ANYUTA
MANAGED HEALTHCARE
Anyuta Medinet Healthcare Insurance Company
TPA in Healthcare Private Limited Financier
Healthcare Service Provider
24Hour Help Line
For Emergency and all Health related Services,
Contact AMHPL 24 Hour, Help Line - 1800 425 1111.
Dedicated Help Line: 98450 10136
Phone: # 080 26638876 / 22210205. Fax: # 080 26638876
E-mail: anyutamedinet@hotmail.com. anyuta.anyuta@gmail.com
Website: www.anyuta.org
Address: # 73, Kanakapura Road, IOC Petrol Bunk Complex.
Banashankari, Bangalore-560 070.
In crisis you are not alone
ANYUTA MEDINET HEALTH CARE
TPA I N HEALTHCARE PRI VATE LI MI TED.
The Anyuta Medinet Healthcare TPA in Healthcare Private Limited (AMHPL) is a Third
Party Administrator in Healthcare (IRDA License No 017) providing Healthcare through
its networked Hospitals, Nursing homes, Diagnostic Centers, Clinics, and Doctors and
other Healthcare providers across the country to the insured and Non – insured people.
We aim at making, quality Healthcare Affordable and Available to every Indian.
Affordability is made possible by Risk pooling, Standardizing the Medical
Documentation and Accounting System along with Transparency. The Availability is
made possible by integrating the Public and Private Sector Healthcare Delivery System.
Our investment in the Research and Development in the field of Healthcare Financing,
Delivery System, Documentation and Accounting, resulted in a win – win situation for
the Healthcare Financiers, Healthcare Provider Network and the Policyholders.
For the R&D work, we selected one Public Sector Company, The New India Assurance
Company Limited (NIAC), one healthcare Product, Universal Health Insurance Scheme
(UHIS), dedicated Network of Hospitals and a group of dedicated doctors, practicing
ethical medicine. This resulted in a Health care System, with inbuilt checks and
balances, creating a marginal surplus to all the stakeholders and giving the best of
healthcare to the Policyholder.
Anyuta wants to take this forward with people participation and hence requests to
exercise their Individual and Corporate Social Responsibility to make this world a better
place to live. Together we can wean the people depending on the Government for
their healthcare needs. Healthcare is not the government’s responsibility only, it is ours
too. This is the way to help ourselves and those people in pain and misery.
We request you to follow `Anyuta Managed Healthcare ` guidelines to get the best of
the existing Healthcare infrastructure and also participate to create National Health
Service, by the people and for the people that you could be proud of.
You’re ID card
This is not a Credit but a Cashless Health Card, to identify you as the beneficiary of the
Health Insurance and to give access to our Network Hospitals willing to provide
Cashless Services by signing the MOU.
Secure your ID card and carry it with you at all times. Quote your Anyuta ID Card No.
when you call our Helpline.
Information about AM H – TPA -IHPL Network of Service P roviders
AMH-TPA-IHPL Healthcare provider network consists of reputed Doctors, Nurses,
Paramedics, Hospitals, Nursing Homes, Daycare Centers, Group practices, Dentists etc,
with in India.
Remember the Insurance money is your money, use it carefully. Cashless Services
(subject to terms and conditions of your policy.) is possible In the Network Hospitals,
Nursing Homes, etc. To get the money’s worth it is better for you to discuss the health
problems with the Primary Physician, understand the benefits of Conservative Line of
Management over the Surgical Intervention, advantage of Home Care over
Hospitalized Care and take an Informed Healthcare decision. Call us we will help.
Once you are admitted to a Hospital, check on every aspect of the Hospitalized care.
The drugs that you buy and consume should match with the Doctor’s Prescription.
Check the rates in the Bill and the expiry date of the Medicine in the package. Always
sign on the backside of the Prescriptions, Bills and the Discharge Summery.
We advice you to pay the Bills upfront wherever possible and submit to us the Claim
Form duly filled and signed along with the Bills and Discharge Summary as per the
check list written here under. This will save you and the Insurance Company money at
the same time will help the Hospitals to standardize their Medical Documentation and
Billing System. Thus you will see the Transparency in the Healthcare System. Arrange the
Original Bills in order and submit it along with Anyuta Summary Bill Format duly signed.
