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Medi Assist TPA: Benefits, Claim Process and Hospital List

Oct 30, 2023


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Group Health Insurance Policy

Medi Assist TPA: Benefits, Claim Process and Hospital List

About Medi Assist TPA

Medi Assist TPA is one of India’s leading IRDA-approved Third-Party Administrators with a network of more than 15,000 network hospitals and tie-ups with 30+ Group Health Insurers in India. They were also awarded India’s best Third-Party Administrator by Asia’s Insurance Awards in 2020. Medi Assist TPA is a trusted partner for organizations seeking a TPA for efficient Claims Process under a Group Health Insurance Policy.

A Third-Party Administrator (TPA) is one of the most important factors to consider when purchasing a Group Health Insurance Policy. A TPA is an intermediary between the Group Health Insurance Company and the Policyholder. A TPA is responsible for Issuing E-Cards for Group Health Insurance Policy, increasing network hospitals for policyholders to avail cashless claim settlement and Claims Servicing.

What are the Benefits of Medi Assist TPA?

Extensive Network of Hospitals and PAN India Presence: There are around 11000+ Medi Assist TPA network hospitals in India where the employees can avail cashless claim settlement. The company also has a PAN India presence through its network of 27 offices throughout the country.

Quick Claims Settlement: Medi Assist has an excellent and a quick claims settlement process for Group Health Insurance Policy. Medi Assist TPA has settled over 60 lakh plus claims.

Digital Platform: Medi Assist has a great digital platform allowing the policyholder to do everything from intimating a claim, download E-Cards, download Claim Forms etc. at the click of a button.

What is the Process for Availing Cashless Claims Settlement at Medi Assist TPA?

In a Cashless Hospitalization Claim, a policyholder can be admitted to a hospital and receive necessary treatment, for which the Group Health Insurance Company settles the bills directly with the hospital. The Insured Employee does not need to bear any expenses out of his own pocket.

Availing Cashless Claims Settlement at Medi Assist TPA is a simple and straightforward process. Here’s a step-by-step guide to avail cashless claims settlement at MediAssist TPA.

  • Network Hospital: Visit the Medi Assist Portal to find a hospital that falls within your Group Health Insurer network.
  • Submit Pre-Authorization form: Ensure that the hospital sends your preauthorization claim form to Medi Assist with relevant information like policy number, reports, bills and estimated treatment cost.
  • Approval: MediAssist TPA will review the request and communicate the approval or denial of the claim to the hospital and policyholder.
  • Cashless Treatment: If the claim settlement request is approved, the policyholder can proceed with the treatment without paying for the hospitalization expenses. After discharge, the hospital will send all the documents related to your claim to Medi Assist for settlement.

Medi Assist TPA – List of Network Hospitals

You can view the entire list of Network Hospitals with Medi Assist TPA by clicking on the following link

Medi Assist TPA list of Network Hospitals

Qian assists its clients with the entire cashless claims process in a Group Health Insurance Policy. The dedicated claims settlement team at Qian will intimate the claim and follow up with the Cashless Claim Team at Medi Assist regarding Claim Status and documentation and ensure quick claims settlement for the employee. If you wish to purchase a Group Health Insurance Policy with Qian, you can email us at support@qian.co.in

What is the Process For availing Reimbursement Claims Settlement at MediAssist TPA?

Reimbursement Claims Settlement means that the Policyholder pays the hospital bills first out of his own pocket and then gets the expenses reimbursed at a later stage. Medi Assist TPA provides the added advantage of submitting reimbursement claims online. Below is the step-by-step guide to submit reimbursement claims at Medi Assist TPA.

  • Intimate Claim to Medi Assist TPA: Login to the Medi Assist app or portal and click the “reimbursement” tab, fill in the required details and Intimate the claim
  • Upload Documents online: Upload a scanned copy of the required documents along with a completed copy of Mediassist reimbursement form on the app or portal.
  • Claim Processing Medi Assist: Once you upload the documents on Medi Assist TPA, they will verify if all the necessary documents are submitted. They will inform you if any documents are missing or if further information is required.
  • Send Hard Copies of Claim Documents: Medi Assist initiates claim settlement upon receipt of scanned copies. However, to complete the process, you must send the hard copies of bills and documents within 15 days from the discharge date. Claims are settled only upon receipt of hard copies, ensuring faster processing and verification of reimbursement claims through this two-way approach.

What are the list of Documents that need to be submitted to Medi Assist TPA For Reimbursement Claims?

The list of documents to be submitted for reimbursement claims at Medi Assist TPA are listed below:

  • Original Hospital Bill with Complete Breakup and Receipts for payments made to the hospital
  • Original Discharge Summary
  • Original Investigation Reports along with prescriptions
  • Original Pharmacy Bills with relevant prescriptions
  • Duly Signed Mediassist Reimbursement Form (Part ‘A’ should be filled and signed by claimant and Part ‘B’ should be filled and signed by Hospital)
  • ID Proof along with Health Insurance ID Card

The above-mentioned documents need to be couriered to Medi Assist Office. Find the complete list of Mediassist TPA offices here.

How do I Track Reimbursement Claim Status at Medi Assist TPA?

At Medi Assist TPA, you can keep track of your claim based on your Claim Number, Medi Assist ID or Employee ID. Follow these simple steps below to track your claim status.

  • Go to medibuddy.in/claim and enter your details to search for the claim details.
  • Opting for SMS alerts is another good way of keeping track of your claim. Just SMS “CLAIMS ” to +91 96631 49992 to obtain real-time status of your claim.

Policyholder Benefits at Medi Assist TPA

The online portal of Medi Assist TPA provides several benefits for the policyholder with easy and quick processing. You can avail following benefits at Medi Assist TPA.

Download ECard – You can download your Medi Assist ECard anytime from the online portal, by inputting either your Medi Assist ID or employee ID.

Intimate Claim – Intimating your claim is now very easy for a reimbursement claim. Just log into Medi Assist TPA online portal and submit all your documents online to have your claim reimbursed faster.

Preplan Hospitalization – If you’re planning a hospitalization, you can also preauthorize your hospitalization claim 48 hours before your hospitalization. By preplanning your claim process, you can avoid long queues at the time of admission.

Download Claim Forms – You can also download Medi-Assist Claim Forms online which prevents unnecessary hassles at the time of emergency hospitalization.

With all these added benefits, Mediassist TPA stands out as the preferred TPA for policyholders due to its ease of processing and efficient claims settlement process.

Medi Assist Customer Care: How do I contact Medi Assist TPA?

You can get in touch with Medi Assist TPA with the following options:

Customer Support Helpline: You can reach out to Medi Assist TPA ‘s dedicated call center assistance at 1800 208 9449**.** The team will address queries related to your policy or claim settlements.

Email: You can write your queries to info@mediassist.in or submit a query through the online portal.

Chat on Whatsapp: You can also chat with them in real-time by dropping a ‘Hi’ on the number +91-70266 69449.

The Bottomline

Mediassist TPA is one of the leading TPAs in India with an extensive hospital network, ease of online processing and comprehensive support.

You also need an experienced Group Health Insurance Broker to assist you in comparing Group Health Insurance Coverages and Quotes. Qian is a licensed Group Health Insurance Broker with experience of serving leading corporates for their Group Health Insurance Policies and tie-ups with leading Group Health Insurance Providers and a dedicated claims settlement team.

If you wish to purchase a Group Health Insurance Policy, you can email us at 📧 support@qian.co.in. We would be glad to assist you.

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