My father had an urine infection and he 2 days before his operation has done in (Shri Markandey Solapur Sahakari Rugnalaya And Research Centre Niyamit)hospital, so my question is, he paid full payment for operation without any scheme as they were not aware about any scheme. So is there any chance to claim bill?
Hello Swapnil ji,
Thank you for your question. I understand your concern regarding the hospital bill after your father's surgery. Here's what you need to know:
Can You Claim the Hospital Bill After Surgery?
Before proceeding, it's important to clarify:
Are you referring to the Ayushman Bharat (PM-JAY) scheme or a private health insurance policy?
If It’s Ayushman Bharat Scheme (PM-JAY)
Ayushman Bharat works on a pre-authorization, cashless treatment model. That means:
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The hospital must be empanelled under the scheme
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Approval is required before treatment
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Reimbursement is NOT allowed if you've already paid the bill and Ayushman benefits weren’t used at the time of treatment
What You Can Do:
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Check if the hospital is empanelled
Use the official portal:
👉 https://hospitals.pmjay.gov.in/Search/empnlWorkFlow.htm -
Speak to the hospital’s Ayushman Coordinator
Some hospitals may help if eligibility was missed by mistake. -
File a grievance (if applicable)
If you believe Ayushman card was valid and the hospital denied it wrongly:-
📞 Call: 14555
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📝 Submit at: https://cgrms.pmjay.gov.in
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If It’s a Private Health Insurance Policy
If your father has a private insurance policy, then reimbursement may be possible, depending on the insurer’s rules.
Steps to Claim:
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Collect Original Documents:
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Discharge summary
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Hospital bill
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Payment receipts
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Investigation reports
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Doctor’s prescription and treatment summary
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Insurance policy copy
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File Reimbursement Claim:
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Submit all documents to your insurer within the allowed timeframe (usually 7–30 days post-discharge)
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Some insurers allow online submission via their website or mobile app
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Track claim status using the claim reference number
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TAT for Reimbursement:
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Most insurers process claims within 15–30 working days
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Wishing your father a full and speedy recovery.
Vianam Healthtech Private Limited (HexaHealth), Third Floor Building B, The Presidency, 46/4, Sector 14, Mehrauli Gurgaon Road, Gurgaon, Haryana 122001
