Insurance clam complain , My Self take medical treatment from N.M. Virani Wockhardt Hospital Rajkot

Dear sir,
My Self take medical treatment from N.M. Virani Wockhardt Hospital Rajkot. on 20/ 09/2018 to 21/09/2018. with cashless treatment The total bill clamed by hospital from Bajaj Allianz general insurance. Hospital deposit of RS. 9500.00 from me. Hospital not return me deposit of Rs. 9500.00 other detail as below.


30-OCT-2018
The Billing Department
Hospital Name N.M.VIRANI WOCKHARDT HOSPITAL - Rajkot
Address Kalawad Road, RAJKOT 360007
Contact Number [0281]6694444
Fax Number [0281]6694242
Name Of The Patient BHASKARRAI G. JOSHI.
ID Card No GMC-19193330020-G00971
Claim ID 2039098
Claim Number OC-19-1002-8403-00075141
IP No 0
Hospital Bill No 0
Period Of Hospitalisation DOA: 20-SEP-2018 DOD: 21-SEP-2018

Claimed Amount Details

Note: **** Field are to be considered as a deduction and should not be added in the Bill Amount.
Particular Bill Amount Disallowed
Amount

Approved Amount Disallowance Reason
Miscellaneous 218850 9270 209580 admission, CSSD, reg, assessment, BMW, drape,

dress, bactorub, mask, glvoe

Discount*** 20658 20658 --- 10% Disocunt On Total Hospital Bill Excluidng Phar-
macy, Consumables And Medicines

Payment Details
Approval Number SIN00043Q6836180
UTR No SIN00043Q6836180
PAN No AAACW3342G
Approval Date 30-OCT-2018
Bill Amount INR 218850
Paid Amount INR 170029
Disallowed Amount INR 29928
TDS Amount INR 18893
Hospital Service Tax No AAACW3342GSD010
Kindly Contact us at [email protected] or 020-30305858 in case of any clarifications are required.
Looking Forward to a mutually beneficial relationship.
With warm regards,

Authorised Signatory
For Bajaj Allianz General Insurance Co. Ltd
Health Administration Team
Bajaj

Reviewer : Bhaskarrai G. Joshi

Review Date : December 20, 2018

Reviewed Item : Insurance Complaint

Author Rating : 5

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