[Resolved]  Bharti Axa Health Insurance Tpa Mediassist — denial of cashless facility saying it is op basis treatment

Address:

Hyderabad, Andhra Pradesh

k.vishnu vardhan MAID [protected](bharatiAXA General insurance--mediassist india tpapvt ltd) applied for cashless facility at KIMS HOSPITAL ,HYDERABAD for 100 millicurie Iodine 131 radiation ablation therapy dose FOR ABLATION OF REMANANT THYROID TISSUE AS IAM DIAGNOSED WITH FOLLICULAR CARCINOMA OF THYROID. ihave been denied cashless facility and when i contacted the customer service today i have been told the reason is--- it is an out patient treatment and hence cashless facility is denied. when i tried to explain that a patient with 100 mCi I 131 dose is to be isolated for minimum 24 hours due to radiation harzard to other people and the dose at discharge is to be less than 15 millicurie before patient is to be discharged from hospital---- i am being told we cannot help you as the cashless facility is denied on consideration that it is op basis treatment.
hence can try with reembursement and my luck. i have also explained that earlier 50 millicurie dose which was administered at apollo hospital hyderabad i- care has given cashless treatment and now with double the dose being administered iam being denied cashless facility by mediassist saying that it is outpatient basis treatment.
AERB IS THE REGULATORY BOARD FOR SUCH TREATMENT GUIDE LINES AND THEY SUGGEST THE PATIENT IS TO BE DISCHARGED ONLY WHEN THE WHOLE BODY RADIO IODINE 131 RADIATION LEVEL IS LESS THAN 15 MILLICURIE
THIS particular denial of cash less facility for such isolation treatment citing that its op basis treatment is causing me lot of inconvenience as i have to arrange for the expenses with in a short notice period. i even wanted to talk to higher officials in mediassist regarding this which they are not allowing and want me to try my luck with reembursement. mobile no [protected]