Reimbursement :
Service | Turn Around Time (TAT) | Remarks |
Claim Intimation | Claim Intimation- Before 48 Hrs in case of planned Treatment After 24 Hrs in case of emergency | after sharing of claim intimation from Paytm/Customer end |
Documentation Cycle | Fresh Claim Documents Submission : Claim documents can submitted within 30 Days post discharge, Query Documents Submission- 7 Days after received query letter. | closure on 7 Working days |
Claim Processing | 7 working days | after receipt of all claim documents (LDR) |
Claim Payment | NA | NA |
Claim Rejection | Same as processing TAT | |
Investigation TAT | Indemnity Policy- 21 Days for verification CI/Benefit policy- 30 Days for verification | TAT will be counted from verification triggered date/LDR. |
Cashless/Preautth :
Service | Turn Around Time (TAT) | Remarks |
Claim Intimation | Claim Intimation- Before 48 Hrs in case of planned Treatment After 24 Hrs in case of emergency | after sharing of preauth documents from Hospital via portal/email to NIVA BUPA |
Documentation Cycle | NA | NA |
Claim Processing | Initial Approval- 30 Min Final Approval- 2 Hrs After query reply- 2 Hrs | TAT will count from the LDR/Status updated. |
Claim Payment | NA | NA |
Claim Rejection | NA | NA |
Investigation TAT | 48 Working Hrs | TAT will count from verification triggered date |