Insurance & TPA Claims

What you get

• Your own list of insurers — TPA, government scheme, private or corporate — each with its contact, your panel or empanelment number, and its own claims
• A patient's policy recorded once: insurer, policy and member number, plan, what it covers as a percentage, and the annual maximum
• Claims raised from the invoice itself, numbered and dated in Indian Standard Time, so the reference you quote the insurer matches the day you filed it
• Settle for less than you claimed and the claim is recorded as partly approved, with the difference placed on the patient's share — the gap is visible on the claim rather than found at month end
• A settlement typed wrongly can be corrected, and the policy's used-against-annual-maximum figure recalculates itself from the claims rather than being adjusted by hand
• Pending Recovery shows what insurers have approved but not yet paid — the figure worth ringing them about, rather than a lifetime total that keeps counting claims settled long ago
• A rejection is recorded with the insurer's reason and can be appealed, and an appealed claim stays counted in your pending work
• Claim data is limited to staff with the finance permission, enforced on the server rather than only hidden in the page

What it replaces