About Heritage TPA

‍What is Heritage TPA?

Heritage TPA, also known as Heritage Health Insurance TPA is one of the leading Third Party Administrators (TPA) in India. The Heritage TPA works with 5000+ network hospitals to provide cashless claims services to policyholders.

Also Read: What is TPA?

Why choose Heritage as your TPA?

The various benefits of Heritage TPA include:

1. Extensive TPA Hospital Network: Heritage TPA works with a list of 5000 + hospitals ensuring that policyholders are able to avail cashless claim benefit in multiple hospitals across the country.
2. International Services: Apart from offering TPA services in India Heritage TPA offers also assistance to settle overseas claims for Indian insurance companies.

Understanding Heritage TPA Claims

Heritage TPA Claims Process: How to file a cashless claim with Heritage TPA?

1. Ensure that the hospital you choose is a part of the network hospital list of your insurer or the Heritage TPA
2. Intimate Heritage TPA of your admission to a cashless network hospital
3. Verify your identity at the network hospital through your insurance ID card, corporate ID and personal ID proof
4. Fill out the pre-authorisation form so that the hospital can raise the cashless claim request to the Heritage TPA
5. Upon receiving your request, Heritage TPA verifies all details and shares an approval for the claim
6. If in any case the claim is rejected due to any reason you will be required to pay the entire bill at the hospital and then raise a reimbursement claim with the Heritage TPA after discharge (only applicable for admissible cases)

View all Heritage TPA Network Hospitals →

Heritage TPA Claims Process: How to file a reimbursement claim with Heritage TPA?

1. Inform the Heritage TPA within 24 hours of being admitted to the non-network hospital
2. Submit all necessary documents such as claims form, hospital bills, prescriptions and other information to Heritage TPA
3. Once the documents are submitted, Heritage TPA will view your documents and inform you if any further documents are required (you might need to submit either hard or soft copies of the documents depending on the type of claim and requirements of the TPA)
4. Once your claim is approved, Heritage TPA will begin the reimbursement process to ensure the covered amount is deposited to your account
5. Ensure that you keep all documents handy including the bills, Heritage claim form, discharge summary, prescriptions and other hospital-related documents in case of an queries regarding your claims

Read more - How to choose between cashless or reimbursement claim?

What are the documents required to file a successful claim with Heritage TPA?

The following documents can help you ensure a smooth claims process:

1. Claims form
2. ID proof along withInsurance ID Card
3. Hospital bills, prescriptions and receipts
4. Investigative diagnostic lab reports
5. Pharmacy bills 
6. Discharge summary
7. Any documents related to your hospitalisation

Heritage TPA Claims Status

Steps to track your claim status with Heritage TPA:

1. Visit - http://223.31.103.204/HeritageHealthTPA/HOME/CardSearch.aspx 
2. Select your insurance company
3. Share the following details -  policy number, card number, policy year and employee ID

Once you follow these steps, your claims status should be displayed.

Heritage TPA Hospital List

Heritage TPA currently has more than 5000 network hospitals in cities across India.

View all Heritage TPA Network Hospitals →

Heritage TPA Customer Care

You can access the Heritage TPA customer care through the following:

Call Heritage TPA at: 1800 102 4547

Mail Heritage TPA at: [email protected]

FAQs

1. How to know about medical claim status in Heritage TPA?

Steps to track your claim status with Heritage TPA:

1. Visit -   http://223.31.103.204/HeritageHealthTPA/HOME/CardSearch.aspx 
2. Select your insurance company
3. Share the following details -  policy number, card number, policy year and employee ID

Once you follow these steps, your claims status should be displayed.

2. What is TPA in medical claims?

A Third Party Administrator (TPA) is an intermediary between the insurance provider and the policyholder. Its key function is to ensure the settlement/processing of insurance claims.

3. Which insurer should I choose with Heritage TPA?

Heritage TPA functions as a A Third Party Administrator (TPA) - that is an intermediary between the insurance provider and the policyholder. Its key function is to ensure the settlement/processing of insurance claims.

If you are looking to find the right insurer for your group health insurance policy, feel free to reach out to insurance experts at Nova Benefits.