Standard Guide Book

Cashless Service

Cashless hospitalization can be availed only at a hospital that falls within your insurer network, upon approval of your preauthorization application.

1. Search for a network hospital:- Navigate through Hospital Network- Select your Insurer.
2. During admission, present your Good Health Card id along with any other valid Government ID. (Click on <<Ecard link>> to download Ecard)
3. Ensure that the hospital sends your preauthorization form to Good Health TPA (preauth@ghpltpa.com). You will receive updates on the status of your cashless on the registered Mobile no and Email.
4. We shall send the approval to you and the hospital. Further enhancement approvals may be issued on request, subject to the terms and conditions of the policy.
5. In case the request cannot be approved or if the expenses are not covered by your policy, you will have to settle the hospital bill in full and subsequently raise a reimbursement claim after discharge. Do remember that denial of a preauthorization request must not be construed as a denial of treatment or denial of coverage.
6. During discharge, ensure to sign Hospital related documents for the further claim process.
7. After discharge, the hospital will send all the documents related to your claim to Good Health for settlement.

Submit a claim

• For Hospitalization in any non-network hospital, ensure to intimate about your hospitalisation well in advance in case of planned admission or with in 24 hrs of admission in case of an Emergency.
• Attain all original documents at the time of Discharge from Hospital.
• Submit Hospitalization claim at any Good Health office (<<Office locations link>>) within 15 days from Date of Discharge
• Good Health shall process the claims:
  • Incase of Approval, Amount will be reimbursed through NEFT
  • Incase of Query/Denial- same shall be intimated by a mail/Letter to you.
• Documents that are to be submitted

• IRDA Claim form – Duly filled and signed
• Copy of Good Health ID
• Copy of a valid Govt.Photo Id proof
• Original discharge summary
• Original hospital final bill
• Original numbered receipts for payments made to the hospital
• Complete breakup of the hospital bill
• All original investigation reports along with prescriptions
• All original medicine bills with relevant prescriptions
•  current policy copy and previous years’ policy copies (if any)

• Covering letter stating your complete address, contact numbers and email address or any intimation information (if available).

Dos and Don’t

Do’s

• Obtain pre-authorization from Good Health 2 days prior to admission for planned admissions
• Produce the ID card and obtain pre-authorization letter for availing admission and cashless treatment.
• In case preauthorization is not obtained by the policy holder from Good helath, ensure that the NWH obtains it prior to admission.
• Leave back all the original documents and the signed claim form with Hospital  at the time of discharge.
• Contact local Good Health office or callcentre in case of any query.
• Make the payment to the Hospital for the expenditure over and above the eligible limit and for the Non-Reimbursable items under the mediclaim policy.
• In case of emergency produce the ID card for availing cashless hospitalization from Hospital. Ensure that the Pre-Authorization is acquired from Good Health within 24 hours of admission under Emergency.
• In case of availing treatment at Non listed Hospital, inform GHPL about the admission and forward the complete documents and claim form with signature within 7-15 days from discharge.

Don’ts

• Don’t insist upon admission for investigations or evaluation purpose.
• Don’t carry back any original document at the time of discharge from the hospital for Cashless admission
• Don’t forget to sign on the Claim Form.
• Don’t insist on planned admission at Hospital without obtaining the preauthorization from Good Health.

Download E Card

How to Obtain Ecard

1. Log on to www.goodhealthtpa.com and click ‘Download E-Card’.
2. Enter your Good Health ID/employee ID/ policy number or your claim ID.
3. Fill all the other mandatory fields and click ‘View’ to verify and confirm your details.
4. You can now download the E-Card.