of Ayushman Mitra -

1. Beneficiary Handling & Verification

Verify Ayushman Bharat (PMJAY) eligibility using BIS/Transaction Management System (TMS). Authenticate patient identity through Aadhaar, Ration Card, or approved documents.

Generate Ayushman Golden Card where applicable.

Provide guidance to beneficiaries regarding scheme advantages and empanelled services.

1. Pre-Authorization Management

Prepare and submit Pre-Authorization (Pre-Auth) requests within prescribed timelines. Upload all required clinical documents (case sheets, investigation reports, prescriptions).

Coordinate with doctors for accurate diagnosis, procedure codes, and package selection.

Respond promptly to queries/objections raised by Medical Officers or Insurers.

1. Claim Processing & Submission





Ensure discharge/death entry is done as per PMJAY norms. Submit final claims within TAT (7 days) from discharge or death.

Upload complete documentation including discharge summary, operative notes, bills, and death summary (if applicable).

Monitor claim status and follow up for approvals, deductions, or rejections.

1. Coordination & Documentation

Coordinate with Billing, Nursing, ICU, Medical Records, and HMIS teams. Maintain accurate Ayushman MIS reports, daily admission and discharge logs.

Ensure zero deviation from Ayushman Bharat guidelines.

1. Proficiency in English & Computer Skill

📌 Walk-in || Ayushman Mitra (Bhopal)
🏢 Peoples Hospital
📍 Bhopal