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Rotator Cuff Repair Under Insurance 100% Cashless

If Rotator Cuff Repair surgery is medically necessary, your insurance will likely cover the cost of the surgery. However, some insurance policies may have specific exclusions or limitations that could impact coverage. This page will give you a brief about rotator cuff repair insurance coverage, best insurance providers in India for rotator cuff repair, and so on.

If Rotator Cuff Repair surgery is medically necessary, your insurance will likely cover the cost of the surgery. However, some insurance policies may ... Read More

Rotator Cuff Repair Treatment Insurance Claim

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Why Insurance Covers Rotator Cuff Repair

Insurance companies cover rotator cuff repair surgery because it is a medically necessary surgical procedure for treating certain injuries or conditions of the shoulder joint. The rotator cuff is a group of muscles and tendons that surround the shoulder joint, and can become torn or damaged due to repetitive use, overuse, or a traumatic injury.

Rotator cuff repair surgery involves repairing the torn or damaged tissue in the rotator cuff through various techniques such as arthroscopic surgery or open surgery. The surgery can help reduce pain, improve shoulder function, and prevent further damage to the joint.

Insurance companies generally cover rotator cuff repair surgery when it’s medically necessary, meaning that the surgery is required to treat a medical condition or injury that is causing significant pain or functional impairment. However, insurance coverage can vary depending on the specific policy and the individual case. It is always recommended to check with your insurance provider to determine the coverage for rotator cuff repair surgery.

Rotator Cuff Repair Surgery Cost Calculator

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How to get Rotator Cuff Repair under Insurance?

Both, health and Mediclaim insurance policies cover the cost of Rotator Cuff Repair .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 treatment for Rotator Cuff Repair .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

Fill up the pre-auth form at the network hospital for cashless approval. Fill up the pre-auth form at the network hospital for cashless approval

2 Approval/Rejection

Fill up the pre-auth form at the network hospital for cashless approval. Fill up the pre-auth form at the network hospital for cashless approval

3 Hospitalisation

Hospitalisation can be done on the basis of pre-auth approvalHospitalisation can be done on the basis of pre-auth approval

4 Claim Settlement

At the time of discharge, we settle the claim directly with hospitalAt the time of discharge, we settle the claim directly with hospital

1 Hospitalization At Non Network Hospital

You need to pay the bills initially and preserve the original invoices

2 Register A Claim

Post hospital discharge send us all your invoices and treatment documents

3 Verification

We verify your claim related invoices and treatment documents

4 Claim Settlement

We send the approved claim amount to your bank account

Best Doctors for Rotator Cuff Repair Surgery

Dr. Pradeep Choudhary

MBBS, MS-Orthopedics

33 Yrs.Exp.

4.8/5

33 + Years

Indore

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6366-370-250

Dr. Kamal Bachani

MBBS, MS(Ortho), M.Ch(Ortho)

32 Yrs.Exp.

4.7/5

32 + Years

Delhi

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6366-370-250

Dr. Nallamothu Anil Kuma...

MBBS, DNB,MS-orthopedics

29 Yrs.Exp.

4.9/5

29 + Years

Hyderabad

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6366-370-250

List of Expenses Covered By Health Insurance and Mediclaim

The expenses covered by health insurance and mediclaim policies can vary depending on the specific policy, but here are some of the common expenses that are typically covered:

Hospitalization expenses, including room rent, doctor’s fees, and medical tests.
Surgical expenses, including surgeon’s fees, anesthesia charges, and operation theater charges.
Outpatient care expenses, including doctor’s consultation fees, diagnostic tests, and prescription medications.
Maternity expenses, including pre-natal and post-natal care, delivery charges, and newborn care.
Ambulance charges for emergency transportation to the hospital.
Treatment for pre-existing illnesses or injuries, depending on the policy’s terms and conditions.
Treatment for critical illnesses like cancer, heart disease, or kidney failure.
Rehabilitation expenses, including physical therapy, occupational therapy, and speech therapy.

It’s important to note that the exact expenses covered may vary depending on the policy terms and conditions, and the coverage limits specified in the policy. It is always recommended to carefully review the policy documents and consult the insurance provider to understand the specific expenses covered by the policy.

All Major Insurances Accepted

What is the Difference Between Health Insurance and Mediclaim?

Health insurance and mediclaim are two different types of insurance policies that offer different levels of coverage for medical expenses. Here are the main differences between the two:

Coverage: Health insurance provides coverage for a broad range of medical expenses, including hospitalization, outpatient care, diagnostic tests, prescription medications, and preventive care. On the other hand, mediclaim policies provide coverage specifically for hospitalization expenses, such as room rent, doctor’s fees, and medical tests related to your hospital stay.
Premiums: Health insurance policies generally have a higher premium than mediclaim policies because they offer a wider range of coverage options. Mediclaim policies have a lower premium but offer limited coverage than health insurance policies.
Coverage Amount: Health insurance policies usually have a higher coverage amount compared to mediclaim policies. Health insurance policies often offer a higher sum insured which can cover a wider range of medical expenses.
Additional Benefits: Health insurance policies may offer additional benefits like maternity benefits, wellness programs, coverage for pre-existing diseases, and emergency medical evacuation, which are not offered by most mediclaim policies.
Claim Process: The claim process for health insurance policies is more extensive and requires more documentation as they cover a wider range of medical expenses. The claim process for mediclaim policies is relatively simpler since they offer limited coverage.

In summary, health insurance provides comprehensive coverage for a wide range of medical expenses, while mediclaim policies provide coverage specifically for hospitalization expenses. It’s important to consider your healthcare needs and budget before choosing a policy that fits your requirements.

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FAQs Related to Rotator Cuff Repair Insurance Coverage

What is the cost of rotator cuff repair surgery in India?

The average cost of rotator cuff repair surgery in India typically ranges from INR 60,000 to INR 80,000 depending on the type of surgery and the preferred surgical approach. There are other factors that can affect the overall cost range, such as the city of surgery, the choice of hospital, etc. Visit Pristyn Care if you want a more accurate cost assessment for surgery. You can consult expert orthopedic doctors at Pristyn Care for a thorough diagnostic evaluation.

What set of documents are necessary for the approval of a health insurance claim?

To initiate the insurance claim process, you may require the following documents: The policy number Claim form Medical record Prescription receipts Hospital and pharmacy bills

What factors can affect the cost of rotator cuff surgery in India?

If you need rotator cuff surgery, then you must consider the following factors while calculating the cost of surgery: Choice of hospital and surgery Type and severity of injury Consultation and surgeon fees Patient’s age, gender, and health condition Cost of diagnostic tests Anesthesia cost and anesthetist fees Type of hospital room Cost of postoperative care and follow-up treatment

Cashless Payment Service For Spine Surgery at Pristyn Care

Visit Pristyn Care to undergo safe and effective rotator cuff surgery. We offer cashless payment services for rotator cuff surgery. Our first goal is to make sure that our patients are at ease and do not face any inconvenience during the course of their treatment. The cashless payment system at Pristyn Care operates in the following manner:

We initiate the insurance by collecting all the documents from the patients and then verify the documents with the insurance providers.
We offer two options to patients, i.e., cashless payment and zero cost EMI to pay for the spine surgery.
We provide care coordinators to handle all the documentation and submit the claim documents with the patient’s insurance provider.
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.