Please visit www.anyuta.org
for the Networked Hospitals, Claim Form, Pre – authorization request form, Draft MOU.
Contact AMH-TPA-IHPL for any information on Healthcare. In case of an Emergency,
save life first by availing the best Healthcare in any of the Hospitals (networked or not
networked) in your vicinity. We will service your claim as per the Insurance Company
guidelines.
*The Provider Network is subject to deletions and additions. The cashless access in
AMH-TPA-IHPL network of hospitals is merely a facility extended to you by the TPA under
contract with your insurer. We do not guarantee the availability, quality and outcome
of the treatment. Selection of a network or a non-network hospital is a prerogative of
the beneficiary.
How to get admitted in a
Network or non networked Hospital/Nursing Home willing to provide
Cashless Healthcare Service
Pre-Authorization Request, by the Hospital, is necessary in case of Cashless Facility.
Please send AMHTPAIHPL, the filled and signed Pre-Authorization Request Form
indicating your admission for treatment.
The Physician ordering your admission will have to fill in the following information in the
Pre-Authorization Form,
1. Diagnosis or the Differential Diagnosis
2. Treatment Plan
3. The approximate duration of stay,
4. The approximate expenses,
5. Split Costing
a. Ailment and its duration,
b. Known past illness if any,
c. Hypertension or Diabetes
d. The name of the Hospital / Nursing Home and Consultant.
e. Contact no. of Consultant / hospital / Policyholder
f. The Proposed date of admission.
g. Type / Class of accommodation,
The Pre-Authorization Form could be sent to us by Fax/Courier/e-mail/messenger.
(Sample request note is on the last page)
Authorization Letter from AMH-TPA-IHPL
After due scrutiny of the Pre-Authorization Request, we will promptly respond. Our
response is in three forms, Accepted, Accepted with Co – Payment clause, Denied. If
accepted, will get an Authorization Letter (AL) along with the Check List to the hospital
or to the Policyholder, for Cashless treatment and guarantee of payment.
To expedite your Claim Processing and payment, please send us all the Original Bills,
Discharge Summary, Investigation reports etc. as listed in the Check List, pertaining to
your treatment. The Cashless service or Reimbursement of the Claim amount is subject
to the terms, conditions, exclusions and limitations of your Health Coverage Plan.
Admission Procedure
In case of Planned Admission, register your name with the hospital well in advance.
o Approach the Admission / Reception Counter of the Hospital on the day of
admission with the Authorization Letter and your ID Card. (On request, AMH –
TPA IHPL can also arrange to send the Authorization Letter to the Hospital.)
o The Hospital/Nursing home will admit you and extend the credit facility upto the
amount guaranteed by the Insurance Company.
What is Co – Payment?
Charges for the certain facilities are not covered by majority of Health Plan; few of
them are as under:
Telephone / Fax
Food & Beverages for Relatives
Barber
Ambulance (unless the policy specifically covers it.)
External Implants and accessories such as Crutches, spectacles, etc., unless
specifically covered.
The list of non covered items are published in the Web: www.anyuta.org
Cost of such services may have to be borne by you and paid directly to the Hospital. In
Case hospital inadvertently bills Anyuta for such services, these amounts will be
recovered from you.
The charges that are not allowed by the Insurance Policy will have to
be born by the Policyholder as Co – payment.
WHEN CASHLESS ACCESS TO HOSPITAL
CAN BE DENIED
A. In case sufficient information in the prescribed format is not given.
B. In case of AMH-TPA-IHPL medical team is not convinced of the eligibility under the
coverage, pre-authorization for cashless can be denied.
Since a large percentage of the Hospitalizations are planned, obtain your Authorization
Letter in advance.
Some Insurance Policies, do not cover pre-existing diseases & complications of chronic
conditions, your are advised to give all required information to the Medical Team of
AMH-TPA-IHPL to verify the eligibility well in advance in case of planned surgery.
