1. Claims Processing Software:
Our in-house developed claims processing software, known as "ClaimStack," is tuned for managing the entirety of the journey involved in the processing of insurance-related hospitalization claims. It is a high-end programme that meets all of the pre-requisites that are needed for flawless processing for insurance companies and TPAs. "ClaimStack" uses a robust database and many AI modules for the automation and correct estimation of claims.
2. Hospital Management System:
Our HMS is intended to handle the operational tasks that are needed on a day-to-day basis at the hospital. Because it comes with a multiplicity of built-in capabilities that assist with operational excellence and real-time time tracking of a variety of operations, it ultimately provides superior customer experience.
3. Non-Network Cashless:
We provide a short-term bridge loan to insured patients who choose to access healthcare at a non-network hospital. We then use our expertise in the claims-filing process to ensure that the patient is reimbursed before the loan is due, making the entire process cashless for the insured.
4. Medical Loan:
We are able to make available, through our network of lending partners, no-cost EMI medical term loans to patients who do not have insurance but do want to finance their treatment.
5. Documentation for Reimbursement:
We provide support for the preparation of insurance claims related documentation to the patients who either approach us through hospital or directly. We make it a point to check that the documents that are submitted to the TPA are comprehensive, free of errors, and complete on the very first submission. This is one of the areas in which we excel. In addition, we identify questions in advance and provide documents that are relevant to the questions we anticipate being asked.
6. Tracking of Claims and settlements:
We help the hospitals in the settlements of all unresolved claims. We also periodically share you with crucial reports and observations, which helps to make the process more efficient and shorten the amount of time it takes for the settlements to be concluded.
7. Cashless Help Desk (Virtual):
Obtaining authorization for cashless patients is a substantial challenge for any hospital, especially for smaller hospitals. By automated systematic follow-up with insurance companies and TPAs, we support hospitals in gaining pre-authorization, additional treatment approvals, and final authorization. Our expert, well-connected recovery team also ensures the prompt settlement of claims through relentless follow-up.
8. Financing Support:
We connect hospital with specialized financial institutions, who provides the hospitals with advances against your pending authorized cashless claims with various Insurance Companies and TPAs, will streamline your cash flow cycle even further. This will ensure that you have more liquidity for working.
9. Customized Packages for Surgical Procedures:
We provide assistance to hospitals in the process of developing customized pricing structures for a wide range of surgical procedures by utilizing our experienced medical professionals and data analysts. These packages are designed and priced after analyzing the hospital’s location, infrastructure, available specializations, and the experience of the medical fraternity. This makes the billing of the hospital more acceptable to the insurers and TPAs, overcome the problem of short payment, and in turn contributes to a reduction in the patients’ out-of-pocket expenses.