Here we are going to discuss about what is TPA in Health Insurance, TPA main uses and List of TPAs with contact details
TPA in health insurance is also called as Third-Party Administrator. TPA main role is to process health claims behalf of Insurance companies. TPA holds a valid licence from IRDA. TPA has to get licence from IRDA before starting its functions. One TPA can provide services to many Insurance companies. In same way An Insurance company can have many TPAs. TPA will be paid by Insurance company for each Health policy attached to TPA as a TPA charge at the time of commencement of each policy.
Some Insurance companies settle health claims without any TPA. This particular companies have an in-built trained team for processing and settling claims. Policy holder (Insured) have a choice to select TPA services or not. Policy holder need not to pay any amount to TPA for processing their claim.
TPA have network hospitals to provide cashless services to Policy holders. It not necessary to take treatment from the network hospital. Insured can go for Reimbursement process also. They can go for a hospital of their choice and all required documents to be submitted to TPA for further claim processing.
A hospital having a tie up with Insurance company or Third-Party Administrator for treatment of Policy holder. Claim amount will directly transfers to Hospital account. Customer have to pay any balance payment is pending.
In network hospitals TPA will have packages for treatments and all documents will be shared to TPA by hospital. TPA will approve claim amounts behalf of Insurance company. Approved claim amount will be transferred to Hospital account directly from Insurance company.
Cashless process is a hassle free and Insured have no role except submitting valid ID proof, Insurance policy and TPA ID card. Once TPA approved for treatment Policy holder can relax.
Reimbursement process Insured can take treatment from any hospital. But required documents have to submit to TPA along with proof of treatment. Then TPA experts will examine the claim documents and process of treatment and other proofs for supporting the treatment.
Reimbursement process is Tedious process. Every document has to submit by Policy holder and every query has to reply by Policy holder only. Only good thing is Insured can go for treatment from a hospital of his wish.
List of TPAs in India
Following are the list of TPAs in India with their address, customer care numbers, e-mail id and official website.
|TPA Name||Name of CAO / CEO / Address||Contact Details|
|Medvantage Insurance TPA Private Limited (formerly known as United Health Care Parekh Insurance TPA Private Limited)||Mr. Shiva Belavadi, Chief Administrative Officer,3B/1 Gundecha Onclave, Kherani Road,Saki Naka, Andheri (East), Mumbai – 400 072||Senior Citizen Helpline No.: 022 49337781 Toll Free No.: 1800 209 8884 Email: [email protected] Website: www.uhcpindia.com|
|Medi Assist Insurance TPA Private Limited||Mr. Surendra Tiwari, Chief Administrative Officer Tower D, 4th Floor, IBC Knowledge Park, 4/1, Bannerghatta Road, Bangalore, 560029||Senior Citizen Helpline No.: 1800 419 9493 Toll Free No.: 1800 425 9449 Email: [email protected] Website: www.mediassist.in|
|MDIndia Health Insurance TPA Private Limited||Mr. Suresh V. Karandikar Chief Executive Officer S.No. 46/1 E-space A-2 Building, 3rd Floor, Pune-Nagar Road, Vadgaonsheri, Pune – 411 014.||Senior Citizen Helpline No.: 020-25300126 Toll Free No.: 1800 209 7777 Fax : 1860 233 4449 Email: [email protected] Website: www.mdindiaonline.com|
|Paramount Health Services & Insurance TPA Private Limited||Dr. Nayan Shah Chief Executive Officer Plot No. A-442, Raod No. 28, Ram Nagar, MIDC Industrial Area, Wagle Estate, Thane (W) – 400 604||Senior Citizen Helpline No.: 022 66629813 Toll Free No.: 1800 22 66 55 Email: [email protected] Website: www.paramounttpa.com|
|Heritage Health Insurance TPA Private Limited||Mr. Manash Chakraborty, Chief Administrative Officer NICCO HOUSE, 5th Floor, 2, Hare Street, Kolkata-700001||Senior Citizen Helpline No.: 033 40145100 Toll Free No.: 1800 345 3477 Email: [email protected] Website: www.heritagehealthtpa.com|
|Family Health Plan Insurance TPA Limited||Ms. G. Bharathamma Chief Executive Officer No: 8-2-269/A/2-1 to 6, 2nd Floor Srinilaya Cyber Spazio, Road No. 2, Banjara Hills, Hyderabad – 500 034.||Senior Citizen Helpline No.: 1800 102 4273 Toll Free No.: 1800 102 4033 Email: [email protected] Website: www.fhpl.net|
|Raksha Health Insurance TPA Private Limited||Ms. Palak Dhall Chief Administrative Officer C/o Escorts Corporate Centre 15/5, Mathura Road, Faridabad, Haryana – 121 003||Senior Citizen Helpline No.: 1800 180 1555 Toll Free No’s: 1800 180 1444, 1800 220 456, 1800 425 8910 Email: [email protected] Website: www.rakshatpa.com|
