top of page

Hospitals | Diagnostic Centers

Government Health Schemes and General Health Insurance

Doctor
Doctor Diagnosis

Empanelment Support

Support and guidance in empanelment of Hospitals under various Government Schemes like

  •      Central Government Health Scheme - CGHS

  •      Employees State Insurance Corporation - ESIC

  •      Ayushman Bharat Pradhan Mantri Jan Arogya Yojana  - ABPMJAY

  •      State Sponsored Health schemes 

  •      Insurance companies 

  •      Third Party Administrator - TPAs.

Operating various Software's in General Health Insurance, TPAs  & Government Health Schemes like​

Government Health Schemes Portals

Insurance Company Portals

Third Party Administrator (TPA) Portals

Quality Accreditation Support

Supporting Hospitals in getting quality accreditation / certificate like 

  •     NABH Entry Level Certification,

  •     NABH Accreditation

  •     Joint Commission International (JCI) Accreditation

  •     National Accreditation Board for Testing and Calibration Laboratories (NABL)

  •     Other quality certifications like ISO.

With NABH Entry Level Certification hospital can get 10% extra over and above defined package amount under various health schemes.

Our team of Hospital Administrators, Project Managers, Architects, Planners and Equipment Specialists will assist in Hospital Design, Plan, Architecture Market Feasibility Studies, Detailed Project Report (DPR), Equipment Planning , Hospital Staff Training and Recruitment Solution. (only professionals and authorized vendors). 

Supporting Hospitals in Claims Settlement

Supporting Hospitals in providing Start to end solutions in claim  settlement in various Insurance Schemes:

  • Step 1 : Verification of patient/Beneficiary before registration. (Without depending upon TPAs or ISAs.)

  • Step 2 : Patient/Beneficiary Registration

  • Step 3 : Selection of Right package/Procedure in TMS/Portal.

  • Step 4 : Pre-authorization request to TPAs / ISAs.

  • Step 5 : Reply of Pre-auth queries (if any).

  • Step 6 : Post treatment, Submission of Claim documents and required photographs of patient /beneficiary as per requirement of STGs or as demanded by schemes like ABMJAY etc. or Insurance Companies.

  • Step 7 : Reply of claim queries (if any). (we work on Zero query mechanism )

  • Step 8 : Provide support to hospital in claim settlement. with regular reminders to authorized authority in organization in cases of delay. 

  • Step 9 : Preparation of MIS reports to show case volume of  business performed and revenue generated.

Resolution of Rejected claims by appealing to authorized committee under various Government schemes and ombudsman in case of general Health policy. 

Supporting health facilities in preparation of documents to reply against any received show cause notices or complaints received from Insurance Companies, TPAs and Government Health Schemes.

Other Services

  • Arrangement of trained and technical staff in Hospitals to manages all the IT related applications (mentioned above).

  • Arrangement of ON CALL Specialist Doctors for performing various medical treatment in Hospitals.

  • We have team of Super specialist doctors from esteemed institutes like AIIMS, PGI , Medical colleges that can provide solution to even complex queries of TPAs/ISAs/Insurance companies. 

  • We have team of legal experts to advise clients  about their legal rights and responsibilities.

bottom of page