This Insurance Disclaimer explains the limitations and process related to cashless, reimbursement, and insurance-supported treatment services at [Website Name] / [Business Legal Name].
1. Insurance Approval Is Not Guaranteed
Mention of cashless facility, insurance support, reimbursement support, or TPA assistance does not guarantee approval of any claim. Final approval depends entirely on the insurance company, TPA, policy terms, waiting periods, exclusions, room eligibility, treatment eligibility, documentation, and authorization process.
2. Patient Responsibility
Patients are responsible for checking their insurance policy coverage, validity, waiting period, exclusions, co-payment, sub-limits, network eligibility, and claim conditions before admission or treatment.
3. Cashless Treatment
Cashless treatment, where available, is subject to pre-authorization and approval from the insurer/TPA. Treatment may begin as per hospital policy and medical need, but claim approval, partial approval, denial, or deduction is decided by the insurer/TPA.
4. Reimbursement Claims
If cashless approval is not available, delayed, denied, or only partially approved, the patient may need to pay directly and apply for reimbursement with the insurer as per policy terms. We may assist with available documents, but we are not responsible for final claim settlement.
5. Deductions and Non-Payable Items
Insurance companies may deduct or reject certain charges such as consumables, non-medical items, registration charges, special services, medicine differences, documentation charges, room differences, co-payments, exclusions, or items not covered under the policy.
Any amount not approved or paid by the insurer/TPA must be paid by the patient/attender.
6. Documentation
Patients must provide accurate policy details, ID proof, health card, previous medical records, doctor notes, investigation reports, discharge summary, bills, prescriptions, and any other required documents on time. Incorrect, incomplete, or delayed documents may affect claim approval.
7. No Liability for Claim Rejection
We are not liable for claim rejection, delay, short settlement, deductions, policy exclusion, authorization delay, or insurer/TPA decision. Our role is limited to providing treatment documentation and assistance as applicable.
8. Contact
For insurance-related assistance:
Phone: [Phone]
Email: [Email]
Insurance Desk / Billing Desk: [Optional Contact]