Insurance

1. Does Daya General Hospital provide cashless insurance facility?

Yes, we offer cashless hospitalization for patients covered under empaneled insurance companies and TPAs, subject to policy terms and approval.

2. Is treatment completely free under insurance?

No. Insurance covers only eligible expenses as per your policy. Any non-admissible charges, co-payment, ailment capping, proportionate disallowance, etc., must be paid by the patient at the time of discharge.

3. What documents are required for cashless admission?

You need to submit:

• Valid insurance card / e-card and recent policy copy
• KYC documents of the main proposer (policyholder): Government ID proof (Aadhaar), PAN card, and passport-size photo
• Government ID proof of the patient, if the patient is not the main proposer
• Doctor’s advice / admission notes
• All treatment records related to the current ailment and comorbidities, if any

4. How long does it take to get insurance approval?

• Planned admission: Usually 4–6 hours after submission
• Emergency cases: Initial approval within a few hours, subject to insurer response

5. What if my insurance approval is delayed?

The patient may be asked to pay the hospital bill as a caution deposit to proceed with treatment. Once approval is received, billing will be adjusted accordingly.

6. What happens in emergency admission?

• The patient will be admitted immediately
• Insurance request will be sent within 24 working hours
• Cashless facility depends on insurer approval based on policy terms and conditions

7. What if my requested amount is partially approved?

Hospital will request enhancement. If not approved, balance amount must be paid by patient.

8. What expenses are not covered under insurance?

Common exclusions include:

• Registration / admission charges
• Food (non-medical diet)
• Attender charges
• Personal items (toiletries, etc.)
• Certain non-medical expenses and consumables

9. Can I use insurance for all treatments?

No. Coverage depends on policy terms, waiting period, pre-existing diseases and medical necessity.

10. What is reimbursement claim?

If cashless is not approved, patient pays full bill and later claims reimbursement from insurer with required documents.

11. What documents will I receive at discharge?

• Final bill copy
• Discharge summary
• Investigation copies upon request

12. What if my insurance claim is rejected?

Patient is responsible for full payment. Our insurance desk will assist in clarification or resubmission.

13. Does Daya Hospital accept government insurance schemes?

• ECHS (Empaneled departments only)
• ESI (Empaneled departments only)

14. Can I upgrade my room during insurance admission?

Yes, but room eligibility depends on your policy. Upgradation may lead to proportionate deduction.

15. When should I contact the insurance desk?

• Before planned admission
• Immediately after emergency admission
• For any clarification regarding approval, billing, or discharge

16. Who should I contact for insurance assistance?

Our Insurance Help Desk is available at the hospital to assist with:

• Pre-authorization
• Cashless claim processing
• Billing clarification

Our team at Daya General Hospital is committed to making your insurance process smooth, transparent, and patient-friendly.