Complaint against Raksha TPA in cashless and reimbursement claims - India Consumer Forum

Complaint against Raksha TPA in cashless and reimbursement claims

Today my client Sxxxxa Txxxxxxl mother of Kxxxxn Txxxxxl had been admitted to RG Stone Hospital in Khar. Hospital had sent the cashless preauth since from yesterday and today after 24 hours Raksha Tpa sended a letter stating to send all the relevant documents with original discharge cards for the settlement of cashless file of hospital. Even the approval was not given to my client the letter was been sent first. Then after a follow ups Raksha Tpa asked me for policy copy for the year 2015-16 which was already in the system of Raksha TPa then also the harrasmnet was been delivered to my client Sxxxxa Txxxxxl and her family in hospital. Finally after a long follow ups with Raksha TPa the cashless was approved with the copayment of 10% which was supposed to deducted in final bill before the discharge of the patient.

In reimbursement claims Raksha Tpa ask for the same queries again and again and even after giving all the relevant documents to them the claim is not settled immediately within two days.

Raksha TPA is overruling on OICL as if they are only insurance company. Due to this harrasmnet we are losing our prestigous clients and OICL is loosing faith in market. This TPA should be also banned in India.

Rakesh Suthar
Teligali, Andheri East Mumbai 400059

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