Star Health cashless CABG (Bypass Surgery) claim – insurer says amount "not to be collected from patient" but hospital collected it. Is this normal?
My father (61) underwent an elective CABG at a Star Health network hospital under an Arogya Sanjeevani Policy (₹6 lakh sum insured, active for more than 3 years).
Final hospital bill: ₹3,47,726
Star Health approved: ₹2,69,953
I paid ₹77,554 at discharge.
In the final authorization letter, Star Health mentions:
5% co-pay: ₹14,208
₹63,346 as "Excess amount charged over the agreed package/SOC"
What confuses me is that the same letter places this ₹63,346 under "Amounts NOT to be collected from the patient."
However, the hospital collected exactly ₹77,554 (₹14,208 + ₹63,346) as the insurance balance.
My policy document doesn't mention a CABG package cap or procedure-specific sub-limit, and the authorization letter also says "Sub-limit applicable: No."
Has anyone faced a similar situation with Star Health or another insurer?
Does "Excess amount charged over the agreed package/SOC" normally become payable by the patient?
Why would the authorization letter say "not to be collected from the patient" if the hospital collected it?
Should I pursue this with Star Health, the hospital, or both?