Our Services

Tariff Restructuring

We will help you in formulating a unique tariff structure by simplifying, merging and demerging the various billing heads in such a way that it is transparent, uncomplicated and acceptable to the health insurance providers as well as the patients, while safeguarding the interest of healthcare organisations. This also includes defining the packages/tariff/discounts for each TPAs/Insurer in Hospital software.

Incomplete or incorrect information/billing is the number one cause of medical claim rejections and disallowances during final settlement. Over the period of time healthcare providers tend to dilute their credit billing structure and packages as part of their general tariff updations. This will create a deviation from the agreed tariff and package - inclusions/exclusions with the Credit party. This will not only lead to delayed claim processing and disallowances, but also lead to patient dissatisfaction as they will be forced to settle higher patient payable part. If not addressed in time, it may lead to suspension of cashless services or even blacklisting of the healthcare provider by insurers.