- Compassion for every patient. Care in every moment.
Trusted Since 1978
TPAs
Mallige Medical Centre offers hassle-free, cashless treatment through tie-ups with leading insurance providers and TPAs. Whether covered under corporate, private, or government schemes, our insurance desk ensures smooth claim processing and full support throughout your treatment.
Q. Who is a Third Party Administrator (TPA) and what is their function?
A Third Party Administrator (TPA) is an important link between insurance companies, policyholders and healthcare providers (hospitals). They provide administrative support—claims processing, ID-card issuance and operational services—on behalf of insurers. Many companies outsource these functions to TPAs to streamline policy servicing.
Services Offered by TPAs
- Cashless Hospitalisation: Access treatment without up-front payment at empanelled hospitals.
- ID Card Issuance: TPAs provide ID cards and policy copies for admission validation.
- Claims Management: They administer and settle claims for both hospitals and policyholders.
- 24×7 Customer Support: Round-the-clock helpline for policy, network, and claims enquiries.
If You Are Currently Insured
- Have you received your insurance ID card? If not, contact your agent or TPA immediately.
- Verify the TPA name on the card before admission to avoid delays.
- For new or renewed policies, confirm your enrolment with the TPA to prevent authorisation issues.
- Note: Out-patient consultations and pre-hospital tests are not covered under cashless schemes.
- Submit original bills and prescriptions to the TPA for any pre- or post-discharge reimbursements.
Role of the Insurance Help Desk
- Open Mon–Sat: 8 AM–8 PM; Sun: 9 AM–6 PM.
- Assists only policyholders with cashless approvals—subject to policy terms.
- Facilitates TPA authorisation but cannot guarantee approvals or reimbursements.
For Planned Hospitalisation
Provide your ID card, updated policy copy, Aadhar, PAN and patient reports to the Insurance Desk at least 3–4 days before admission for smooth cashless processing.
For Emergency Hospitalisation
Show your insurance card or policy copy at reception and sign an undertaking to pay any charges if TPA authorisation isn’t received within 24 hours.
Claim Processing Steps
- TPA issues an initial authorisation letter for coverage.
- Proceed to the hospital admission counter with your ID card and documents.
- Receive treatment up to the TPA-approved limit.
- If the limit is exhausted, contact the Insurance Help Desk for enhancement (may take a few hours).
- At discharge, inform the desk and sign the claim form if required.
Note: The Insurance Help Desk only assists with processing. If authorisation is denied, you must settle the bill and claim reimbursement later.
Dos
- Provide all relevant documents for claim processing.
- Wait for explicit TPA authorisation before treatment.
- Contact your local TPA office for any queries.
- Pay for any services beyond the approved limit.
- Declare your medical history accurately.
Don’ts
- Don’t seek hospitalisation solely for investigations or check-ups.
- Don’t insist on cashless admission without pre-authorisation.
- Expect a 3–4 hour window for claim processing and queries.
What is a TPA?
A Third-Party Administrator (TPA) acts as a bridge between insurers, policyholders and hospitals—managing administrative tasks to deliver seamless, cashless healthcare.
How can we help?
Could not find what you are looking for?
Request a Callback
