To ensure smooth facilitation of cashless policy and documentation, the BMB has a dedicated third-party administrator (TPA)/insurance help desk. A list of empanelled TPA/insurance companies is listed for reference.
Guidelines for Seamless Qualification of Health Insurance Policies
Essential Documentation Required for Cashless Services
- Cashless card from TPA
- Photocopy of ID card
- Photocopy of current insurance policy
To avail in-patient hospitalisation services, follow the procedure stated below:
For Planned Hospitalisation
- Contact the insurance helpdesk with the mentioned documents, along with the doctor’s admission advice, at least 3 days prior to the admission for necessary formalities
- Authorisation for cashless service from patient’s TPA
For Emergency Hospitalisation
- Admit the patient
- Contact the insurance helpdesk with the essential documents as early as possible for necessary formalities
- If authorisation for ‘cashless service’ from TPA is received, one can avail cashless facility thereafter for treatment in the hospital, up to the amount sanctioned by the TPA
Please fill the declaration form related to patients with mediclaim policies at the time of admission. Do try and ensure accuracy in information to help us serve you better.
Payment for Non-Authorised Items
If authorisation for cashless service from the TPA has been received at the time of discharge, the patient needs to pay for the following:
- Items that are not reimbursable under the mediclaim policy
- Hospitalisation expenses in excess of the insured amount
Denial of Cashless Service
In case of denial of cashless service by the TPA, the patient is requested to settle hospital bills themselves. BMB will then supply all bills and reports to enable the patient to lodge their claim for processing and reimbursement directly with the TPA.
Being a referral & model hospital for many organizations, the centre has agreements with many PSUs, state government and private companies. For guidance for admissions and other processes, please contact the corporate. Our team of executives stand ready to assist you.
|2||Balmer Lawrie & Co.Ltd|
|4||Bharat Petroleum Corpn Limited|
|5||Bharat Sanchar Nigam Limited – Itpc|
|6||Bharat Sanchar Nigam Limited – Telecom Factory, Alipore|
|7||Bharat Sanchar Nigam Limited – Telecom Stores|
|8||Birla Industrial And Technological Museum|
|9||Border Security Force|
|11||British Deputy High Commission|
|13||Central Coalfields Limited|
|14||Central Hospital South Eastern Railways, Gardenreach|
|15||Central Mine, Planning & Design Institute Limited|
|16||Central Warehousing Corporation|
|19||Clacutta High Court|
|20||Coal India Ltd|
|22||Csir – Central Glass And Ceramic Research Institute|
|23||Csir – Central Institute Of Mining & Fuel Research|
|24||Csir-Indian Institute Of Chemical Biology|
|25||Damodar Valley Corporation|
|26||Dredging Corpn Of India Ltd.|
|27||Dredging Corporation Of India Limited|
|28||Eastern Coalfields Limited|
|29||Employees State Insurance Corporation Esi – Pgimsr & Esic Hospital & Odc(Ez)|
|30||Employees State Insurance Corporation, Ssmc|
|31||Employees State Insurance Corporation, West Bengal Region|
|32||Engineering Projects (India) Ltd.|
|33||Ferroscrap Nigam Limited|
|34||Food Corporation Of India|
|35||Garden Reach Shipbuilders & Engineers Limited|
|38||Hindalco Industries Limited – Belur Works|
|39||Hindustan Copper Limited|
|40||Hindustan Petroleum Corporation Limited|
|41||Housing & Urban Development Corporation Limited|
|42||Icar- National Institute Of Research On Jute And Allied Fibre Technology|
|44||Iiser – Kolkata|
|45||India Government Mint|
|46||Indian Airlines(Nat.Aviation Co.Of India)|
|47||Indian Ass.For Cultivation Of Science|
|48||Indian Institute Of Management Calcutta|
|49||Indian Institute Of Technology – Kharagpur|
|50||Indian Institute Of Technology Hall Management Centre – Kharagpur|
|51||Indian Oil Corporation Limited – Marketing Division|
|52||Indian Oil Corporation Limited – Pipelines Devision|
|53||Indian Oil Corporation Limited – Refinery Division|
|54||Indian Science Congress Association|
|56||Ircon International Limited|
|58||Joint Plant Commitee|
|60||Kolkata Port Trust|
