[Resolved]  Mediassist/medimanage Insurance — Comparing Holep treatment with TURF for BPH

Address: Mumbai City, Maharashtra

I have a corporate Mediclaim policy with MediManage(Mediassist) team, recently my father age 69yrs was diagnosed with Prostrate issue and after a months time he was suggested to undergo a Laser treatment. Now i had been suggested to go S.L.raheja hospital where they told me around 1.85L approx cost.
Since they have a Cashless benefit i spoke to Medimanage team on how to proceed since it takes time for approval and also we have a 20% cap for members.
He has to undergo cystoscopy and HOLEP treatment which i emailed them with doctors reading and recommendations. They came back stating since it falls under the 11 illness it would have a cap of 42000 and only this much will be paid back to me. I saw the illness column and they have mentioned "TURP for BPH" and my fathers treatment is HOLEP(Holmium Laser Enucleation of the prostate) which i spoke to my Doctor and he said its totally different from TURP procedure and uses high end machines laser etc...
medimanage is adamant that they will only pay 42000 as per their TPA advise.

"TURP for BPH" is mentioned in 11 illness and HOLEP is nowhere mentioned and they need to get this reimbursed.

Please help as this guys are taking me for a ride and not ready to reimburse the same

My details:
Prabhakar S
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