IP Processes

Who comes to you, and what happens first

Admission is advised by the treating doctor. It happens one of two ways: planned, arranged days in advance, or from the emergency department on the day.

Either way the same few things happen. The patient is given a hospital record number, the MRN, if they do not already have one. A bed is allotted. The GRE goes through the costs with you, takes the deposit and completes the forms at the bedside. In the emergency department all of that is done while treatment carries on, not before it.

If there is time before a planned admission, register on the hospital website or the VHealth mobile app first. Registration is free, takes only basic details and generates the MRN before you arrive.

• Ask who the treating consultant is, and the name of the ward or floor
• Ask the GRE for the estimate in writing before you pay the deposit
• If there is insurance, hand the card and policy number over straight away, because pre-authorisation takes time

What to bring

The hospital has not published a list of what to carry for an admission, so treat the list below as the things its own process asks for and the things families are most often sent home for. Confirm it with the GRE who calls you, because what is needed depends on who is paying.

• Earlier reports, scans, films and discharge summaries for this illness
• The medicines the patient is taking now, in their boxes or strips, including anything bought outside
• Photo identification for the patient and for the attendant
• The health insurance card and policy number, if there is one
• The Aarogyasri white card or health card, if the admission is under that scheme
• The admission or referral note from the treating doctor, for a planned admission
• Money for the deposit, and a card, since the deposit is taken at admission
• Nothing valuable. The hospital is not liable for the loss of valuables from the room

Choosing a room

The hospital has about 300 ward beds and 140 intensive care beds in one building. If the patient needs intensive care, that is a clinical decision and there is no category to choose. For a ward admission you choose, and the GRE asks you for that choice at admission.

• Economy ward: a cluster of eight beds with partitions, couches for attendants, and its own nursing station
• Executive suite: a single room, the lower cost way to have privacy
• Platinum suite: a single room with a relationship manager who handles billing, investigations and pharmacy for you, a higher nurse to patient ratio, and video access to consultants
• Presidential suite: a single room with an anteroom for relatives and dedicated nursing support
• Intensive care: allotted on clinical grounds, not chosen
• Every single room has Wi-Fi, so reports and the running bill can be seen from the bed

Two questions to ask before you pick a room

Room charges are not published on this site, so ask the GRE for the daily charge for each category before you choose.

Then ask the second question, which families almost never think to ask: what else changes with the room. In Indian hospitals the room category commonly sets the rate charged for tests, procedures and doctors' visits as well as the bed, so a category that costs a little more each day can lift the whole bill by much more than the difference in room rent. Ask for that answer as part of the written estimate.

If you want to move to a different category during the stay, ask the GRE whether a bed is free and how the change is billed.

The deposit, the estimate and the running bill

Before the admission is completed the GRE does what the hospital calls financial counselling: an estimate for the treatment proposed, and the deposit to be paid now. Neither figure is published here because both depend on the treatment and the room. Ask for both, and ask what the estimate leaves out.

If the plan of care changes during the stay, the change and what it costs are to be brought to you and recorded. If the treatment has clearly changed and nobody has told you, ask.

Every service is posted to the bill as it is used, so the total is complete at any moment rather than assembled at the end. You can watch it from the bed. That running total is the earliest warning you will get that a bill is heading past the estimate, and it is worth looking at every day rather than on the last one.

Some treatments are sold as fixed-price packages, with the list on the web portal and the mobile app. If a package covers what the patient is having, ask what is inside it and what is charged on top.

Consultants and GREs can issue discount vouchers and coupons, in denominations of 5 and 10 per cent, towards part of the cost for patients below the poverty line and some other categories. One coupon or voucher can be used for one patient. If paying is going to be a problem, say so at the financial counselling, not at discharge.

• What is the deposit, and which payment methods do you take?
• Does the estimate include medicines, implants, blood and the consultants' fees?
• What happens to the estimate if the patient needs intensive care?

If you have health insurance

Hand the insurance card, the policy number and the patient's identification to the GRE as early as you can. For a planned admission that can be done days ahead. For an emergency admission the GRE collects the documents in the ward, and treatment does not wait for them.

The GRE sends those documents and the estimate to your third party administrator, the TPA, for pre-authorisation. Pre-authorisation is the insurer agreeing in advance to pay, and it is what makes an admission cashless. The GRE tells you where the request has reached.

Two things are worth knowing before you rely on it. The decision belongs to the insurer, not to the hospital. And an approval often comes back smaller than the estimate, because many policies cap the room charge and some tests and consumables, and the difference is yours to pay.

The hospital has cashless arrangements with a number of insurers and TPAs, but not with every one. Check with the GRE, and check with your own insurer, before the day if you can.

Government and employer schemes, and what ARY means

If you see ARY on a bill or a form, it stands for Aarogyasri. It is the state government health scheme, run by the Aarogyasri Health Care Trust, and the hospital's billing system marks services covered by it with those three letters. It is a code, not a charge.

Under the scheme the hospital's medico applies online for pre-authorisation, uploading the white card or health card, the medical reports and films, and clinical photographs where they are asked for. Doctors and specialists at the trust examine the request and give the approval. The government then pays the whole amount on the patient's behalf.

The hospital also treats patients under employee health schemes, central government schemes and credit arrangements with public sector and corporate employers. For those the GRE prepares an estimate and a credit letter, and the employer's own office has to approve it. Start that as early as you can, because the approval happens outside the hospital and the hospital cannot hurry it.

