Suman Eye Clinic is empaneled with major government and private health insurance providers.
Understand how we obtain pre-authorization approvals on your behalf in five steps.
Share your health insurance card, Aadhaar card, doctor prescription, and relevant reports with our cashless desk on diagnostic day.
Our billing desk coordinates with the doctor, fills the TPA pre-authorization form, and files the request electronically to your insurer.
The insurance doctor panel audits the medical necessity. They issue an initial pre-authorization approval letter defining the covered cost limit.
You undergo the cold micro-incision phaco cataract procedure on the scheduled day. Foldable premium lens is implanted successfully.
We submit final hospital discharge billing details to the TPA. Upon final approval check, you pay only non-medical costs and return home.
Please bring original copies and two photocopy sets of these files when booking surgeries.
Government ID proof of the patient (Aadhaar or PAN Card).
Physical medical card or active digital policy copy showing the Policy Number.
Formal consultation sheet from Suman Eye Clinic prescribing Cataract surgery.
A-scan biometry lens measurements and systemic clearance reports (e.g. blood sugar, ECG).
Are you planning cataract surgery and wondering if your policy is active, requires a waiting period, or has co-payment clauses?
Our cashless coordinator desk can audit your policy guidelines for you. Simply fill the form with your insurer details, and we will contact you within 24 business hours to clarify your coverage terms.
Clarifying waiting periods, limits, and the difference between cashless and reimbursement options.
In a Cashless Claim, the hospital coordinates directly with the TPA, and the insurer settles the medical bills directly with the clinic, requiring zero upfront deposits from you. In a Reimbursement Claim, you pay the clinic bills yourself out of pocket upon discharge, and later submit all papers to your insurer to get the amount refunded.
Most standard individual health policies have a mandatory 2-year waiting period for specific ailments, including cataracts. However, corporate employee medical shields often have this waiting period waived from Day 1. We recommend checking your policy terms or submitting your document copy to our desk for verification.
Coverage limits depend on your policy clauses. Some policies have a fixed capping on cataract costs per eye (e.g. ₹40,000 or ₹60,000), while others cover actual surgical bills. If you select a premium lens that exceeds your insurance capping limit, you will need to pay the difference amount out of pocket at discharge.
Typically, the initial pre-authorization approval is issued by the TPA within 2 to 4 hours of submission. Suman Eye Clinic handles all paperwork to avoid delays. We recommend submitting your papers 1-2 days before the scheduled surgery date to ensure complete peace of mind.