The denial of Authorisation Letter for cashless access does not mean denial of
treatment and does not in any way prevent you from seeking necessary medical
attention for hospitalization. In such cases you are advised to file your claim for
reimbursement and AMH-TPA-IHPL will settle the claim as per eligibility and policy
coverage.
What to do after discharge from Hospital
You have to send the following documents in original to AMH-TPA-IHPL office within
7 days after discharge
1. Insurance Claim Form, duly signed by you. Claim Form has to be collected by you
from AMH-TPA-IHPL or nearest branch of the Insurance Company Branch or download
from www.anyuta.org along with discharge voucher.
2. Original Discharge Card/ Discharge Summary
3 Original reports of all investigations.
4. Prescriptions, pre hospitalization bills, and bills of drugs and surgical applicances if
purchased by you, along with duly stamped receipt, if payment is over Rs.500/-
Please keep the Photocopy of discharge card and reports.
Reimbursement of Post Hospitalization Expenses.
Medical expenses incurred after discharge from the Hospital will be reimbursed as per
your Health Coverage Plan. Prescriptions and bills/receipt of such services should be
submitted to AMH-TPA-IHPL along with Insurance claim form duly signed by you.
Reimb ursement of expenses incurred for
Treatment at Non Network Hospitals.
Intimation to AMH-TPA-IHPL is a must even in a Non - Network Hospital.
In case you choose to get treated in a Non – Network Hospital, find out if they are
willing to sign the MOU with us and advance Cashless facility to you, or else you will
have to pay the cost of your treatment in the first place and ask for reimbursement. To
get the best treatment, call us our Doctors who will help you.
You have to submit the following documents in original to AMH-TPA-IHPL to obtain
reimbursement of the eligible claim amount.
a) Insurance claim form duly signed by you.
b) All Original Doctors and Hospital Bills.
c) Discharge card / Discharge Summary.
d) Original Reports of all investigations.
e) Prescriptions and bills of drugs if purchased by you.
All receipts of payments over Rs.500/- should be duly stamped with a revenue stamp.
Kindly insist on a stamped, preferably numbered Bills and Receipts from the Doctors.
Insist on Bills for every service that you have availed in the Hospital including the
Doctors Consultation / Procedural Fee.
Note
1. The Laboratory and Diagnostic procedures should be prescribed by the Doctor
in charge of the patient and reported by the Specialist in the concerned
specialty. The technician signed report will not be accepted.
2. The drugs prescribed should match the drugs dispensed. The prescription and
the dispensed bill should carry the Doctors and the Dispensing Pharmacists,
name, qualification, registration number, signature and seal.
3. The drug prescription and the bills should be listed separately.
Organize your Receipts and Bills for convenience of accounting and payment.
Health Insurance Claim Bill
Prepare the bill in this Format. Policyholder and the Doctor should sign with Hospital seal
Emloyment Number Salary certificate No Health coverage limit:
Name of the Policyholder Policy No:
Name of the Patient Relationship
Claim No: Claim Amount:
Diagnosis Treatment
Hospital Name Tel: E- mail:
Address
Bill No: Dt.: D.O.A: D.O.D:
Patient Name: Age: Yrs Sex: M/F
Address:
E- mail: Tel: Fax:
Original Bills, Hospital, doctors, pharmacy, lab etc, listed under separate heads, signed on the
back by the patient and the Doctor should be submitted along with this Format,
Particulars No. Days Amount
Bed Charges
Nursing Charges
Medicine Charges
Anesthetist Charges
Physician’s name & Charges
Surgeon` s name & Charges
Lab / ECG / Scan etc. Charges
OT Charge
OT Consumables
Utilities
Medicine From Pharmacy
Any other admissible Charges
TOTAL
Advance
Balance
Total Amount in words:
Doctor’s Signature / Hospital/seal Patient `signature Policyholders Signature
Please furnish the following documents for faster settlement of the Bills.
Check List For Hospitalized Patients.
