What is a Network hospital and TPA?
A network hospital is one that has a tie-up with your insurer to offer cashless treatment. A TPA (Third Party Administrator) is the agency that issues your health card and processes claims between you, the hospital and the insurer. Some insurers process claims in-house instead of using a TPA.
Network hospitals
Insurers empanel hospitals where they have agreed rates and a cashless arrangement. At these hospitals you can get cashless treatment; at others you pay and claim reimbursement.
Networks change over time, so it is worth checking the current list — and whether the hospitals you would actually use are on it — before you need to claim.
What a TPA does
A TPA is the intermediary that issues your health card, receives pre-authorisation requests, and coordinates approvals and settlements. Where an insurer runs claims in-house, that team plays the same role.
Example
Before a planned surgery you check that your preferred hospital is in the insurer's network, so you can use cashless. Your TPA card and policy number are what the hospital's insurance desk uses to raise the request.
Common mistakes
- Assuming a hospital is in-network without checking the current list.
- Confusing the TPA with the insurer — your cover and terms come from the insurer, the TPA only administers the process.
Frequently asked questions
Does the network hospital list ever change?
Yes. Hospitals can be added or removed from an insurer's network over time. Check the latest list before a planned admission.
Is a claim slower with a TPA than in-house?
Not inherently. Speed depends on documentation and the specific insurer/TPA. Both route to the same policy terms for the final decision.