Sanjivani Hospital Insurance and TPA Checklist

- TPA I-card, insurance e-card, or policy ID card
- Government-issued photo ID, preferably PAN card or Aadhaar card
- Current year policy papers
- Authorisation letter for planned admission
- Initial authorisation letter for planned admission or planned surgery
- Admission papers and previous payment receipts, if already deposited
- Inform the TPA desk within 12 hours of admission
- Cashless processing is handled only from 10:00 AM to 8:00 PM during working hours
- There is no cashless processing on Sundays, public holidays, or hospital holidays
- Emergency admissions may begin on e-card or policy papers, but authorisation must still reach the hospital
- Until initial authorisation is received, necessary hospital charges must be paid first
- If final discharge approval is delayed beyond 4 hours after hospital submission, the bill may need to be settled in full
- If TPA rejects or delays authorisation within 2-3 days of admission, the bill must be borne by the patient and reimbursement may be pursued
- A minimum non-interest-bearing security deposit of 15% of the final approved amount is collected at discharge from TPA patients
- If the stay increases beyond 21 days, the security deposit is 20%
- TPA or insurance deductions for administrative charges, admission charges, pharmacy charges, or non-medical items must be paid by the patient
- Outside investigations such as MRI or some pathology tests may need patient-first payment with later adjustment
- LAMA cases are not eligible for cashless processing
- If approved class and admitted class differ, the patient must pay the difference
- SMS approval is not treated as authorisation; email letterhead or portal approval is required

Cashless approval depends on insurer or TPA timelines, portal communication, and policy terms.