|61||Kolkata Port Trust – Haldia Dock Complex|
|62||Kolkata Port Trust-Haldia Dock Complex|
|63||Mahanadi Coalfields Limited|
|66||National Bank For Agriculture And Rural Development (Nabard)|
|67||National Council Of Science Museums|
|68||National Hydro Electric Power Corporation Limited|
|69||National Institute For The Orthopaedically Handicapped|
|70||National Mineral Development Corporation Limited|
|74||North Eastern Coalfields Coal India Limited Margherita|
|75||Northern Coalfields Limited|
|77||Ntpc-Sail Power Company Limited|
|78||Oil And Natural Gas Corporation Limited|
|79||Oil India Limited|
|80||Paradip Port Trust|
|83||Power Grid Corporation Of India Limited|
|84||Punjab National Bank Sramik Union|
|85||Rastriya Ishpat Nigam Limited|
|87||Reserve Bank Of India|
|88||Saha Institute Of Nuclear Physics|
|89||Sail Alloy Ateel Plant|
|90||Sail Iisco Burnpur|
|91||Sail, Bhillai Steel Plant|
|92||Sail, Growth Division|
|93||Sashastra Seema Bal|
|94||Satyajit Ray Film And Television Institute Is A Film And Television Institute|
|95||Satyendra Nath Bose National Centre For Basic Sciences|
|97||South Eastern Coalfields Limited|
|98||South Eastern Railways Main Hospital, Kharagpur|
|99||State Bank Of India|
|100||State Trading Corpn.Of India Ltd|
|101||State Trading Corpn.Of India Ltd|
|102||Steel Authority Of India (Raw Material Division)|
|103||Steel Authority Of India Ltd (Bokaro Steel Plant)|
|104||Steel Authority Of India Ltd (Central Marketing Organization)|
|105||Steel Authority Of India Ltd (Durgapur Steel Plant)|
|106||Steel Authority Of India Ltd (Rourkela Stell Plant)|
|107||Tata Communications Ltd.|
|108||Tata Motors Limited|
|109||The Shipping Corporation Of India Ltd.|
|110||The West Bengal Power Development Corporation Limited.|
|111||United Bank Of India|
|112||Uranium Corporation Of India Ltd.|
|113||Uti Asset Management Company Limited|
|114||Variable Energy Cyclotron Centre|
|115||Victoria Memorial Hall|
|116||Visva Bharati (Pn Memorial Hospital)|
|117||West Bengal Police|
|1||National Insurance Company Limited|
|2||The New India Assurance Co. Ltd|
|3||The Oriental Insurance Company Ltd.|
|4||United India Insurance|
|1||Atal Amrit Abhiyan Society Limited|
|2||Central Government Health Scheme|
|3||Govt Of Tripura|
|4||Govt. Of Meghalaya|
|5||Govt. Of Mizoram|
|9||Regional Center Echs – Kolkata|
|10||Tripura State Illness Assistance Fund|
|11||Wbsh Family Welfare -Sishu Sathi|
|12||West Bengal Health Scheme|
|1||Aditya Birla Health Insurance Corporation Limited|
|2||Bajaj Finanace Limited|
|3||Bajaj Allianz Insurance Corporation Limited|
|4||Chola Mandalam Ms General Insurance Co. Ltd|
|5||Ericson Insurance Tpa Private Limited|
|6||Future Generali Ins. Co. Ltd.|
|7||Hdfc Ergo General Insurance|
|8||Icici Lombard Genera Insurance Company Ltd.|
|9||Icici Prudential Life Insurance Company|
|10||Iffco Tokio General Insurance Co Ltd.|
|11||Max Bupa Health Insurance Co. Ltd.|
|12||Reliance General Insurance Company Limited|
|13||Religare Health Insurance Co. Ltd.|
|15||Star Health & Allied General Insurance Co. Ltd.|
|16||Universal Sompo General Insurance Company Limited|
|1||Ambuja Cements Limited|
|3||Hindustan Unilever Limited|
|5||Itc – Head Office|
|6||Itc – Khidirpore Factory|
|7||Mn Dastur And Company Limited|
|8||Tata Main Hospital|
|9||Tata Steel Limited|
|10||The Tinplate Company Of India Limited|
|1||Ericson Insurance TPA Pvt. Ltd|
|2||East West Assist Pvt|
|3||E-Meditek Solutions Ltd.|
|4||Family Health Plan Tpa Ltd|
|5||Genins India Tpa Ltd|
|6||Good Health Plan Ltd|
|7||Happy Insurance Tpa Services Pvt Ltd|
|8||Health India Tpa Services Pvt. Ltd.|
|9||Heritage Health Services Pvt Ltd.|
|10||Md India Health Care Services|
|11||Medi-Assist India Tpa Pvt Ltd.|
|12||Medicare Tpa Services (I) Pvt Ltd.|
|13||Medsave Healthcare Tpa Ltd.|
|14||Paramount Health services Pvt Ltd.|
|15||Raksha Tpa Pvt. Ltd.|
|16||Safeway Tpa Services(P) Ltd|
|17||Ttk Healthcare Tpa Pvt. Ltd.|
|18||United Healthcare India (Private) Limited|
|19||Vidal Health Insurance Tpa Pvt. Ltd.|
|20||Vipul Medcorp Tpa Pvt. Ltd.|
Given below are a few frequently used terms pertaining to medical insurance that you need to be familiar with.
