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IRDAI Guidelines on Standard Non-Payables

The Non-Payable Consumables Auditor

Did the hospital charge you ₹20,000 for gloves, sanitizers, and admission fees? Verify the 12 most-disputed non-payable items, and what the hospital illegally billed if you had a packaged surgery.

Statutory Script for Hospital Billing Desk

How to Challenge OT Consumables in Packaged Surgeries

If you were admitted for an agreed surgical package (e.g., Gallbladder, Hernia, C-Section, Stent), use this statutory statement when the hospital billing desk hands you a consumables bill:

"Our pre-authorization was approved under an agreed GIPSA / Insurer composite procedure package. Under IRDAI Master Circular 2024 and standard TPA network agreements, basic OT consumables (gloves, surgical drapes, antiseptic solutions, and needles) are strictly inclusive in the procedure tariff and cannot be billed as separate out-of-pocket expenses to the patient."

OT & Surgery Consumables (Illegal to Deduct if Under Package Tariff)

Surgical Gloves & Gowns

Exempt if surgery is under agreed package rate. Non-payable only in a la carte billing.

Surgical Blades, Scalpels & Drapes

Integral to Operation Theatre. Must be challenged if billed additionally.

Antiseptic Solutions (Betadine, Spirit)

Part of OT charges. Should not be billed separately to patient.

Spinal Needle / Epidural Set

Should be included in Anesthesia charges under package deals.

Room & Hygiene Supplies (Payable ONLY with Consumables Rider)

Cotton, Gauze & Bandages

Non-payable under standard policy; 100% covered if you have a Consumables Rider.

Thermometer & BP Cuff Sleeves

Hospital administrative equipment; strictly non-payable by base insurance.

Sanitizer & Hand Rubs

Non-payable under standard policy; covered via rider.

Tissue Paper, Face Mask, Caps

Non-payable personal toiletries under the IRDAI exclusions list.

Hospital Admin & Overhead Surcharges (Disputable / Non-Payable)

Admission & Registration Fees

Hospital administrative overhead. Consistently rejected by TPAs.

Medical Record Management (MRD) Charges

Administrative expense; non-payable by insurer.

Bio-Medical Waste Management Fee

Regulatory compliance overhead. Hospital cannot shift this to patient.

Nutritionist / Dietician Consultation

Non-payable unless part of primary medical treatment plan.