Verify patient insurance details, coverage limits, and policy eligibility immediately upon admission, and secure rapid approvals for cashless treatments and planned surgeries. [1, 2]
- Claim Submission &
- Documentation:
Prepare, compile, and submit accurate medical bills, discharge summaries, and claim documents to TPAs and insurance providers within stipulated timelines. [1, 2]
- Query &
- Discrepancy Resolution:
Follow up on pending claims, address query letters or deductions raised by insurance companies, and coordinate with treating doctors or the billing/accounts department for missing information. [1, 2]
- Patient Guidance: Help patients and their families understand their insurance policy coverage, sub-limits, exclusions, and estimated out-of-pocket expenses. [1]