Scribd
Upload
4 views2 pages

Paramount Health Services & Insurance Tpa Private Limited: Deficiency Letter Without Prejudice

Paramount Health Services & Insurance TPA has issued a deficiency letter regarding a claim for hospitalization related to the patient Sonal Khandwe. The letter specifies that additional documents are required to process the claim, including details from the attending doctor and positive investigation reports. The claimant is requested to submit the necessary documents within 14 days for further processing.

Uploaded by

prathamesh.bhavsar
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
4 views2 pages

Paramount Health Services & Insurance Tpa Private Limited: Deficiency Letter Without Prejudice

Paramount Health Services & Insurance TPA has issued a deficiency letter regarding a claim for hospitalization related to the patient Sonal Khandwe. The letter specifies that additional documents are required to process the claim, including details from the attending doctor and positive investigation reports. The claimant is requested to submit the necessary documents within 14 days for further processing.

Uploaded by

prathamesh.bhavsar
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
You are on page 1/ 2

PARAMOUNT HEALTH SERVICES & INSURANCE TPA PRIVATE LIMITED

(IRDA License No.006) Validity: From 21-03-2023 to 20-03-2026


[formerly known as PARAMOUNT HEALTH SERVICES(TPA)PVT.LTD]

Office No. 304,Meera Manan Arcade,,Near Krupa Petrol Pump Parimal Cross Roads Ellisbridge Ahmedabad,Ahmedabad-380006 Tel-079-40399287 / 88, ,Fax-
(079)-26401545,E-mail -ahmedabad.phs@paramounttpa.com

Deficiency Letter
Without Prejudice

To, Date : 24/06/2025


AEL THEIR SUBSIDIARIES AND
ASSOCIATED GROUP CO.,
C/O PRATHAMESH BHAVSAR,

Email id:
prathamesh.bhavsar@adani.com
Mobile No. : 9766077002

Policy & Member Details Claim Details

Insurance Company : Go Digit General Insurance Ltd. CCN No. : 7496128 Ext: Partial :

Policy No. : D181718474 Name of Patient :B/O SONAL KHANDWE

Policy Validity : 01/01/2025 to 31/12/2025 Date of Admission :31/05/2025

Employee Name : PRATHAMESH BHAVSAR Date of Discharge :03/06/2025

PHS ID.No. : 40083282 Employee No. : 30092193


Provider Name:PARIJAT HOSPITAL
Insurance Claim No:

Ailment : Full Term 39 Wks Lscs Fch Bciab Infant Of Diabetic Mother

Dear Sir/Madam,
We are in receipt of the documents forwarded by you pertaining to the captioned claim. On scrutinizing the documents,it is observed that the following
documents / information are required to process your claim:

Sr.No Deficiency Type Mandatory Status

1 DETAILS FROM ATTENDING DOCTOR: indicating need for inpatient hospitalization Yes Pending

POSITIVE INVESTIGATION: all report / investigation / films / plates to establish the


2 Yes Pending
ailment/diagnosis.

You are requested to submit the original documents as mentioned above within 14 days from the receipt of this letter,so that we can proceed further and
process the claim.Please note that the conclusion regarding the eligibility of coverage/admissibility amount can only be decided once we have a full set of
original documents. Your co-operation in this regard shall be highly appreciated.
Kindly quote the CCN for all future correspondence regarding this claim.

Thanking You,

Medical Officer
For Paramount Health Services & Insurance TPA Private Limited

Please Provide your Email Id. & Contact No. for future correspondence.

For complete guidance on your current claim status,please log on to our website www.paramounttpa.com
PARAMOUNT HEALTH SERVICES & INSURANCE TPA PRIVATE LIMITED
(IRDA License No.006) Validity: From 21-03-2023 to 20-03-2026
[formerly known as PARAMOUNT HEALTH SERVICES(TPA)PVT.LTD]

Office No. 304,Meera Manan Arcade,,Near Krupa Petrol Pump Parimal Cross Roads Ellisbridge Ahmedabad,Ahmedabad-380006 Tel-079-40399287 / 88, ,Fax-
(079)-26401545,E-mail -ahmedabad.phs@paramounttpa.com

CLAIM ACKNOWLEDGMENT SHEET

Name of Insurer : Go Digit General Insurance Ltd. CCN NO : 7496128


Insured Name : PRATHAMESH BHAVSAR Policy No : D181718474
PHS ID : 40083282 Patient Name : B/O SONAL KHANDWE
Mobile No : 9766077002 Employee No : 30092193

Name of Corporate :

Type of Claim (To be ticked) : Main Hospitalisation / Pre-Post Hospitalisation / OPD Claim
Total no of documents received 0
Sr No. Category Document received Yes/no No of documents
1 claim Form NO 0
2 KYC DOCUMENTS NO 0
3 NEFT DOCUMENTS NO 0
4 DELAY INTIMATION / SUBMISSION DOCUMENTS NO 0
5 DISCHARGE CARD /DEATH SUMMARY /TRANSFER SUMMARY NO 0
6 Indoor Case Paper NO 0
7 FINAL HOSPITAL BILL NO 0
8 FINAL HOSPITAL CASH RECEIPT NO 0
9 CONSULTATION CASH RECEIPT NO 0
10 INVESTIGATION CASH RECEIPT NO 0
11 INVESTIGATION REPORT NO 0
12 MEDICINE CASH RECEIPT NO 0
13 MEDICINE PRISCRIPTION NO 0
14 IMPLANT STICKER NO 0
15 64 VB DOCUMENTS NO 0
16 POLICY COPY NO 0
17 PAN CARD NO 0
18 AADHAR CARD NO 0
19 CKYC NO 0
20 Other NO 0

You might also like

pFad - Phonifier reborn

Pfad - The Proxy pFad of © 2024 Garber Painting. All rights reserved.

Note: This service is not intended for secure transactions such as banking, social media, email, or purchasing. Use at your own risk. We assume no liability whatsoever for broken pages.


Alternative Proxies:

Alternative Proxy

pFad Proxy

pFad v3 Proxy

pFad v4 Proxy