Learn about Good Health Insurance TPA (A Simple Guide)

Good Health Insurance TPA is an Indian Third-Party Administrator (TPA), which was incorporated in 2003. Good Health Insurance TPA is headed by Mr. Srikanth Charan Mudigonda, who serves as the company Managing Director. The company has settled over 1.5 Lac claims, which has won it numerous awards including “India’s Most Promising TPA of the year- 2016.”

Let us now look at some of the most important topics concerning Good Health Insurance TPA, including:

• Role of the company
• How to submit a claim?
• How to login and register under their website
• Downloads
• Network Hospitals
• Customer Care

Role of the company

As a TPA company, Good Health Insurance TPA has to fulfil the following important roles:

Acts as a link: The company acts as a link between the insurance company and the policyholder. The TPA company will have to act as a mediator between both parties and will have to act in the best interest of both parties.

Claim Management: All claim related logistics will have to be handled by the TPA company, from customer guidance to submission of documents. Once all of the documents are submitted to the TPA company, the company will then forward the same to the insurance company. Once this is done, the TPA company will correspond with the policyholder on behalf of the insurance company pertaining to the claim.

Customer Support: This is a very important function of any TPA company, they are mandated to provided customer support to policyholders. Most TPA companies also provide a 24×7 Customer Support Helpline that policyholders can avail of.

How to submit a claim?

If you are a Good Health Insurance TPA customer and are wondering about how to submit a claim, then please follow through. You can submit two type of claims, cashless claim, and reimbursement claim. Let us go through with the claim submission steps for both.

How to submit a cashless claim?

Step 1) Inform your insurance agent / TPA Company

The first thing you need to do is to inform your agent or TPA Company about the hospitalization. It is vital the company be informed as soon as possible about the hospitalization.

Step 2) Submit the policy bond or Health Card to the hospital

Now, upon admission, the policyholder’s family must submit the policyholder’s policy bond or Health Card to the hospital. Once submitted, the hospital will enter into correspondence with the TPA Company and verify the policy bond. Once verified, all hospital bills will be directly paid by the insurance company to the hospital, the policyholder will not need to spend out of pocket.

Note: Cashless hospitalizations can only be availed at network hospitals.

How to submit a reimbursement claim?

A reimbursement claim can be applied in the following steps:

Step 1) Inform your insurance agent / TPA Company

Here again, the first thing you need to do is to inform your agent or TPA Company about the hospitalization.

Step 2) Keep all original medical documents

Now, you will need to meticulously keep a record of all medical documents, including admission summary, doctor’s certificates, diagnosis reports, hospital bills, receipts, discharge summary, etc. You will have to submit all of the original copies to the TPA company upon discharge.

Step 3) Submit all documents to the TPA Company

All medical documents must be submitted to the company within 15 days of discharge, it is extremely important that there is no delay here. You will have to submit the following forms along with the medical documents:

• Filled-up claim form
• Copy of your policy bond or E-Card
• ID and address proof

Once submitted, your claim will be registered.

How to login and register under their website

The various benefits and features of Good Health Insurance TPA can be accessed by registering and logging into their official online portal.

How to login?

Step 1) Visit the official website

You can access the official Good Health Insurance TPA Website here.

Step 2) Navigate to the ‘Logins’ section

Now, you will need to navigate to the ‘Logins’ section on the top of the website. Once there, click on the type of login. There are a variety of logins such as:

• Corporate Employee Login
• Insurer Login
• Provider Login
• Retail Policies Login
• Retail Agent Login

And more.

Downloads

You can also download important documents through the official website of Good Health. How?

Step 1) Visit the official website

Step 2) Navigate to the ‘Downloads’ section on top of the page

Here, you can download the following documents/forms:

• Pre-Auth Form
• Reimbursement Form
• Cashless Form
• CKYC Form
• PPN Declaration Form

Network Hospitals

It is pivotal that all hospital admissions be done in a network hospital if you wish to avail cashless hospitalization. You can check out a list of all network hospitals navigating to the ‘Network Hospital Search’ button on the far right side of the official home page of Good Health TPA. Once on this page, you will have to enter the following:

• Insurance company name
• State and City

Click on ‘Submit’ once done. You will now get a list of all network hospitals in your area.

Customer Care