Who is Vidal Health Insurance?

Vidal Wellbeing is a company that provides benefits for individuals when they are dealing with stressful situations that affect their health. They have a friendly and approachable group of people who are there to support and help customers, clients, and everyone involved. 

What Does Vidal Health Do?

Vidal Health is one of the largest health insurance companies in India. They are a big player in the country with 800 offices and more than 35 million members. They work with more than 12,000 hospitals, laboratories, and doctors to provide healthcare services.

Vidal Health Insurance processes annually about 1 million insurance claims and 800,000 requests for pre-approval of medical treatment. Their aim is straightforward – to be the number one health insurance company in India.

Vidal Health Insurance Claim Guide

Insurance is a way for many people to redistribute the unexpected financial costs of a few people who end up being sick or injured. 

Health insurance covers the hospital expenses of patients who are admitted to a hospital or nursing home as inpatients.

Vidal Health Insurance offers a Cashless Claim Guide to help you realize the process of making a claim without paying any money in advance.

Pre-Authorization Guide

• Please fill out the latest form provided by Vidal Health and send in the pre-authorization request.
• Fill out the form legibly and do not use abbreviations.
• Get the patient’s or attendant’s signature on the form.
• Do not leave out anything about the patient’s medical history, co-morbidities, or alcohol status.
• Please follow the tariff rates that you have filed with Vidal Health for different charges.
• Submit the pre-authorization request a couple of days in advance for scheduled admissions.
• Liaise with the pre-authorization team to know the status of your request.
• Use the online pre-authorization submission model instead of fax for prompt attention and real-time status updates.
• Submit the required documents listed during the preliminary pre-authorization or final pre-authorization process.
• If a shortfall is raised, promptly submit the requested documents.
• Check the approval for any conditions, such as room rent cap, ailment/procedure cap, or co-pay deductions.
• Understand the standard conditions mentioned in the approval letter.

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Services provided by Vidal Health Insurance

Vidal Health Insurance offers many different services to help people with their healthcare needs

1. Pricing and Actuarial

Vidal Health Insurance has a team of professionals who collaborate with insurance companies to price products, design new products, and streamline their processes.

2. WhatsApp Service

Vidal Health Insurance now provides services on WhatsApp, thus patients are given an opportunity to obtain information and help more easily.

3. Administration

Health is able to bring together all the healthcare providers, insurance companies, and patients into a single platform through the integration of technology, processes, and people.

4. Advisory

Vidal Health offers advisory services that allow individuals to be more knowledgeable when making healthcare choices.

5. Analytics

Vidal Health Insurance gathers the data to analyze it and enhance the healthcare services and processes.

6. Call Centers and Helpdesks

Vidal Health Insurance employs a large call center with more than a hundred staff members from various backgrounds including medical experts. They offer help and guidance to members on different issues ranging from the status of the claims, eligibility, and customer satisfaction.

In addition, they have helpdesks in hospitals to support their members and to help them use the technology platforms properly.

7. Claims Processing

No other insurance company had created an online platform for hospitals to submit pre-authorization requests and finally settle claims until Vidal Health. 

This has enabled the speedy processing of applications and reduced the turnaround time for approvals for members, which in turn has been a great benefit to the members.

8. Customer Engagement

Vidal’s Health’s technology platforms ensure that insurance companies can enroll members in a few hundred or millions of people, which they can do without any stress. They have helped their clients register over a million members by the end of the short time frame from remote areas.

Documents Required for Vidal Health Insurance Claim

For Preliminary Approval of Vidal Health Insurance claim

• Pre-authorization form duly completed and signed by the insured/patient
• ID proof of the patient
• Admission notes (if the patient is already admitted)
• Investigation reports (before and after admission)
• Blood alcohol reports (for accidental injuries)
• Consultation papers and referral letters
• Medico-legal papers for accident cases (MLC report, Police FIR)

For Final Approval of Vidal Insurance claim

• Enhancement request with a justification
• Report on alterations in diagnosis, treatment, or medical history
• Comprehensive discharge summary or death summary.
• Investigation reports (except those that have already been submitted).
• Histopathology report
• Operation theatre notes
• MLC report/FIR for accident cases (if not submitted earlier)
• Sticker and invoice for the implants used.
• The hospital main bill and break-up bill were signed by the patient.
• Receipt for the co-pay amount collected.
• The copy of the bill and receipt for non-admissible amounts collected.

For Cashless Approved Settlement of Vidal Health Insurance claim

• Preliminary pre-authorization request and approval letter signed by the patient
• Final enhancement approval letter signed by the patient
• Original enhancement request with justification
• Admission notes (certified copy)
• OPD case papers/consultation papers/referral letters (certified copy)
• ID proof of the patient (copy)
• Detailed discharge summary or death summary (original)
• Investigation reports (original)
• Histopathology report (original)
• Operation theatre notes (certified copy)
• MLC report/FIR for accident cases (certified copy)
• Sticker for implants (original)
• Invoice for implants (certified copy)
• Hospital main bill and break-up bill signed by the patient (original)
• Copy of receipt for the co-pay amount collected
• Copy of bill and receipt for non-admissible amounts collected
• Covering letter for each claim

Follow these steps to ensure a smooth and hassle-free claims process with Vidal Health Insurance.