A planned admission

Once your doctor asks for the admission, the GRE books it: the date, the time, the room category and the deposit. If there is insurance, pre-authorisation is started then. That is the reason to arrange a planned admission days ahead rather than the night before.

The day before, the GRE calls to confirm. If that call has not come by the evening before, call +91 40 4699 9999 and ask.

On arrival the GRE takes you to the room and the admission is completed at the bed. A tablet is handed over, which the patient can use to follow their own treatment. Treatment starts from there.

If the procedure is day care, you will be asked to come early in the morning, because the patient is likely to go home the same day. The GRE receives you and takes you to the day care unit. What day care covers is set out on the short stay care page.

If you came in through the emergency department

The emergency department runs 24 hours a day, every day of the year. Treatment starts on arrival and the admission is arranged around it.

If the emergency doctor advises admission, the GRE generates the hospital record number and completes the admission while treatment carries on. The patient is then moved from the emergency room to the allotted bed.

If the patient has a cashless facility the GRE completes that paperwork in the ward, and if the patient has insurance the GRE collects the documents and sends them to the TPA. None of it holds up treatment.

One person from the family should stay at the bedside and reachable through this. The bed, the room category and the deposit all need decisions quickly, and the GRE will be looking for someone who can make them.

The day of the operation

When an operation is advised, the GRE goes through the costs with the attendants and records the date and time. The operating surgeon books the theatre in the hospital's information system at that moment.

The day before, the theatre coordinator confirms the day and time with the surgeon, and the theatre in-charge calls the patient to confirm. The theatre is prepared and any special equipment the surgeon needs is arranged.

The team will tell you when the patient must stop eating and drinking before the operation. Follow that exactly. Ask where you should wait, who will come out to speak to you, and roughly when.

What happens inside the theatre, and the theatres themselves, are described on the surgical services page.

During the stay

Meals are available round the clock and can be ordered from the room or from the mobile app. If a particular diet has been ordered, a dietician draws up a chart and the duty nurse makes sure the patient gets it. Attendants and guests can order meals too, at an extra charge.

Reports and the running bill can be seen during the stay on the Virinchi web portal or the VHealth mobile app, using the user ID and password issued at registration. A text message goes to the registered mobile number when a report is ready. Bills can be paid online.

Visiting hours are not published on this site. Ask the nurse on the floor, and ask separately about intensive care, where the rules are usually different.

• One attendant should stay with the patient at all times
• One attendant pass and one visitor pass are given at admission. Keep them safe and hand them back at discharge
• A free valet ticket is provided
• Food and medicines from outside are not allowed
• Patients wear hospital clothes
• Do not keep valuables in the room. The hospital is not liable for their loss

Going home: what discharge actually involves

Discharge is the part of a hospital stay that most often goes wrong, with families waiting most of a day for paperwork and nobody able to say what for. It is worth knowing the steps, because then you can see which one you are waiting on and ask the right person about it.

One thing works in your favour here. The bill does not have to be built from scratch at the end, because every service was posted as it was used. The figure is already there when discharge is advised.

• The treating consultant advises discharge. Nothing before this starts the process
• The nurses mark the discharge advice, return unused medicines to the pharmacy and cross-check the investigations that were ordered
• The duty medical officer writes the discharge summary in the hospital information system, and the treating consultant reviews it
• The bill is finalised. If there is insurance it goes to the TPA at this point, and from then the wait is the insurer's rather than the hospital's
• The GRE comes to the room and explains the final bill
• You settle what is due, the nurse goes through the medicines for home, and the file with the reports and the discharge summary is handed over

How the last step differs depending on who is paying

If you are paying yourself, two checkout slips are made out and handed to you. The GRE books the follow-up appointment and tells you the date and time, and asks you for feedback on the stay.

If you have insurance, the final bill goes to the TPA with the discharge summary for final approval. Any co-payment left after that is brought to the room, explained and settled there. If the insurer or TPA refuses at that point, you settle the bill yourself, and the hospital hands you the bills, copies of the reports and tests and the claim form so you can claim it back.

Under Aarogyasri, once the trust has settled, the nurse explains the medicines to be taken after discharge and hands over the file with the reports and the discharge summary. The floor GRE and the nurse complete the discharge checklist together, the checkout slip and visitor passes are collected, and transport is arranged if it is needed.

How long it takes, and what to ask on the day

How long discharge takes from the moment it is advised is not published, and this page will not guess at a number. What you can do is ask, early, and ask the right person at each step.

Ask on the morning of the day, not the afternoon. Ask the nurse what time the consultant is expected on the round. Ask the GRE when the bill will be ready. If you have insurance, ask what time the file went to the TPA, because that wait is outside the hospital and knowing when it started tells you more than asking again an hour later.

Ask for the follow-up appointment at the same time, so you are not queueing for it after everything else is done.

Before you leave the building

Check that you are carrying all of these. Coming back for one of them is a wasted journey across Hyderabad.

• The discharge summary
• The prescription, and the medicines if they have been issued
• All reports, scans and films
• The paid final bill, and the claim form if you are claiming reimbursement
• The date and time of the follow-up appointment
• Anything left in the room, and the patient's own clothes

Refunds

If you have paid for an investigation or a procedure and it is not done, for whatever reason, there is a refund policy. The consultant has to recommend the refund, and you sign and return the original bill copy.

Do not leave a refund to be settled after discharge. Raise it with the GRE while the file is still open.

• Refunds are made for outpatient and inpatient services
• Cash paid on the same day is refunded in cash the same day
• Card payments are refunded by cheque, on the terms that apply