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Arthroscopy Surgery Under Insurance 100% Cashless

Most health insurance companies in India cover the cost of arthroscopy surgery as it comes under the category of medically necessary treatment. However, the extent of coverage can vary from policy to policy. Read on to know all about the insurance coverage of arthroscopy surgery in India.

Most health insurance companies in India cover the cost of arthroscopy surgery as it comes under the category of medically necessary treatment. However, ... Read More

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Arthroscopy Treatment Insurance Claim
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No-Cost EMI

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USFDA-Approved Procedure

Benefits of Choosing Pristyn Care Treatment with Insurance

Hospitalization Expenses
Get a wide range of expenses associated with surgery covered seamlessly, including room rent, medical procedures, diagnostic tests, surgeon’s fees, nursing fees, ICU costs, OR charges, etc.
Pre & Post Hospitalization
Comprehensive coverage as specified by your insurance, including preparation and recovery for 30/60 days before and after hospitalization. Additional support through free follow-ups beyond the policy.
Cashless Payment
Eliminate the need to carry cash and make the payment process swift and easy. Pay and track the hospital transactions with added security.

Why Is Arthroscopy Covered Under Insurance?

Arthroscopy is often covered under insurance because it is considered a minimally invasive and effective treatment for a variety of joint conditions. It is a surgical procedure that involves the use of a tiny camera and surgical instruments to diagnose and treat problems within a joint.

Insurance companies generally cover arthroscopy surgery if it is deemed medically necessary, meaning that it is necessary to diagnose or treat a particular joint condition. The decision to cover arthroscopy surgery is typically based on the patient’s symptoms, medical history, and the results of diagnostic tests and imaging studies. Some common joint conditions that may be treated with arthroscopy surgery include:

  • Torn cartilage
  • Damaged or inflamed synovium
  • Loose bone fragments
  • Ligament or tendon tears
  • Arthritis

In addition to being a minimally invasive treatment option, arthroscopy surgery also ensures faster recovery times and lower complication rates compared to traditional open surgery. This results  in cost savings for insurance companies and lower out-of-pocket expenses for patients.

In summary, arthroscopy surgery may be covered under insurance if it is deemed medically necessary to diagnose or treat a particular joint condition. However, insurance coverage for arthroscopy surgery may vary depending on the patient’s individual circumstances and the requirements of their insurance policy. It’s important to check with your specific insurance provider to understand what is covered under your plan.

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How to get Arthroscopy Surgery under Insurance?
Both, health and Mediclaim insurance policies cover the cost of Arthroscopy Surgery.However, it is advised to choose an insurance policy that provides extensive benefits at an affordable price. At Pristyn Care, you get not only the best Arthroscopy Surgery.but also a hassle-free experience during filing the health insurance and Mediclaim. We take care of the complete procedure, including insurance-related paperwork, of getting approval on an insurance claim. This is to ensure that the patient nor their family members have to face any additional hassles.
1 Intimation
All you need to do is to fill a pre-authentication form along with relevant insurance documents for availing cashless treatment at our partner hospital.
2 Approval/Rejection
Your pre-authentication form is approved or denied based on the terms and conditions of your health insurance policy.
3 Hospitalisation
Hospitalisation can be done based on pre-authentication approval. Hence, it is advisable to finish the pre-authentication procedure beforehand.
4 Claim Settlement
At the time of discharge, we will coordinate and settle your bills directly with the hospital and insurance provider.
1 Hospitalization At Non Network Hospital
If hospitalised at a non-network hospital, you don't need to pay the medical bills. Pristyn Care will settle the bills with the hospital on your behalf.
2 Register A Claim
To register a claim, please fill in the claim form with all your receipts, reports and relevant documents received from the hospital at the time of discharge. We, at Pristyn Care will help you claim reimbursement from your health insurance company.
3 Verification
We will share all your claim-related medical documents in original with your insurance provider to check if everything is in order.
4 Claim Settlement
We will coordinate with your insurance company to reimburse the claim amount to your registered bank account. You can later pay back that amount to us as per the policy terms and conditions.