|Vidal Health Insurance TPA Private Limited||Mr. Rajan Subramaniam Chief Executive Officer First Floor, Tower No. 2, SJR iPark, EPIP Zone, Whitefield, Bangalore – 560 066.||Senior Citizen Helpline No.: 080 46267070 Toll Free No.: 1860 425 0251, 080 46267018 Email: [email protected] Website: www.vidalhealthtpa.com|
|East West Assist Insurance TPA Private Limited||Mr. Malay Kumar Lala Chief Administrative Officer 38, Golf Links, New Delhi – 110003||Senior Citizen Helpline No.: 011 47222647 Ph. No.: 011-47222666 FAX: 011-47222640 Email: [email protected] Website: www.eastwestassist.com|
|Medsave Health Insurance TPA Limited||Mr. S. Aravamuthan Chief Administrative Officer F-701A, Lado Sarai, Mehrauli, New Delhi – 110030||Senior Citizen Helpline No.: 9319810070 Toll Free No.: 1800 111 142 Email: [email protected] Website: www.medsave.in|
|Genins India Insurance TPA Limited||Dr. Sumit Garg Chief Administrative Officer D-34, Ground Floor, Sector-2 Noida – 201301 (U.P.)||Senior Citizen Helpline No.: 0120 4144100 Toll Free No.: 1800 890 2359 Email: [email protected] Website: www.geninsindia.com|
|Health India Insurance TPA Services Private Limited||Mr. Kamaljeet Gupta Chief Administrative Officer Neelkanth Corporate Park, Office No. 406 to 412, 4th Floor, Kirol Road/Village, Vidya Vihar Society, Vidya Vihar (West), Mumbai-400086||Senior Citizen Helpline No.: 1800 2269 70 Toll Free No.: 1800 2201 02 Ph. No.: 022-40881000 Email: kam[email protected] Website: www.healthindiatpa.com|
|Good Health Insurance TPA Limited||Ms. Saigeeta Dikshit, Chief Administrative Officer Suite 403 – 406A, 4th Floor, Ashoka My Home Chambers, Behind Ashok Bhoopal Chambers, Sardar Patel Road, Secunderabad, Telangana State – 500003||Senior Citizen Helpline No.: 1800 102 9919 Toll Free No.: 1860 425 3232 Email: [email protected] Website: www.ghpltpa.com|
|Park Mediclaim Insurance TPA Private Limited||Mr. Anurag Bhatnagar Chief Executive Officer 702, Vikrant Tower, Rajindra Place, New Delhi-110008||Senior Citizen Helpline No.: 9821236752 Toll Free No.: 1800 11 55 33 Email: anur[email protected] Website: www.parkmediclaim.co.in|
|Safeway Insurance TPA Private Limited||Mr. Mahesh Sharma Chief Executive Officer 815, Vishwa Sadan, District Centre, Janakpuri, New Delhi-110058||Senior Citizen Helpline No.: 011 45451300 (Ext: 206) Toll Free No.: 1800 102 5671 Email: [email protected] Website: www.safewaytpa.in|
|Anmol Medicare Insurance TPA Limited||Mr. P. S. Kshatriya Chief Executive Officer 2nd Floor, NBCC House, Opp. Ahmedabad Stock Exchange, Ambavadi, Ahmedabad – 380015, Gujarat||Senior Citizen Helpline No.: 07961609990 Toll Free No.: 1800 233 1999 E-mail: [email protected] Website: www.anmolmedicare.in|
|Rothshield Insurance TPA Limited||Ms. Janki M Bhate Chief Executive Officer 402, Raheja Chambers, Nariman Point, Mumbai 400 021||Senior Citizen Assistance: [email protected] Toll Free No.: 1800 228 144 Email: [email protected] Website: www.rothshield.co.in|
|Ericson Insurance TPA Private Limited||Ms. Punam Singh Chief Administrative Officer 11-C, Corporate Park, ST Road, Chembur, Mumbai – 400 071 (Maharashtra)||Senior Citizen Helpline No.: 022-25280208 Toll Free No.: 1800 22 2034 Email: [email protected] Website: www.ericsontpa.com|
|Health Insurance TPA of India Limited||Ms. Smita Srivastava Chief Executive Officer 2nd Floor,Majestic Omnia Building, A-110, Sector-4, Noida 201301 (Uttar Pradesh)||Senior Citizen Assistance: [email protected] Toll Free No.: 1800 180 3600, 1800 102 3600 Email: [email protected] Website: www.hitpa.co.in|
|Vision Digital Insurance TPA Private Limited||Ms. Priyanka Jain Chief Administrative Officer Time Square Building 3rd & 4th Floor, Sushant Lok-1, Block-B, Gurugram – 122002||Toll free no: 1800-419-9982 Ph. No.: 0124-4003171 Email: [email protected] Website: www.visiontpa.in|
Main Functions of TPA
- Issuing TPA ID cards to Policy holder
- Maintenance of Health records of Insured
- Processing Cashless claims
- Processing Reimbursement claims
- Maintaining Good Network hospitals
Is TPA mandatory for health policy?
No, TPA is not mandatory for health policy. Insured have a choice whether TPA to be added or not to his policy. But having a TPA in health policy will smoothen your claim process.
Is TPA will work for only one insurance company?
No, TPA will work for multiple insurance companies. Same way insurance company will have multiple TPA’s.
Is TPA will provide service to Reimbursement claims?
Yes, once TPA added to a policy it has to provide service whether it is a cashless claim or reimbursement claim.
Where we can find TPA Network hospital list?
You can find TPA network hospital list in official websites
Is health claim will be settled by TPA?
TPA will service for claim processing and will approve claim amount in behalf of insurance company but final payment will be done from insurance company only.