Health Administration
Claims can be remitted in the following 2
ways
Cashless Claims
Reimbursement Claims
Health Administration
Customer approaches Bajaj Allianz
Network Hospital for Cashless Treatment
Hospital verifies customer details and send
pre-auth by email/fax to Bajaj Allianz – HAT
Bajaj Allianz verifies pre-auth details with
policy benefits and send response to Hospital
Hospital
Approved Query Denial
Approval letter sent Query letter sent by Denial letter sent by
by Bajaj Allianz Bajaj Allianz to Hospital Bajaj Allianz
Hospital admits the patient Hospital responds to the Hospital Admits the Patient as
Without any deposit and Queries Asked by Cash Patient and Patient has to
Provides Cashless treatment Bajaj Allianz Pay the Bill
Health Administration
Get the Pre-authorization done in advance
Pre-authorization is done to determine whether cashless facility can be granted
based on all medical information about your ailment and coverage
Pre-authorization forms are available at NETWORK hospitals
Your treating doctor has to fill the form and sign it
You will also have to sign the Pre Authorization form
The hospital will email/fax this form to us to get an authorization
Our doctors will examine the form and decide on cashless admissibility
If cashless is granted, we will send an authorization letter to the member
and the hospital
Carry your ID cards and authorization letter when you go to the hospital for
admission
If cashless is denied, we will send a denial letter to the hospital and inform you
In a planned case, the hospital will not admit you without the authorization letter
even if you are carrying the Health Card
The TAT for issuing Cashless Authorization is 45 min to 1 hr from
receipt of Pre-Authorization Request on Weekdays
Health Administration
Contact our Call Centre and inform them about the nature of emergency
If possible, always go to a network hospital
If not, then go to the nearest hospital
In a network hospital, the patient can be admitted by showing your Bajaj
Allianz Health Card
After admission, the pre authorization has to be done
Our doctors will inform you and the hospital if cashless can be given
The hospital will ask you for a deposit incase there is denial of cashless
Health Administration
Preliminary scrutiny of claim &
Verification of:
- Policy Benefit
- Date of Loss
- Mandatory Doc.
Deficient Repudiated
(Some Document required (Not falling within policy
Approved
(Admissible under policy)
For Admissibility) Terms & Conditions)
Intimation of the Denial Letter Claim Payment via
Deficiency sent to client NEFTsent to client
is sent to the client
Reply received along Reply not Consequent reminders Documents Claim closed
received sent at fixed intervals not received without payment
with all
deficient documents
Health Administration
Claim Intimation to be done within 7 working days from the Date
of Discharge. All the claim documents should reach within 30
days from the Date of Discharge.
Claim form duly filled and signed by the claimant.
Discharge summary in original.
Consolidated hospitals bill with bill break up.
Original payment receipts.
Original investigation reports & films (e.g. X-ray, ultrasound etc.).
Consultation receipts with prescriptions.
Medical bills with prescriptions.
Other documents, if required (pre & post hospitalization bills)
GPLA Certificate or Obstetric History in Maternity Cases
Main hospital bill with break-up of medicines etc.
All investigation/lab. reports.
Advice from treating doctor for the medicines purchased/tests done outside
thehospital during hospitalisation period.
Pre & post hospitalisation bills supported with prescription/advice of treating
doctor.
The TAT to reimburse a claim after complete submission of documents is 7-10 days.
Health Administration
Cashless:
preauth@bajajallianz.co.
in
Reimbursement
hat@bajajallianz.co.in
HAT:
24 X 7 Helpline
1800 209 5858 (Toll free Any Landline /
Mobile)
1800 209 7073 ( Cashless team Health
claims )
020 30305858 (STD)
hat.helpline@bajajallianz.c
o.in
hat@bajajallianz.co.in
Health Administration
ImportantLinks
• E Card Download Link :
• https://hcm.bajajallianz.com/BagicHCM/Health_Ecard/hlth_idcrddwn.jsp
• List of Network Hospital :
https://general.bajajallianz.com/BagicNxt/hm/hmSearchStat
e.do
• Claim Status :
https://general.bajajallianz.com/BagicNxt/InHouseSP/hm/externalUser
CC.jsp
• Check Claim Status by SMS as well :
• Claim status on SMS: Type CSTATUS <space> ID Card NO and send to
9773500500
Health Escalation matrix :
Details Name Designation Phone No. Email Id
Rohan
Primary Sharm
Contact a Sales Support +91- 8587800197 Rohan.Sharma@bajajallianz.co.in
1
Relationship Manager
Nil Kamal
Escalation Kunwar +91-9599223582 Nil.Kunwar@bajajallianz.co.in
Health Administration
Team
