revert to
hospital

APPROVAL/REJECTION/Q
Cashless department UERY will be provided
sends documents to Within 4 hrs
Insurance Co.

Note:
1. Based on document, insurance company will approve cashless request
OR raise query.
2. If the claim is payable, insurance company will approve initial amount
within 4 hours of receipt of the same, if there are no queries.
3. The initial amount approved will be less than the requested amount.

INITIAL CASHLESS APPROVAL

Hospital will send final bill along with discharge summary and supporting
documents to Insurance company.

Insurance company
will check and
revert to hospital

APPROVAL/REJECTION/Q
Cashless department UERY will be provided
sends documents to Within 4 hrs
Insurance Com.

Note:
1. Based on document, insurance company will approve balance/final amount as
per policy terms and condition OR raise query if any details are required.
2. Final approval will be provided on receipt of final bill and discharge summary
within 4 hours of receipt of the same, if there are no queries.
3. Non approved amount will have to be paid by employee directly to hospital.

FINAL CASHLESS APPROVAL

Points to be noted.
1. At the time of admission, if hospital requests to deposit some amount to start
the treatment, please do so. If the claim is payable hospital, will refund the
deposited amount at the time of discharge.
2. Please ensure that you collect the deposited amount before taking discharge.
3. Non-payable amount should be paid by employee directly to the hospital before
taking discharge.
4. Collect all payment receipts with detailed breakup before taking discharge.
5. Pre & post hospitalisation expenses can be claimed on reimbursement mode
within 30 days from date of discharge.
6. Mention your email id and contact number in all forms.

In case of any query or problem in cashless hospitalisation, you may contact

Level of
Name of Person E-mail ID Mobile No
Escalation
1 Ms.Vishwa Bhatt Bhatt.vishwa@paramounttpa.com 7304482034

2 Ms.Dona Shah Dona.shah@paramounttpa.com 7304482036

3 Mr. Kamal Motwani kamal.motwani@paramounttpa.com 937401121

Adani
• Business HR OR
• Insurance Department Mr. Bhavesh Panchal # 94266 02486