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a. Name of TPA/Insurance company: PARAMOUNT HEALTH SERVICES & INSURANCE TPA PVT.LTD. b. Toll free phone number : 1800-22-66 55 c. Toll free fax: 022- 66444754 / 66444755 / 66444709 d. Name of Hospital: i. Address ii. Rohini ID: iii. E-mail ID: A. Name of the Patient: B. Gender: Male Female Third Gender C. Age: Years Months
Cashless Request Form: Pre-authorization Form (Cashless) Reimbursement Claim Form: www.nivabupa.com
Pre-authorization Form (Cashless).pdf. PARAMOUNT HEALTH SERVICES & INSURANCE TPA PRIVATE LIMITED (IRDA License No. 006) [formerly known as PARAMOUNT HEALTH SERVICES (TPA) PVT.LTD] Plot no.A-442, Road No-28,M.I.D.C Industrial Area, Wagale Estate, Ram Nagar, Vitthal Rukmani Mandir, Thane (W), Mumbai, Pin Code – 400 604.
Pre-Authorisation_Request_Form.pdf. PARAMOUNT HEALTH SERVICES & INSURANCE TPA PRIVATE LIMITED (IRDA License No. 006) [formerly known as PARAMOUNT HEALTH SERVICES (TPA) PVT.LTD]
Edelweiss - Health Pre Authorization form. Request for Cashless Hospitalization for Health lnsurance Policy Part - C (Revised) NEED CASHLESS HOSPITALISATION? PLEASE HELP US WITH SOME DETAILS. (Do fill up this form in BLOCK LETTERS) DETAILS OF THE THIRD PARTY ADMINISTRATOR/ INSURER/ HOSPITAL. a. Name of TPA/Insurance company: b.
This document is a request for cashless hospitalization from Paramount Health Services & Insurance TPA Pvt. Ltd. It contains forms to be filled out by the insured patient, treating doctor/hospital, and declarations.
Paramount cashless request form. DO UHTXHVW#SDUDPRXQWWSD FRP . REQUEST FOR CASHLESS HOSPITALISATION FOR MEDICAL INSURANCE POLICY Paramount Health DETAILS OF THE THIRD PARTY ADMINISTRATOR "'OUR LINK to GOOD HEALTH (To be filled in block letters) Paramount Health Services (TPA) Ltd, (IRDA LICENCE No. 006) a) Name of TPA b) Toll free phone number ...
