REIMBURSEMENT CLAIMS

We do investigate the reimbursement claims by visiting all the required needs of the Client in all aspect to assure the authenticity of the claim .

In view of the Hospital part Investigation , we manage to obtain all the possible documents from the hospital pertaining to the particular patient in order to very the Genuinity of the documents and Bills provided by the patient .

In View of the Patient part Investigation , we manage to obtain all the details in respect to the patients medical history in the past and present details . Further we ensure that the patient was been hospitalized or not during the said period . If Required the Neighbor check , employer check will also be made .

In View of the earlier admissions or OPD in term of the conditions of the Claim , the past medical records from the respective hospitals will also be collected .

All reimbursement cases are investigated and closed in a turn around time of 7 to 10 days .

The reimbursement investigation includes member verification , hospital documentations , Family doctor and Treating doctor verification’s, Pathology lab verification’s , Pharmacy verification’s , Employment verification’s if applicable , Vicinity survey and past hospitalization documentations if any .

The success rates are maintained between 45% to 65% in reimbursement cases with a TAT of 75% to 90%