With a fast-growing Indian Healthcare Economy, quick, cashless treatment has given rise to the necessity of pre-authorizations. One such important tool comes in the form of the Vidal Pre Auth Form that must be submitted for approval of scheduled medical procedures under health insurance coverage through Vidal Health TPA (Third Party Administrator).
Whether from a policyholder, caregiver, or hospital personnel engaged with insurance claims, knowledge of the Vidal health Pre Auth Form would make the treatment go smoothly. In this blog, you will be taken through the form, where to get it, how to fill it out, and the procedures for submitting it properly, with some other important FAQs.
What is the Vidal Pre Auth Form?
The Vidal Pre Auth Form is an official document used by Vidal Health TPA to evaluate and approve medical treatments before these are carried out. It is a bridge between the policyholder, the hospital treating the patient, and the insurance provider that facilitates cashless treatment at network hospitals.
Specifically, the pre-authorization process allows pre auth form Vidal Health to confirm whether:
- Patient treatment falls under the policy
- Estimated cost of hospitalization
- Necessity and medical justification for the procedure are considered.
- Status of pre-existing conditions
From there, Vidal Health TPA finishes the communication with the insurer and hospital, seeking adjudication of approval or rejection of the cashless treatment.
Why Is the Vidal Pre Auth Form Important?
- Patients may consider pursuing cashless treatment.
- It gives assurance that your insurance would cover the procedure planned for you.
- It eases the claim process for the hospital and sometimes for the policyholder.
- It expedites discharge after treatment.
Any mistakes in the form or failure to submit it may delay approvals and result in patients being asked to pay at the outset and then seek reimbursement at a later time.
Where to Get the Vidal Pre Auth Form
The following channels allow access to the Vidal Pre Auth Form:
1. Vidal Health TPA Website
The pre-authorization form needs to be searched for under, “Forms for Insured” or “Cashless Hospitalization” in the downloads section of www.vidalhealthtpa.com.You. You may also find the Vidal Health pre auth form PDF or the Vidal Health TPA pre auth form download options here.
2. Hospital Insurance Desk
Form copies have to be pre-printed in the hospital from Vidal Health’s network. The hospital insurance desk usually initiates the form-filling process.
3. Customer Care / Email Request
You can call or write an email to Vidal Health for a copy as well. These agencies would generally mail a Vidal pre auth form download link to the registered email address.
4. Mobile App (if applicable)
Provided any mobile application is available for your insurer or for Vidal Health, you may digitally fill out and submit the form.
Tip: Always check for the latest version or update of the vidal tpa pre auth form, as older ones may be rejected.
Key Sections of the Vidal Pre Auth Form
Generally, this Vidal health insurance pre auth form is divided into two primary sections:
Section A – To Be Filled by the Policyholder/Insured Person
Personal Details
- Patient’s name, age, sex, and contact details
- Relationship with the policyholder
Policy Details
- Insurance company name
- Policy number and Vidal Health card number
Hospital Details
- Name and address of the hospital
- Hospital ID, if it is an empanelled hospital
Type of admission
- Planned/Emergency
- Expected date and time of admission
Previous hospitalisation (if any)
- Details of any past hospitalisations for the same ailment
Declaration by the policyholder
- Signature and date
- Consent for the Insurance company to obtain medical records
Section B-6 To Be Filled by the Treating Doctor/Hospital
Diagnosis and Proposed Treatment
- Diagnosis and ICD Code
- Suggested Procedure or Treatment Plan
- Whether it’s Emergency or Elective
Cost Estimate of Treatment
- Detailed breakup or breakup including room charges, surgery charges, investigation charges, consultation charges, and post-operative care
Duration of Hospital Stay
- Expected number of days of stay (ward, ICU, recovery)
Pre-existing Disease Disclosure
- Whether the present illness is related to any pre-existing condition
Hospital Declaration
- Signature and stamp of the treating doctor
- Signature and seal of the hospital administration
How to Submit the Vidal Pre Auth Form
Follow the easy and smooth process to submit the Vidal pre-auth form.
Step 1: Fill in the Form Accurately
Ensure that all details are legible, are correctly filled in, and that no mandatory information is omitted. Check over all spellings, policy numbers, and dates.
Step 2: Get Necessary Supporting Documents
Usually, along with the form, the following documents can be submitted:
- Patient’s insurance e-card/policy
- Doctor’s prescription/admission note
- Latest diagnostic reports
- Patient’s ID card
Step 3: Submission to Vidal Health TPA
The forms and documents can be submitted either by (or through):
- Online (hospital TPA portal/app)
- By Fax (contact numbers are there on Vidal Health’s website)
- By Email (dedicated TPA email for pre-auth cases)
- Hand delivery to the TPA desk in the hospital
Step 4: Follow-Up
After submission, you or the hospital should get a reference number. The status may be tracked by:
- Vidal Health customer service
- Hospital TPA desk
- Insurance Co. helpline
Time Frame: For planned cases, approvals usually take 6 to 24 hours. Emergency approvals are expedited in a matter of a few hours.
Frequently Asked Questions (FAQ’s)
1. What happens if the Vidal Pre Auth Form is rejected?
In case of rejection, the treatment can be undergone on a cash basis, and a reimbursement claim can be made later with the required proof.
2. Can I submit the form without the hospital’s help?
Part A can be filled in by the policyholder. Part B requires medical input and must be completed by hospital staff and its doctors.
3. Do I require preauthorization for every hospitalization?
Pre Auth is mandatory only for cashless treatments in network hospitals. If you’re opting for reimbursement, it’s not compulsory, but still advisable.
4. How shall I verify whether my hospital is in the Vidal Health network?
You can call customer service or go to the website of Vidal Health and use the hospital locator tool.
5. Can the same form be used for multiple insurance providers?
No. The Vidal Pre-Authorization Form is only applicable to cases handled by Vidal Health TPA and cannot be used for other TPAs or insurers.