Specialized Healthcare & Insurance Management Services

We offer specialized advisory solutions to assist hospitals in planning, establishing, and scaling dedicated Cashless & TPA Helpdesks from the ground up.

• Designing standard operating procedures (SOPs) for cashless admissions.
• Structuring helpdesk staffing and defining key performance indicators (KPIs).
• Aligning department workflows with IRDAI guidelines.

Complete end-to-end management of hospital claim cycles, ensuring seamless pre-authorization requests and minimal query generation times.

• 24/7 pre-authorization processing and initial approval management.
• Real-time query resolution and medical documentation enhancement.
• Accelerated final authorization clearing at the time of patient discharge.

Expanding your hospital’s network reach by securing empanelments with private insurers, public PSUs, Third-Party Administrators, and corporate groups.

• Empanelment application preparation and contract negotiations.
• Tariff revision negotiations and package pricing structuring.
• Maintaining strong liaison relationships with TPA medical officers.

Step-by-step guidance for medical facilities to attain Entry Level, Full NABH accreditation, and clinical quality compliance standards.

• Gap analysis, mock audits, and safety protocol implementations.
• SOP documentation, staff training, and clinical record preparation.
• On-site support during official accreditation inspection visits.

Professional skill development programs for hospital desk executives, billing staff, and nursing managers handling insurance documentation.

• Training on ICD-10 coding and medical necessity documentation.
• Query avoidance techniques and proactive authorization handling.
• Customer communication skills for handling patient insurance queries.

In-depth financial analysis and medical chart auditing to eliminate unbilled services, reduce bill deductions, and protect hospital profitability.

• Pre-discharge billing audits to prevent non-payable line item errors.
• Procedure cost benchmarking and package pricing optimization.
• Post-settlement audit analysis to pinpoint repeat denial causes.

Dedicated reconciliation and recovery mechanism to recover overdue outstanding payments, old unsettled claims, and short-paid balances from TPAs.

• Comprehensive aging analysis of unpaid TPA balance ledgers.
• Direct TPA and insurance company reconciliation meetings.
• Re-submitting wrongful claim rejections with supportive medical evidence.

Health Insurance Consultancy

Strategic corporate Group Medical Coverage (GMC) advisory. We help HR leaders evaluate policy structures, negotiate competitive premium quotes, and expand coverage limits.

Insurance Complaint Management

Acting as employee advocates to resolve complex, delayed, or rejected health insurance claims, escalating cases to Ombudsman levels when necessary.

Health Check-ups & Wellness

Organizing customized annual executive health checkups, workplace diagnostic drives, mental wellness sessions, and lifestyle management camps for corporate teams.

CSR Consultancy Services

Assisting corporate entities in designing, managing, and auditing healthcare-focused CSR projects, community health camps, and rural medical assistance drives.