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TPA Service - MD India |
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| About MD India |
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MDIndia Healthcare Services (P) Ltd
IRDA License No: 005
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CLAIM RATIO OF SERVICING U/Os |
Claim Ratio’s Vary Between 49% (Being the Best) and 82% (Being the Worst)
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| Statewise Hospital List of MD India |
State |
No. of Hospitals |
State |
No. of Hospitals |
ANDHRA PRADESH |
304 |
ASSAM |
3 |
BIHAR |
15 |
CHANDIGARH |
11 |
CHATTISGARH |
7 |
DADAR NAGAR HAVELI |
1 |
DAMAN & DIU |
2 |
DELHI |
191 |
GOA |
41 |
GUJARAT |
473 |
HARYANA |
102 |
HIMACHAL PRADESH |
3 |
JHARKHAND |
4 |
KARNATAKA |
286 |
KERALA |
101 |
MADHYA PRADESH |
115 |
MAHARASHTRA |
867 |
MEGHALAYA |
1 |
ORISSA |
10 |
PONDICHERRY |
8 |
PUNJAB |
39 |
RAJASTHAN |
53 |
TAMIL NADU |
326 |
UTTAR PRADESH |
227 |
UTTARANCHAL |
9 |
WEST BENGAL |
141 |
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CASHLESS AUTHORIZATION….. |
•We Train Hospitals on Regular Basis on Cashless Authorization Procedure
•MDIndia Approves/rejects Cashless Authorization Requests With in 4-8 Hrs.
•The Cashless Treatment is Authorized As Per SOC
•In Case of Denial of Cashless, MDIndia Retains the Right Not to Disclose the True Reason
•In Case of Any Document Deficiencies/queries, U/O’s Are Requested to Respond to the Deficiencies Faster to Provide Prompt and Speedy Services to the Insured
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PROCESS FOR CASHLESS AUTHORIZATION….. |
•Valid Insured Person
–Policy Copy
–VB 64 Compliance
–With-in MDIndia Service Period
•Coverage of Illness Under Policy
–Pre-Existing
–1st Year Exclusions
–30 Days Waiting Period
–Exclusion 4.4 to 4.13
–Any Tailor Made Provisions
•Necessity Of Hospitalization
–Clinical History
–Investigation Results
–Treatment Already Undergone
–Duration of Stay
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•Necessity of Medical Expenses Planned
–Based On Investigation Results
–Historical Experience
–Evidence Based Medical Practice
–Concurrent Illnesses
•Probable Medical Expenses
–As Per SOC
–Consumables, Disposables & Implants (Customary & MRP)
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CLAIMS PROCESSING & PAYMENT…. |
•Cashless Claims
–Photo Identification is Mandatory to Ascertain Identity of Patient
–Authorization Letter Carries Photograph of the Patient for Physical Verification
–Authorization Amount Payment is Subject to Genuineness of Information Provided at the Time of Hospitalization, Subject to Necessity & Schedule of Charges
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•Reimbursement Claims
–All Claims Are Subject to Rigorous Processing & Audit
–VB 64 Compliance Are Obtained From U/O, if Necessary
–Claim History (Paid & Repudiation) From U/O for Chronic Ailments
–1st Year Claims Other Than Infectious Diseases, Accidents & Below 25,000/- Are Subject to Rigorous Audit
–CB Confirmation is Necessary to Avoid Wrong Payments
–We Intend to Implement MDIndia Claim Form, Which Will Reduce Deficiency in Primary Information
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CALL CENTER…. |
•We Maintain 24x7 Toll Free Call Center At Pune : 1600-233-1166 (10 Lines)
•We Also Offer Toll Free Fax Line to All Our Customers : 1600-233-4505 (3 Lines)
•We Have Qualified & Trained Medical Professionals Supervising the Call Center
•All Branch Offices Phones Are Diverted to Mobiles After Office Hours
•Call Center Acts as CUSTOMER CARE
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MDINDIA HEALTHCARE SERVICES P. LTD.
BRANCH OFFICE ADDRESS/CONTACT NOS (Updated on: 24/02/2007) |
| Sr. |
Branch |
Office Address & contact |
1. |
Indore Branch |
FF-124/125, Palika Plaza, MTH Compound,
Indore-452001.
Tel. No. : 0731- 2549999
Fax. No. : 0731- 2549888
indore@mdindia.com
www.mdindia.com |
| 2. |
Ahmedabad Branch |
Sukhsagar Complex, 806/807, 8thFloor, Usmanpura,
Near Fortune Landmark Hotel,
Ashram Road,
Ahmedabad-380013
Tel. No. : 079- 27560006
Fax No. : 079- 27560057
ahmedabad@mdindia.com
www.mdindia.com |
| 3. |
Mumbai Branch |
101, 1st Floor, Comet Building,
Opp. Bandra Talao, Gurunanak Road,
Bandra (W), Mumbai – 400 050.
Tel. No : 022-26451781
Fax. No : 022 - 26451638
mumbai@mdindia.com
www.mdindia.com |
| 4. |
Pune Branch |
MDIndia House, S.No. 147/8,
First Floor,
Near Kothrud Petrol Pump, Karve Statue Circle,
Kothrud, Pune – 411038.
Tel. No : 020 –25300006
Fax No : 020- 25300010
pune@mdindia.com
www.mdindia.com |
| 5. |
Nagpur Branch |
51/A, 2nd Floor, Dr. Bhiwapurkar Marg, Dhantoli,
Nagpur - 440 010
Tel. No.: 0712-2420391
Fax No.: 0712-2420393
nagpur@mdindia.com
www.mdindia.com |
| 6. |
Goa Branch |
115/9, 3rd floor, Nevrekar Chambers, Above ING Vysya Bank, M.G. Road, Panjim –403001
Tel.No. : 0832 – 2421982
Fax No.: 0832-2425466
goa@mdindia.com
www.mdindia.com |
| 7. |
Baroda Branch |
216, Lalita Towers,
Behind Railway Station,
Near Hotel Rajpath,
Dinesh Mills Road,
Baroda - 390005.
Tel.No. : 0265-2320602
Fax No. : 0265-2323244
baroda@mdindia.com
www.mdindia.com |
| 8. |
Surat Branch |
904, Meridian Towers, 9th Floor, Near Rajkumar Cinema, Udhana Darwaja, Ring Road, Surat - 395002
Tel.No. : 0261- 2343009
Fax No.: 0261 – 2345335
surat@mdindia.com
www.mdindia.com |
| 9. |
Kolkata Branch |
169, Sarat Bose Road, 2nd floor,
Kolkata - 700026
Tel No. : 033-24632726
Fax No. : 033- 24656633
kolkata@mdindia.com
www.mdindia.com |
| 10. |
Chennai Branch |
1402, H Block, 15th Main Road,
Anna Nagar, Chennai- 600040
Tel.No. : 044- 26162386
Fax No. : 044-26164000
chennai@mdindia.com
www.mdindia.com |
| 11. |
Delhi Branch |
E-98, II Floor, Lajpat Nagar –II,
New Delhi – 110024
Tel.No. : 011- 29811840
Fax No. : 011-29811838
delhi@mdindia.com
www.mdindia.com |
| 12. |
Hyderabad |
3-6-562/1, Above Gayatri Bhavan Hotel, Himayatnagar, Hyderabad-500029.
Tel.No. : 040 –27673865, 27673864, 27673863
Fax No. : 040-27673881
hyderabad@mdindia.com
www.mdindia.com |
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