Kokilaben Hospital — grievance related to tpa team

Address:

Bell heaven CHS, marol andheri east, Mumbai City, Maharashtra, 400059

We like to highlight challenge faced while processing documentation for tpa at kokilaben hospital, which has led me to write such email on said subject.

We had done submission for pre-authorized approval on 27th dec 2019, at 3:00pm and received approval by 6:10 pm from medi-assist, same day. On 2nd jan my wife mrs. Raji nair had chemotherapy treatment at kokilaben hospital day care and we got discharge summary at 5:30 pm and we had submitted to tpa team at 6:00 pm (Refer attached screen shot of sms received to me at 5:56 pm)

Simultaneously, i was following up with my insurance company to approve the request which was supposed to receive from kokilaben hospital, refer attached email for reference. I had even spoken with tpa team and they confirmed that email had been sent to medi - assist at 6:30 pm. So, i waited half an hour for approval and checked with insurance company for which they confirmed that no email was received from kokiliaben for above patient.

I had request kokilaben tpa staff to share the email with me so i can support them with approval, which they were not able to support, since no such email was sent to insurance company by kokilben tpa staff and staff was just misleading with the information. Post argument they send another email to medi-assist team with incorrect claim id as[protected], instead of 99933154 which totally blunder done by the staff and even they are not able to read and write the number properly in email, post 8:30 pm tpa staff informed me that due to insurance company communication gap they will not able to support and i have to pay the charges in cash/card for which i was stunned to hear such service lap from kokilaben hospital staff.

I am unable to understand my mistaken/gap due to which such scenario was arise and i have to run to arrange money for discharge (“tpa staff showed me whole bunch of stars running around my head”) i am also sure that such incident will occur in near future, since tpa staff will remain the same with same work attitude and other patient/again me will impact with “sloppy work”.

I am attaching the complete detail for your reference and do correct me if my understand is incorrect and support me to avoid such incident in near future for other patients

Looking forward for communication for said subject and hope we will get the required service which we are paid for it / clear my expectation.