Insurance Empanelment

How do we support doctors and hospitals in the Empanelment Of Insurance Companies?

We Offer –Pre Empanelment Consulting

Consulting, guiding, and advisory services for hospital enrolment with various government and private insurance carriers, enabling cashless facilities at your hospital.

Post-Empanelment Consulting

Guidance with claims processing, such as establishing a proper claims processing procedure, collecting and auditing documents to ensure proper approval, resolving queries, creating and sending final bills for approval, creating and submitting cashless files to related companies, and following up to release payments.

• An expert consultant will also walk you through the eligibility requirements and assist you in preparing the hospital by identifying and addressing critical gaps in infrastructure or processes by IRDA and insurance company standards.
• Private TPA and government insurance firms have their own set of documentation and guidelines for managing indoor patient data. If the hospital adheres to NABH recommendations for retaining medical records, they should have no trouble meeting the insurance company's documentation requirements.
• An expert consultant can instruct your hospital personnel to properly fill out paperwork and prepare patient files.
• A consultant for hospital empanelment (cashless facility) will also review the hospital's scope of services, available infrastructure, number of full-time and part-time consultants, available critical care services such as ICU, number of minimum required beds, bed allocation, different types of charges charged to the patient, lower and upper charge ceilings, and other factors.
• The hospital benefits the most financially by revisiting and rescheduling certain charges. Our expert will assist you maximize your revenue by ensuring that your institution does not undercharge.
• Our expert will also assist you with insurance company compliance requirements such as forms, formats, checklists, registers, care plans, and more. The same can be implemented directly into your program or any HIMS system used by the hospital.
• We will assist you in auditing the licenses and certificates required for successful cashless transactions with insurance providers.
• We will also assist you with follow-ups and query resolution (the most important aspect) to ensure that you are paid in full by the insurance companies, as per the packages agreed upon during the tie-up.

Many hospitals lose significant revenue and are underpaid by insurance companies because either the documents are incomplete or the forms and formats are incomplete, and doctors do not have time to follow up and handle all of the inquiries.