Reimbursement Services

We want to Welcome you to the Rajas Eye & Retina Research Centre, Indore Located at Madhya Pradesh, the central part of India.

Cashless & Reimbursement

Cashless
We provide cashless facility to the Mediclaim Policyholders. Having tie-up with major TPAs appointed by all insurance companies.

What is a network hospital?
Network Hospitals are those hospitals that your service provider has an agreement with. In case of hospitalization, if you get admitted to a Network Hospital you will be eligible for cashless hospitalization, subject to the other terms and conditions mentioned in your policy being fulfilled. In case you are admitted to a Non-network Hospital, you will have to settle the bills directly to the hospital and then seek re-imbursement through your service provider

Procedure for obtaining cashless health care
At first the insured must select a hospital from their network tie-ups of their service provider. They must also check booklet of the hospital and also the website of their service provider for more information. They must also have a check on the latest updated list of the hospitals from the list of service provider.

Pre-Authorization Request
Pre-authorization is basically an authorization issued either by the insurance company or the service provider, specifying the value of the medical treatment that can be claimable under their insurance policy. To receive a pre-authorization, you need to submit duly fill in the Pre-authorization form along with photo id proof of patient (Voter ID Card / Driving Licenses / Aadhar card / PAN Card), three years policy photocopy including current year policy copy, TPA card photocopy, doctors prescription original and if corporate then employee id card instead of three year policy photocopy.

Authorization
After the pre-authorization request has been sent by the hospital to the respective insurance / corporate, it takes a minimum of 2-3 days for the hospital to get the approval or authorization for the patient's treatment. For planned surgery or treatment, the hospital will treat the patient only after the approval from the insurance / corporate.

The Staff members of the Corporate relations department interact and coordinate with the respective insurance / corporate and companies for further clarification or explanation. After the approval from the insurance / corporate, the patient will be informed the same accordingly.

Treatment
Cashless hospitalization and treatment are provided to the patients only with approval of the company. Patients should sign necessary documents to facilitate claim processing for the hospital. Patients who don't get approval due to some reason stated by the insurance company are also treated under general patients category without Cashless hospitalization benefits.

Claim processing
Our has developed a checklist of documents to be submitted for each insurance / corporate for immediate claim processing.

Our Empanelment with Companies/TPA For Cashless
Rajas is authorized to the treatment of State government employee and their family (since 2010) and the BPL card holders. Rajas is also Empanelled with ESIC Indore. Further cashless claims Rajas is empanelled with

  • Bajaj Allianz
  • Vidal Health TPA Pvt. Ltd.
  • Reliance General Insurance Company Ltd.
  • BSNL
  • State Government
  • Vipul Medcorp TPA
  • MD-INDIA
  • ICICI Lombard
  • HDFC ERGO
  • Star Health
  • IFFCO TOKIO General insurance
  • United Health Care TPA
  • Religare Health Care
  • Dedicated Health Care(DHS)
  • Raksha TPA
  • Paramount TPA
  • Reimbursement
    Reimbursement is an act of compensating someone for an expense.Often, a person is reimbursed for out-of-pocket expenses when the person incurs those expenses through employment or in an account of carrying out the duties for another party or member.

    In this process patient have to pay first before surgery or treatment and hospital will give bills and all the necessary documents to patient. Then patient has to submit all the papers at his own accommodation to his/her department/TPA/insurance company.

    EYE CONDITIONS AND TREATMENTS

    RAJAS diagnoses eye conditions and treatments. Our surgeons have experience of unusual conditions rarely seen at other centres. Patients with rare or complex conditions are often referred to RAJAS from around the INDIA for this reason.

    You can find basic information on the following common conditions and treatments here.

    At RAJAS, our consultants have expertise in discrete ophthalmic sub-specialties as follows:

    • Accident and Emergency (A&E) – for urgent sight-threatening problems for treatment for the accessories or anatomical parts attached to the eyeball, such as the eyelids, extraocular muscles, orbit and tear glands
    • Cataract – a common eye condition, in which the lens becomes progressively opaque, resulting in blurred vision
    • External Disease – for conditions relating to the outside of the eyeball, including the cornea, iris and sclera (the tough outer layer of the eye)
    • General Ophthalmology – for general eye problems and those that might need referral to one of our specialist services
    • Glaucoma – for treatments for the signs and symptoms of glaucoma, including increased pressure within the eyeball, which can cause gradual loss of sight if left untreated
    • Medical retina – for conditions at the back of the eye, which are treated medically using drugs, eye drops or lasers, and including diabetic screening
    • Neuro - ophthalmology and strabismus (squints)
    • Paediatrics – services for children’s eye conditions.
    • Refractive Surgery – for the treatment of refractive errors by use of precision lasers
    • Vitreo-retinal – for conditions at the back of the eye that require surgical interventions, especially retinal detachment
Contact with us:
0731-2511333, 2525333
Time: 11:00 AM to 4:00 PM
(Saturday evening & Sunday closed)