- Reimbursement Claim Not Paid For CT Coronary Angiogram Procedure Claim ID ^Open

Naveen Mukund Kamath filed this complaint against Medi Assist India Tpa Private Limited on Jul 26, 2023

I received an SMS on *th July **** from Medi Assist TPA that my reimbursement claim for INR *****/- has been processed for INR ****/-.

Medi Assist TPA rejected the balance reimbursement claim of INR *****/- for the CT Coronary Angiogram procedure. The reason given for rejection was that there is no cost breakdown hospital bill for the total amount of INR *****/-. The submitted hospital bill only stated the total amount of INR *****/- for the CT Coronary Angiogram procedure. As per my telephone conversation with the Insurance Manager at the hospital, he mentioned that INR *****/- is the total amount for the CT Coronary Angiogram procedure and hence it does not have a break-up. I reported this to Medi Assist TPA by e-mail and also asked them to verify the information by providing the contact details of the hospital's Insurance Manager. Yet, they have rejected the reimbursement claim for INR *****/-. Multiple e-mails have been sent to Medi Assist TPA in this regard but there has been no positive response from them.

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