Friend has a corporate policy with Paramount TPA.
His father needs to have cataract surgery tomorrow (day care). Total cost is 55k for 1 eye (25k surgery, 25k lens cost). He called TPA who said that there is no cap/limit on this surgery.
But when he called hospital, they said they have some MOU/Agreement with TPA that only upto 30k will be paid by TPA in cashless mode. So he will have to pay 55-30k from pocket.
Is that how it usually is? Cashless mode has limits? What should he do?