About

To open /establish/operate/assist the insurance counters/ departments of the private hospitals in their health insurance activities of cashless and reimbursement claims at various levels- Pre authorization/pre-approval- Claim approval – Claim submission- along with the bills and medical reports of the insurance patients and finally to get the claim settled by the insurance company.

Functions includes :
Manage the insurance front office counter and the staff –Provide the correct guidance for the claim approved according to the different insurance schemes-till the claim is approved. Follow up for the payment/ continuous and periodical submission of outstanding statements for the settlement to various insurance companies.

Arrange the documents and prepare the billing for the cashless, reimbursement of health claims of all public and private sector insurance schemes like ESI,ECHS, AB-PMJAY-KASP, MEDISEP, Private insurance companies & TPAs and ultimately to get the maximum claim amount as per the terms and conditions of each schemes.

If the hospital have any tie up or empanelment with any other corporates/institutions will provide all sorts of service to the patients of such tie-up hospitals till the claim amount received from the concerned insurance company/authorities.

We will do & follow the insurance policy terms and conditions of various insurance schemes and accordingly assist the clients/patients in the right direction – in the process of claim documentation properly thus minimizing the loss.

We will arrange/help and underwrite all sorts of insurance policies General/Life/Health and other related services to the individuals /companies/group etc. which is according to the requirements of the concerned.

Further Guide/Assist/help them, to liaison with various insurance companies /hospitals/ bodies for getting their insurance claims admitted for approval and lastly for the payment settlement for both cashless /reimbursement claim health insurance policies.

Recovery of due and overdue outstanding claims which were not settled/partially settled/rejected claims by properly addressing to the concerned /vigorous follow up with the respective Govt and Non Govt agencies/bodies etc to recover the outstanding amount.

Other Models :

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