· Ensure accuracy in Pre Authorization and Patient History document before the former is send to TPA.

· Communicate to the CC Manager about any possible denials before the patient is admitted by monitoring the recorded preauthorization or History sheet.

· Proactively follow up on enhancements and ensure that the approval is received before the patient’s time of discharge.

· Monitor the outstanding amount for the patient against the approved packages and inform CC manager about possible payments which the patient has to make.

· Ensure that the bills are complete and according the package.

· Ensure discharges for credit patients are done within 4 hours by coordinating with the ward managers.

· Ensure that the files are sent to Insurance Company as per the defined TAT.

· Keep a positive relationship with the TPA’s and Corporates.

· Ensure accuracy of bills sent to corporates and that they are having the necessary Codes and rates with all supporting documents, thereby reducing disallowances.

· Keep track of the bills send for payments and ensure that they are send within 7 days of discharge.

📌 Patient Services Representative (Ahmedabad)
🏢 Zydus Hospitals Group
📍 Ahmedabad