About Raksha TPA

‍What is Raksha TPA?

Raksha TPA, also known as Raksha Health Insurance TPA is one of the leading Third Party Administrators (TPA) in India. It provides its services through web-based technology that connects the insured or policyholder, the insurer and the provider. The Raksha TPA works with 7800+ network hospitals to provide cashless claims services to policyholders.

Also read: What is TPA?

Why choose Raksha as your TPA?

The various benefits of Raksha TPA include:

1. Extensive TPA Hospital Network: Raksha TPA works with a list of 7800 + hospitals ensuring that policyholders are able to avail cashless claim benefit in multiple hospitals across the country.
2. Multiple Service Locations: Raksha TPA has around 88 offices in different cities of India. This makes it easier for policyholders to go to the nearest office in case any assistance is required from the Raksha team.
3. Tech-first Services: Raksha TPA’s integrated web portal & mobile app connects the insurer, the insured and the providers. They are also connected to their customers through real time web chat, IVRS and SMS services.

Understanding Raksha TPA Claims

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

1. Ensure that the hospital you choose is a part of the network hospital list of your insurer or the Raksha TPA
2. Intimate Raksha 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 Raksha TPA
5. Upon receiving your request, Raksha 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 Raksha TPA after discharge (only applicable for admissible cases)

List of Raksha TPA network hospitals ->

Raksha TPA Claims Process: How to file a reimbursement claim with Raksha TPA? (H3)

1. Inform the Raksha 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 Raksha TPA (you might need to submit either hard or soft copies of the documents depending on the type of claim and requirements of the TPA)
3. Once the documents are submitted, Raksha TPA will view your documents and inform you if any further documents are required
4. Once your claim is approved, Raksha TPA will begin the reimbursement process to ensure the covered amount is deposited to your account
5. Ensure that you keep all the original documents handy including the bills, Raksha 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 Raksha 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

Raksha TPA Claims Status

Steps to track your claim status with Raksha TPA:

1. Visit -   https://www.rakshatpa.com/WebPortal/Login/Anonymous/checkClaim 
2. Provide any details specific to your claim such as member ID, claim number or policy number to get claims details

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

Raksha TPA Hospital List

Raksha TPA currently has more than 7,800 network hospitals in cities across India including Mumbai, Chennai, Kolkata, Bengaluru and more.

View all Raksha TPA Network Hospitals →

Raksha TPA Customer Care

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

Call Raksha at: +1800-180-1444

Available 24X7

Mail Raksha at: [email protected]

In case of further queries, feel free to reach out to us at anytime: https://www.novabenefits.com/

FAQs

1 How to know about medical claim status in Raksha TPA?

Steps to track your claim status with Raksha TPA:

1. Visit - https://www.rakshatpa.com/WebPortal/Login/Anonymous/checkClaim 
2. Provide any details specific to your claim such as member ID, claim number or policy number to get claims details

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

2. How to login into Raksha TPA?

Here are the steps to follow for the Raksha TPA login:

• Visit the Raksha TPA home page and from the login dropdown, choose the option corporate employee from the top right corner.
• Under that please enter the username, corporate name and password shared by Raksha TPA limited during your enrollment process. These details are communicated to your corporate email id.
• Once logged in you can access and download the Raksha TPA id card, check the TPA unique id number, raise a claim, check the claim status, etc.

3. 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.

4. Which insurer should I choose with Raksha TPA?

Raksha 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.

Book a call with us - https://www.novabenefits.com/group-health-insurance