Organisation : Vidal Health TPA Pvt Ltd
Service Name : Vidal Health Vire Mobile App
Applicable States/ UTs : Karnataka
Home Page : https://vidalhealthtpa.com/vidalhealthtpa/#mobileAPP
Vidal Health Vire Mobile App
Vidal Health Mobile App is your one stop for all your transactions with Vidal Health for your Health Claims. As your preferred TPA we bring you a whole set of features that you can access right from your mobile phone.
Related / Similar Service :
Vidal Health TPA Get TTK Health Card & Check Status Online Bangalore
Why Use Vidal Health Mobile App
** No More Searching For Your E-Card : View, download and share your E-card in your mobile and use the same at our network hospitals.
** No More Frantic Calls : Get your policy details, claim & Pre Auth status right in your mobile phone.
** Search Our Network Hospitals : Search for the nearest network hospitals, Contact them or ask for route guidance in a map. You can also review the hospitals on their service.
** No More Shortfalls : Missing out on a simple document is delaying the claim processing. Go through our checklist to get all of them right.
** I Want To Call Bangalore, Not Mumbai : No more searching for branch phone numbers and mail addresses. Find all of them in the contact us section.
** Manage Your Health : Access our proprietary health management tools like Doc Round the Clock and Ask Expert for expert advice on health, nutrition and counseling. What’s more get daily health tips on a range of topics to manage your health.
Claim Guide
In simple terms, insurance is a method of sharing the unexpected financial losses of an ‘unfortunate few’ from a common fund formed out of contributions of the ‘many’, who are equally exposed to the same loss (Spreading of the losses of an individual over a group of individuals).
Health Insurance pays for unexpected Hospitalisation expenses of those few insured persons who suffer from illness or injury requiring treatment as inpatient in a Hospital/Nursing Home, out of contributions (Premium) of many insured persons who are exposed to similar health risks.
Refer Cashless Claim Guide to understand the process. ut of contributions of the ‘many’, who are equally exposed to the same loss (Spreading of the losses of an individual over a group of individuals).
Health Insurance pays for unexpected Hospitalisation expenses of those few insured persons who suffer from illness or injury requiring treatment as inpatient in a Hospital/Nursing Home, out of contributions (Premium) of many insured persons who are exposed to similar health risks. Refer Cashless Claim Guide to understand the process.
Frequently Asked Questions
1. What is the TAT to process the pre-authorisation once shortfall query is responded?
Once the shortfall is responded, within 2 hours the case will be processed.
2. What is the procedure to cancel the cashless approval?
Hospital team needs to send the letter/fax/email to Vidal Health Insurance TPA Pvt. Ltd., asking them to cancel the approval. The cancellation letter will be sent to hospital within 2 hours.
3. Is there any time limit to submit the Pre-authorisation request?
Yes. If it is a planned hospitalization then the pre-authorization request needs to be sent before 48 hours from the date of admission. In case of emergency the pre-authorisation request needs to send within 6 hours from the time of admission.
4. Do I need to pay any amount to the hospital while getting discharged for Cashless hospitalisation?
Yes. The policy holder needs to pay the non medical expenses and the co-pay amount (if applicable). He will need to pay the difference amount (difference between the final bill and approved amount).
5. What are Non-Medical expenses?
Non Medical expenses are : Admission fees, Registration fees, gloves, blade, water bed, food & beverages, extra bed etc.,
6. Is there any minimum time limit for stay in the hospital?
Minimum 24 hours of hospitalization (if not day-care) with active line of treatment is required for cashless treatment
However, there are a few specific ailments specified in the policy which can be covered even though the period of hospitalization is less than 24 hours. Such as Dialysis, Chemotherapy, Radiotherapy, Eye Surgery etc.,
7. What is Cashless Rejection ?
Rejection will be done as per the policy terms and coverage, the below are the few examples for rejection.
a. If hospitalization is for observation & investigation purpose
b. If any particular aliment/disease/treatment is found not covered under policy term and condition
c. If found that the treatment can be done under OPD basis
d. If found that no active line of treatment is available
e. If Shortfall and the policy holder has not responded within the given TAT
f. If policy is invalid
g. Rejection of cashless is not a denial of treatment
8. What if the cost exceeds the level of hospitalization insurance cover ?
In such a situation the policy holder will be liable to pay the difference amount. We will inform the hospital about the policy holder’s eligible amount and hospital will recover the amount over and above the credit amount from the policy holder directly.
9. What are the different types of Claims ?
Member Claim and Network Claim (for Hospital)
10. How will I be intimated about the Claim ?
Policy holder has to intimate Vidal Health Insurance TPA Pvt. Ltd., before sending the claim documents if he/she wants to claim after discharge, Intimation has to be given within the TAT as per the insurance company.