- Claims Processing: Verifies medical documents, checks policy coverage terms, and processes or settles cashless and reimbursement claims. [1, 2, 3]
- Cashless Hospitalization & Pre-Authorization: Coordinates with network hospitals to approve planned surgeries, treatments, and emergency admissions so bills are settled directly. [1, 2, 3]
- Network Hospital Management: Builds and maintains ties with hospitals, clinics, and medical providers to offer pre-negotiated rates and cashless treatment options. [1, 2]
- Health Card Issuance: Issues unique TPA identification cards or e-health cards to policyholders for instant recognition during hospital admissions. [1, 2, 3]
- Customer Support & Helplines: Operates 24/7 toll-free helpdesks to answer queries, track claim statuses, and guide policyholders through rejections or documentation