As a IHA member, you have access to high-quality healthcare services, delivered through a network of pre-screened and accredited healthcare providers.

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IHA works with your treating physicians to monitor and steer the healthcare service delivery to ensure better healthcare outcomes. This is done by:

• Prospective Case Management of intensive and interventional services ensures that our member’s receive the most appropriate treatment in the best healthcare setting available as per their chosen network. This is also referred as ‘Pre-authorization’.
• Concurrent Case Management of your ongoing treatment ensures that you receive the optimum treatment as per medical best-practices and internationally-accepted Clinical Pathways & Guidelines.
• Retrospective Case Management of the delivered treatment ensures that we examine the appropriateness of care offered to you while limiting and occasionally, eliminating over-utilization. This ensures that we incrementally improve your healthcare outcomes every time you return for another treatment.
• Referral Management (or ‘2nd Opinion’ referrals) ensures that we establish the appropriateness and medical necessity of your planned treatment. This also provides you with an opportunity to discuss the planned treatment with another specialist, other than your treating doctor, thus giving you assurance on the planned course of treatment as well as other available treatment options, if any.

Referral System:

• Applicant contact IHA 24/7/365 customer support center hotline and ask for help.
• IHA call center will verify beneficiary ID and IPC.
• The IHA call center will refer the patient to the nearest health facility according to the nature of your illness or as per patient’s preference.
• Once the insured person arrived at the health facility, show the health insurance ID card to the hospital reception as a secondary verification of employee identity.
• Health facility will introduce the insured person to related medical department for medical attention.
• After discharge, follow up appointments will be arranged in coordination with IHA medical department.
• In case, insured is not able to reach IHA call center (i.e. in a place not telephonic coverage) they can refer to any health facility and receive health care services by making a direct payment to the Clinic/Hospital. The Insured must obtain all the required supporting documents (Refer to the Claim Administration in below section). Thereafter, the Insured can claim their expenses, IHA will process claims within a week to maximum two weeks’ subject to receipt of requested information and supported documents.

 Emergency Cases:

• In the event that you require emergency medical treatment in a hospital or clinic, policyholder shall contact the helpline. The IHA emergency assistance service shall be available 24/7/365 to provide the assistance. Services such as arranging an emergency medical evacuation or providing a treatment guarantee to hospital.