Before, during and after a hospital stay
This is written from the patient's side of the counter. Most of it applies to any private hospital in Hyderabad. Where a rule comes from IRDAI or the national Charter of Patients' Rights, it is marked.
Before admission
- Ask for a written estimate. If it is a package, ask what is not included: implants, extra ICU days, pharmacy, blood, and doctor visits after a set number.
- Ask the rates in writing too. The Charter says hospitals should display rates and give you costs in writing.
- With insurance, call your insurer or TPA first. Check three things: is the hospital in network, what is your room rent limit, and what is the co-pay or sub-limit for this treatment.
- Pick a room within your limit. A costlier room can cut your whole claim, not just the room difference (see below).
- Ask how much deposit they need and whether it is refundable if cashless is approved.
Room rent trap. If your policy allows ₹5,000 a day and you take an ₹8,000 room, the insurer may pay only 5,000 ÷ 8,000 = 62.5% of room-linked charges like doctor fees, nursing and OT. Medicines, tests, implants and ICU charges are not cut this way.
At admission
- For cashless, the hospital's insurance desk sends the request. You should not have to chase documents yourself.
- In an emergency, treatment comes first. Tell the insurer within 24 hours (the hospital desk usually does this, but confirm).
- Photograph every form you sign, including the estimate and consent forms.
IRDAI rule (May 2024). Insurers must decide a cashless request within one hour, and insurers and TPAs collect claim documents from the hospital, not from you.
During the stay
- Ask for an interim bill every day or two. Mistakes are easier to fix while you are still there.
- Keep a simple note: date, which doctor came, which tests were done. It takes two minutes and settles most bill arguments.
- You may choose where you buy medicines and get tests done. The Charter lists this as a right. Some hospitals push back for inpatients; ask politely and in writing.
- Return unused medicines before discharge and check they are credited.
Reading the final bill
- Ask for the itemised bill, not just a summary. You are entitled to it.
- Look for: the same test twice on one day, charges after your discharge time, more doctor visits than days, room charged for an extra day, and medicines above MRP.
- Many insurers do not pay for gloves, masks, admission kits, registration fees and similar items. That is usually not the hospital's error, but it is money you pay. A consumables add-on on your policy covers some of it.
- Check the maths. Discounts and advances should be subtracted in the final total.
Use the bill checker to spot these in a photo or PDF of your bill.
Discharge
- Get the discharge summary, all test reports, the itemised bill and pharmacy bills before you leave.
- A hospital cannot keep a patient, or a body, because of a payment dispute. The Charter says so plainly.
IRDAI rule (May 2024). The insurer must give final discharge approval within three hours of the hospital's request. If it takes longer, extra hospital charges for the delay are paid by the insurer, not you.
If something went wrong
Go up this ladder in order. Keep copies of every complaint and reply.
- Hospital grievance desk. Complain in writing and get an acknowledgement.
- Insurer's grievance officer for claim cuts or delays. Their contact is in your policy document.
- Bima Bharosa, IRDAI's complaint portal: bimabharosa.irdai.gov.in
- Insurance Ombudsman, Hyderabad if the insurer rejects you or does not reply within 30 days. Free, no lawyer needed. Covers Telangana and Andhra Pradesh.
6-2-46, 1st floor, Moin Court, A.C. Guards, Lakdi-ka-pul, Hyderabad 500004 · oio.hyderabad@cioins.co.in · 040-23312122
- Consumer Commission for hospital billing or service problems. File online at edaakhil.nic.in