Complete Guide to Anyuta TPA Health Insurance Claim Process

Anyuta Medinet Healthcare Pvt. Ltd. was established on 15th February 2002 under the Companies Act 1956. The company was issued IRDA License No. 17 on 16th May 2002 following which the company added, ‘TPA in Healthcare’ to its name. Anyuta is a Doctor-based TPA, with extensive experience in hospital administration, medical documentation, as well as preventive, curative, and therapeutic care.

This guide consists of detailed information to help you with filling Anyuta claim form, completing the documentation and other claim intricacies.

Anyuta TPA Claim Process - Cashless

Here’s the 5-step process of Anyuta cashless claim:

  • The policyholder visits one of Anyuta TPA’s network hospitals.
  • The policyholder is asked to present their insurance card and a government ID proof to the hospital so that their pre-authorization request is sent to Anyuta TPA.
  • Once the pre-authorization is approved considering the terms and conditions of the policy, the TPA sends an authorization letter to the hospital which is considered as a promise that the network hospital will be paid directly.
  • The patient pays for the deductibles mentioned in the policy, if any.
  • The hospital then sends all the medical documents to the TPA and the TPA makes payment to the hospital if the case is verified.

To check out Anyuta TPA hospital list, please visit this link.

Anyuta TPA Claim Process – Reimbursement

Here’s the reimbursement claim process simplified for you:

  • The policyholder intimates the TPA at least 3 to 4 days prior to the patient’s admission in the hospital. In emergency cases, the insured intimates the TPA within 24 hours of the admission.
  • The insured fills the TPA claim form with details of the medical treatment, the patient and the policyholder.
  • The insured attaches all the documents as specified in the policy with the Anyuta TPA claim form and sends it within 7 days after the patient’s discharge.
  • The insured checks the claim status to see if the TPA has raised a query. If yes, the insured resolves the query by submitting documents or information requested by the TPA.
  • Once everything is verified, the insurance company settles the claim amount.

Documents Required for Anyuta TPA Claim

KYC Documents

KYC documents are required by Anyuta TPA since they help them establish your identity.

  • Patient’s Aadhar card copy
  • Copies of the policyholder’s government ID proof or PAN card
  • Cancelled cheque that belongs to the policyholder
  • An insurance or e-card copy

Hospitalization Documents

  • Patient’s discharge Summary
  • Summary of Bills
  • Breakup of Bills
  • Payment Receipt
  • Operation Theatre Notes
  • Pharmacy Bills
  • Doctor’s Prescriptions
  • Bill breakup against additional packages, etc.

All the documents above must be original, i.e., printed on hospital’s letterhead. The bill or additional package breakup can be printed on a plain paper with hospital’s seal. To file a claim for pre and post hospitalization expenses, enclose the doctor’s prescription with the treatment bills.

Investigation Reports

All the original investigation reports must be sent to Anyuta Insurance TPA. Reports printed on a plain paper with hospital’s seal will not be accepted by the company.

Accident Details, if Applicable

  • FIR (If you have filed a report)
  • Medico Legal Certificate

To prove that the injury isn’t the result of patient’s self-harm attempt, the patient must write, sign and submit a detailed letter to the TPA explaining the incident.

Anyuta TPA Claim Form

Attach the originals of the documents mentioned above with this form

Download Anyuta TPA Claim Form

How to Fill Anyuta TPA Claim Form

Section A

Fill information of the primary policyholder, the one who pays the premium. Be extra careful since the TPA will use this information to contact you. In corporate insurances, the employee is the policyholder.

Section B

If the patient is covered under any other policy in addition to the one you are filling the form for, then mention the details in this section. Ignore the field if the patient doesn’t have additional coverage.

Section C

Enter the demographic details of the patient such as their name, address, age, occupation, etc. in section C. This section also requires you to fill the relation of the policyholder with the patient.

Section D

In section D, fill the hospitalization details of the patient. Mention specifically the type of treatment, number of days at the hospital, admission date, discharge date, Medico-Legal details, FIR number, etc.

Section E

Enter the hospitalization expenses in section E. You will need to enter the sum total of the expenses during your stay at the hospital. You can use the fields given separately in this section to add pharmacy, ambulance, blood bank, and other charges.

Section F

List down all the treatment bills of the patient in this section. There are 10 spaces in this section for bills where you can mention your pre and post hospitalization expenses.

You must calculate the sum total of all the pre and post hospitalization charges and mention it on the right side, and the pharmacy charges must be mentioned separately in the 4th row.

Section G

Section G takes the information of the policyholder’s bank account. So, ensure that you fill the details correctly as they are on the cheque and DD payable details. If the treatment charges exceed 1 lakh, then it is advised that you add the PAN card details in this field.

Section H

The policyholder must sign the declaration in this field with the date and time.

Avoid common mistakes done when filling Anyuta TPA claim form

Anyuta TPA Submissions Timeline

Policyholder gets a 15 to 30-day time to submit the claim. So, collect all the documents as soon as the patient is discharged. If you know that your claim submission may be delayed due to incomplete documents, then enclose a cover-note with the form which has a list of all the documents or reports that are missing. This way, you will get enough time till Anyuta TPA raises a query. You can use this time to get the documents from the hospital and resolve the query by sending rest of the documents to Anyuta.

Claim Submission Address

Click on this link to get the address of Anyuta TPA’s centres.

Corporate policyholders can submit their claim forms in their office premises to the Anuyta representative.

Claim process is a tricky one. And many policyholders give up the hope of getting the entire treatment covered in the policy too soon.

Frequently Asked Questions

Anyuta TPA takes around 3 to 4 weeks to verify your claim request which includes verifying the documents, the claim form, medical history, etc. In this duration, it approves the claim. However, in case the supporting documents are missing, the approval may be delayed. Once the TPA approves the claim, the insurance company is intimated about it. The insurance company then process reimbursement amount within 2 to 3 weeks.

The claim should be submitted at Anyuta TPA since the TPA will verify your claim. The insurance company will only transfer the amount to you once the TPA verifies and approves the claim.

  • A copy of Anyuta TPA card
  • A policy certificate copy
  • Doctor’s prescription or formal advice of hosptitalisation
  • Investigation reports

No. Only the Anyuta TPA claim form must be filled. The claim form is the equivalent of the IRDA claim form part A.

Anyuta TPA claim must be submitted within 7 days of the discharge date with necessary documents. If you do not have all the documents, submit the ones that you have. The TPA will raise the query for the missing documents within a week or two, and in the meantime, you can collect all the documents.

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