1. Name of the Company / Individual. 7. Discharge Summary.
2. Policy Copy. 8. Main Bill- Break up of the Main Bill.
3. Claim Form. 9. Counter signed Receipts of all bills.
4. Copy of the ID Card. 10. Receipt for advance payment.
5. Contact Telephone / Mobile / Fax. 11. Doctors Prescription./ Bills
6. E- mail address. 12. Investigation Reports.
The Bills / Investigation Reports / Discharge Summary / should be signed by the department heads in the
concerned field responsible for patient care / counter signed by the Hospital Administrator.
The Healthcare provider shall keep AMHPL indemnified in the matters relating to the healthcare
provided to the patients by them.
Signature: ________________
Signatory's name: ________________
Place: ________________ ______________________
Date: ________________ Establishment Rubber Stamp
Thank you for being a partner of Anyuta Healthcare Program.
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No. 65 – Lavelle Road, 4th Cross-, Bangalore 560001. Tel: 22210205. 26638876.
Mobile: 98450 10136. 94484 56986. Fax 080 –26638876. E-Mail : anyutamedinet@hotmail.com anyuta.anyuta@gmail.com
Web site :www.anyuta.org
Medical and Financial Audits are mandatory in Healthcare Services.
Anyuta Medinet Healthcare is a neutral organization safe guarding the interests of the Doctors
and the Patients alike. We believe that by Standardization of Medical Documentation /
Treatment Regime / Treatment Costs, it is possible to bring about transparency in the
Healthcare Management.
Our aim is to bring about a high quality healthcare system available and affordable to each and
every citizen of our country provided by the bright and the brilliant Healthcare Provider
Network.
This will result in a special Doctor – Patient relationship based on trust and confidence. The
Emergency Medical and Surgical care would be faster and available in time at all places.
Thank you for being a partner of Anyuta Healthcare Program.
IN CRISIS YOU ARE NOT ALONE
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Anyuta Medinet Healthcare TPA in Healthcare Pvt. Ltd.
65. Lavelle Road, 4th, Cross, Bangalore 560001. Mobile: 98450 10136, 94484 56986.
Tel fax: 080 26638876 E – Mail: anyuta.anyuta@gmail.com anyutamedinet@hotmail.com Website: anyuta.org
ANYUTA MEDINET HELATHCARE TPA in Healthcare PVT.LTD.
th
No 65. Lavelle Road . 4 Cross
Bangalore-560 0001.
Tel: 080 26638876. Fax: 080 26638876
Email: anyutamedinet@hotmail.com. anyuta.anyuta@gmail.com
RE: Hospitalization of Beneficiary
Name of the Insured: Mr./Mrs.________________Age:_________Yrs.
I.D.No_____________________________________________________
Has been advised admission / admitted under Dr.____________ in
____________________________Hospital/Nursing Home.
Details of Signs and Symptoms related to the present ailment.
_______________________Duration of ailment: ___________________
Past history of Hypertension Yes/No since when:
Diabetes Yes/No since when:
Asthma Yes/No since when:
Chest Pain Yes/No since when:
H/O any other diseases / disability Yes / No. If Yes, since when suffered/
Suffering from:
Medication if any: _________________________________________________
Relevant Clinical Findings: _________________________________________
Investigations Report (if any): _______________________________________
Provisional Diagnosis: _____________________________________________
Probable date of admission: _________________________________________
Approximate duration of stay: _______________________________________
Approximate expenses: _____________________________________________
Class of accommodation: ____________________________________________
Name & Signature of Doctor: ________________________________________
Reg.No …………………………………………. Rubber Stamp
BENEFICIARY CONSENT /AUTHORISATION
I have No Objection to AMHTPAIHPL obtaining detail of my treatment / collecting documents and also hereby
authorize NIAC to pay the hospital bill & reimburse itself/receive the amount from my claim receivable from My
Insurance Company. If my claim is rejected. I hereby undertake to pay AMHTPAIHPL the amount paid by them to
the hospital.
SIGNATURE/S:
We follow the Insurers guidelines with out prejudice in case of any
dispute, the interpretation and decisions by AMH TPA I HPL is final.