I had cataract surgery in your Vellore branch on 05.05.2023. My phone[protected]. MR NO VLC/159425/23..Initial consulting done in velachery branch. Testing and surgery done in Vellore. My package cost is Rs 50, 328/-
Surgery completed at 11.15 am. Cashless
Insurance proposal sent after 1.15 only.
To this proposal star health Insurance company restricted a sum of Rs 4, 264/-.
I paid this amount from my pocket.
Today I contacted the star health insurance for reason for the deduction. They replied that your hospital insurance team has not submitted the detailed invoice bill for the implant in complete shape( ie lens I understood). Only because of this, insurance company restricted the claim. If you had submitted all details in complete shape, I could have been sanctioned Rs 4, 264/ more. It is evident that your insurance team is not at all bothered about patient welfare. They simply know if insurance company doesn't pay, then patient is going to pay. So, They are confident that They are not going to suffer and also no one is monitoring this team in depth. Also all patients are not aware of their rights.
If you are patient friendly, Please check your proposal, check the approved letter from the insurance company, contact in insurance company to check the complaint in my statement is true, then take action to rectify the same.
Then
1. I now request you to send me a original detailed bill for Rs 50, 328-including the detailed invoice bill for implant in which only claim is restricted so that at least, I can apply for reimbursement of this restricted amount. ( you may know reimbursement is very delayed process)
2. Also, please send all test report in original, which were carried out for Rs 3, 015/- before surgery, so That I can reimburse this pre hospitalisation expenses.
3. SINCE THIS IS A PACKAGE BASED TREATMENT, YOU COULD HAVE SENT THE CASHLESS PROPOSAL EARLY, ie proposal was sent after 2 hours of cataract surgery.
My phone[protected].
Thank you
Baalakrishnan KS
Now at Vellore.
[protected]@gmail.com
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