What is Pre-authorisation (cashless)?
Pre-authorisation is the approval an insurer, TPA or government scheme gives before a planned or emergency admission so the patient can be treated cashless. The hospital sends diagnosis, treatment plan and cost estimate, and the payer approves an amount. In India it decides whether an insured patient experiences a smooth admission or a stressful wait at discharge.
Why it matters for hospitals
For insured patients the pre-authorisation wait is often the most stressful part of the visit, and a slow approval can push a planned surgery to a competitor. Clear communication around it is a conversion lever, not just a billing task.
How to put it into practice
- Map your pre-authorisation steps end to end and measure time from query to approval by payer.
- Give patients a simple explainer on the website and WhatsApp: what documents to bring and how long approval usually takes.
- Send status updates proactively so families are not chasing the insurance desk.
- Link the treatment estimate shared at OPD to the pre-authorisation request so numbers do not change unexpectedly.
- Check current IRDAI timelines for cashless authorisation and discharge, and design your process to meet them.
The common mistake
Treating pre-authorisation as a back-office function and never telling marketing or the call centre how long it takes, so promises made at enquiry do not match reality.
An illustrative example
A surgical hospital added an automated WhatsApp update at each pre-authorisation stage. Calls to the insurance desk fell and fewer insured patients dropped off between OPD advice and admission. (Composite example, not a specific hospital.)
Related terms
Further reading
- Insurers and TPAs as a growth channel
- What a hospital CRM is actually for
- The after-hours enquiry problem
Part of the healthcare growth and digital glossary. Last reviewed 7 October 2026.