A special benefit extended by an insurer or by the assigned TPA for availing medical treatment as an inpatient without the necessity to pay the treatment costs up front to the hospital. Under this procedure, the payment due to the hospital will be met out either by the insurer or by the assigned TPA. After the discharge from the hospital the bills pertaining to medical expenses incurred at the hospital, are sent to the Insurer/TPA, (subject to insurance policy and conditions) for reimbursement by the hospital. The hospital can claim in accordance to the pre authorised limit and additional cost as envisaged by the enhancement. In any case the upper limit of this facility cannot exceed the sum insured under the contract of insurance.
Repudiation of a pre authorisation request /admission liability/cashless facility and or settlement of a claim under the insurance contract.
Any difference between the amount claimed and admissible amount and also any violation of terms & conditions of the insurance policy or agreement.
Medical treatment for period exceeding 3 days for such illness/diseases/injury, which in the normal course would require care and treatment at a hospital but is actually taken whilst confined at home under certain circumstances (where the patient cannot be moved to the hospital or due to lack of accommodation – as per the definition of insurance policy).
A situation when insurer seeks to increase the limit of the authorized claim amount resulting from extension of hospitalisation.
The items that are specifically and expressly removed from the scope of the insurance contract and hence are not payable.
Medical treatment after getting admitted in a hospital.
The maximum limit up to which the insured can seek medical treatment under that mediclaim policy.
Individual, who by paying a premium, secures himself to receive medical treatment up to a fixed sum of money in the event of injury, loss or damage to his body.
A corporate body licensed by IRDA for underwriting various insurable risks against any or all insurable perils with an assurance to make good the loss in an unforeseen eventuality.
Insurance regulatory & development authority, a body constituted under the ministry of finance to deal with licensing, regulating and monitoring all activities relating to the insurers, brokers, agents, corporate agents and the TPA’s.
Restrictions in the operative clause of the insurance contract to the limit of benefits, use etc.
A card issued by your TPA with a primary purpose of identification. This contains the policy number, name and validity period. Many of the TPA’s prefer to place insured’s photograph & signature to improve its authenticity. Though it is being popularised as a cashless card, it serves only as a means to avail cashless benefit subject to the terms & conditions of the policy.
An insurance policy that covers hospitalisation expenses incurred during an inpatient hospitalisation. Please check terms and conditions of the policy to understand the nature and the scope of risk covered.
Medico Legal Case
A situation arising out of treatment at the hospital for any bodily injuries sustained in an accident or an attempt of suicide, which needs to be intimated to the police and other concerned authorities for any investigation and procedures. For example burns, suicide, road traffic accident, assault, etc.
A hospital which has entered into an agreement/MOU with an insurer or a TPA to request pre authorisation, extend cashless facility and accept payment at a later date on submission of bill complying to the policy requirements. Those hospitals who do not have a prior agreement for cashless hospitalisation with your insurer/TPA are called non-network hospitals.
Taking advantage of the medical condition where one does not require immediate hospitalisation (as it would not affect his quality of life in any way), the insured seeks pre authorisation sufficiently in advance of actual admission in the hospital for treatment on cashless basis.
Policy Terms & Conditions
Terms and conditions outlining the details and the limitations of the insurance contract indicating the requirements for fulfilling or adhering to the contract of the insurance.
Authorisation issued by the insurer or by the assigned TPA for admission and treatment up to a value as deemed fit by the insurer, for treatment by the hospital. To receive pre authorisation one has to make a request providing the details contained in the pre authorisation Form.
Clarification requested to dispel any doubt pertaining to the line of treatment and the contract of insurance.
A facility under which the insured can claim the expenses borne by him during hospitalisation which is otherwise claimable under his insurance contract.
Toll Free Number
A telephone number (calls to which are not charged) provided by your insurer/TPA to get in touch with them for any clarification.
A corporate body licensed by IRDA for processing and setting on their behalf, claims arising under medical insurance policies and to coordinate with hospitals for all relevant and related processes.