Cost Covered Under Health Insurance Policy/Mediclaim Policy For Arthroscopy Surgery

The cost of arthroscopy surgery may be covered under a health insurance policy or mediclaim policy, depending on the specific terms and conditions of the policy. Typically, health insurance policies cover the cost of arthroscopy surgery when it is deemed medically necessary. However, the extent of coverage may vary depending on the policy terms and the nature of the medical condition.

Before undergoing arthroscopy surgery, it is important to check with your health insurance provider regarding coverage details. This may include the extent of coverage, any applicable deductibles, copayments or coinsurance amounts, and any exclusions or limitations on coverage for pre-existing conditions or certain procedures. It is also important to obtain pre-authorization from the insurance provider to ensure that the procedure is covered under the policy.

All Major Insurances Accepted

Difference Between Health Insurance and Mediclaim

Medical expense coverage is provided by two different insurance policies, health insurance and mediclaim, however their coverage and scope are different.

A comprehensive insurance plan known as health insurance covers a variety of medical costs, such as hospitalization, doctor visits, diagnostic tests, surgeries, and other medical procedures. Depending on the policy, it may also cover catastrophic illnesses , accidents, and pre-existing ailments. Generally speaking, health insurance policies are more expensive than mediclaim policies but provide a wider range of coverage.

On the other hand, Mediclaim is a kind of health insurance plan that provides coverage for particular medical costs, including hospitalization costs for a particular illness or injury. It is intended to cover costs associated with hospitalization, such as room charges, nursing charges, doctor fees, and other medical expenses. It is typically less expensive than health insurance. Pre-existing conditions, serious illnesses, and other medical procedures unrelated to hospitalization may not be covered by mediclaim coverage.

In conclusion, health insurance provides comprehensive coverage for a variety of medical costs, whereas mediclaim only provides partial coverage for hospital costs.

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FAQs Related to Arthroscopy Surgery Insurance Coverage

What factors affect the cost of arthroscopy surgery?

Factors that usually impact the cost of arthroscopy surgery: Type and severity of the injury Consultation and surgeon fees Diagnostic tests Type of hospital Cost of postoperative care 

What is the cost of arthroscopy surgery?

Cost of different arthroscopic surgery are as follows: Knee arthroscopy surgery: INR 80,000 to INR 90,000 Ankle arthroscopy surgery: INR 1,00,000 to INR 1,40,000 Shoulder arthroscopy: INR 1,00,000 to INR 1,40,000

What set of documents are required for the insurance claim procedure?

You may require the following set of documents for the insurance claim procedure: Original claim from duly completed along with your signature Valid identity proof Doctor’s prescription suggesting treatment in hospital Ambulance receipt

How to claim the insurance for arthroscopy surgery?

A health or medical insurance claim process of requesting the insurer to provide the benefits and services covered in your health insurance policy. You can either opt for a cashless claim or a reimbursement claim for medical expenses incurred. 

Cashless Payment Service For Arthroscopy Surgery at Pristyn Care

Pristyn Care provides seamless surgical experience to all the patients. At Pristyn Care we provide a cashless payment service for arthroscopy surgery.  Our main objective is to reduce the patients’ financial burden. We have a dedicated insurance team to help patients utilize their health insurance or mediclaim policy. You can avail the cashless service at Pristyn Care in the following steps:

  • Firstly you have to submit insurance related documents and all other required documents and we’ll verify the documents with the respective insurance provider.
  • We offer two options to patients, i.e., cashless payment and zero cost EMI to pay for the Arthroscopy surgery.
  • Our team shares the patients’ preferred mode of payment and their documents with the insurer.
  • Once the claim amount is sanctioned, the patient is admitted to the hospital and our care coordinator takes care of all the hospital related formalities during the treatment. 
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