RESPONSIBILITIES It is the primary responsibility to ensure timely submission of Pre Auth, Query and obtain an approval from TPA | Insurance in accordance with the defined TAT Ensure that all the above data to be captured into Google Sheet | Assigned Portal Maintain guest satisfactions. All telephone calls and email must be responded immediately. Ensure proper counselling of the patient| by stander about KIMSHEALTH Policy on insured guests Maintain regular communication with TPA authorities at all level

DUTIES Confirm the patient s TPA is empaneled with our hospital. Please Refer to the Annexure or obtain confirmation from the Marketing Department if in doubt Brief normal process of TPA about coverage advantages, Co-payment and non medical Collect all required documents from the Patient as per the below check list Tracker Entry must be maintained properly for more details please refer to the Policy regarding Scheme updating in YASASII Ensure all Pre Auth documents to be vetted by the IMOs.



Deviations must be recorded properly Submission of Pre- Auth to concerned TPA with the required documents Tracking of Pre-Authorization, if approval intimate to patient or denial it must be intimate to IP Billing and Patients If the TPA has raised any query and it should be tracked based on the nature of query like clinical and non-clinical. Clinical queries must be handed over to treating doctor as per the defined TAT. Non-Clinical queries must be responded as per the defined TAT During the treatment we have to submit the interim bill with justification on every 07 days for obtaining Enhancement approval and ensure the patient s insurance coverage remain valid and active. If the sum assured exhausted, it should be intimated to the patient and IP billing for collection of difference amount If the patient has more than one policy or top up and the patient would like to submit the balance amount to other TPA. It should be intimated to Insurance Operation Head immediately Resolve any

📌 Internship Trainee (Thiruvananthapuram)
🏢 Care Hospital
📍 Thiruvananthapuram