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Table of Contents
Company Overview
Table of Contents
Company Overview
Company Overview
An Integrated Health Insurance Service provider servicing valued clients since April 2006 Head Office located in Mumbai
Karnataka
Branch Offices:
Haryana Delhi Uttar Pradesh Madhya Pradesh Chhattisgarh West Bengal Orissa Gujarat
: Chandigarh : New Delhi : Lucknow : Indore : Raipur : Kolkatta : Bhubaneshwar : Ahmedabad Baroda Surat : Pune : Hyderabad : Chennai
Kerala
Residential Representatives: Punjab : Amritsar Ludhiana Bihar : Patna Madhya Pradesh : Bhopal Raigarh Maharashtra : Nasik Gujarat : Jamnagar
Servicing More than 11 insurance companies in India in line with their business aspirations
Dedicated Healthcareservices TPA (India) Pvt. Ltd.
Servicing More than 1400 group insurance policies for corporate clients & groups Servicing More than 3.5 million satisfied health insurance policy holders in India
Dedicated Healthcareservices TPA (India) Pvt. Ltd.
Table of Contents
Company Overview
Enrollment
Enhanced IT Infrastructure
Call Centre and Website
Dedicated Healthcareservices TPA (India) Pvt. Ltd.
Enrollment Process
Receipt of Data for Enrollment Data upload and auto check system Send data for correction to Corporate/ Insurance Company
Errors in data
No
YES
Over 3700 network hospitals throughout India Standardized grading technique is devised for all hospitals. Possible bench mark rates implemented ensure new network hospitals are added to Preferred Provider Network. Rates negotiated as per location,, infrastructure, expertise etc.
Type of City Type of Network Regional Distibution Tier 1 Tier 2 Tier 3 Total Primary Secondary Tertiary Only for GIPSA Only for RSBY/UHIS Total East 83 0 316 399 85 58 43 2 211 399 North 207 153 706 1066 397 199 161 93 216 1066 South 176 496 397 1069 461 242 237 128 1 1069 West 328 519 487 1334 833 184 119 80 118 1334 Total 794 1168 1906 3868 1776 683 560 303 546 3868
Tier 1: Mumbai, Kolkata, Chennai, Delhi Tier 2: Pune, Ahmedabad, Hyderabad, Bengaluru, Goa, Raigad (District) Tier 3: Indore, Vadodara, Raipur, Kochi and rest of the Cities
Dedicated Healthcareservices TPA (India) Pvt. Ltd.
Cashless Process
Request for pre-authorization Request from at least 24 hrs prior to getting hospitalized or within 24 hrs of hospitalization incase of emergency show your insurance Card and photo identiy card
Get the preauthorization form filled and signed by the treating doctor, put your sign on the form and hand over to the hospital for the process
Authorization letter will be faxed to the hospital from TPA office and simultaneously you will be kept informed on authorization
Processing the preauthorization and authorize the reasonable amount for hospitalization based on policy terms and conditions
Hospital will stamp the form and fax it to insurer / TPA for authorization
Enhanced IT Infrastructure
Secured VPN connectivity across HO and all Branches System generated Mediclaim cards Policy T&C coded in the system for claim settlement Diseases coded in the system to avoid human errors Online intimation and claims status System login IDs for Employees and Corporate HR
Real-time backup server at our Regional Office BCP provides uninterrupted Pre Authorization, Enrollment and Claims processing The BCP is implemented in the event of fire, earthquake, floods and technical failures Data restored to back-up server within 1 hour New Primary Server restored within 72 hours.
Call Center
State of the Art 24 * 7 Call Centre
Courteous and well trained staff Solutions for customer specific queries Cash claims customer support Hi end telephony and real time information retrieval systems Automatic redialing of calls dropped. Automatic SMS/Email facility for claim status changes. Toll free fax number. System generated reports for measuring customer satisfaction Customer Care toll free number 1800 209 0201
Service Features
Website Features
Online generation of e-cards Online claim status Online intimation form Online hospital network Medical features Wellness & Life style features
www.dhs-india.com
Dedicated Healthcareservices TPA (India) Pvt. Ltd.
Table of Contents
Company Overview
Diabetes check up Cardiac Check up Weight control with Dietitian meet and BMI check Dental check up Blood donation camps Eye check up camps Basic Blood investigations like CBC, ESR, Blood group Total cholesterol with BMI and Physical checkup Bone Density check up for Osteoporosis
Dedicated Healthcareservices TPA (India) Pvt. Ltd.
Employee Benefits
Health Check ups for Employees at their location Evaluation of the Health Check up Results
Maintenance of Health data for every member over a period of years Scanned reports available to members on line Arrange for appointments with networked doctors for second opinions in case required Availing Executive Health Check ups at discounted rates
The Help Desk manned by a qualified and experienced executive Query letters generated at the help desk and sent to the various employees Follow up on the queries can be done at the help desk Assistance provided for smooth and fast cashless services Assistance and guidance on: a) Understanding the terms and conditions of the policy
b) Filing of claims
c) Process for availing cashless cervices
Exclusive Account Management team comprising of a customer relation executive and a manager Separate team of executives and doctors handling pre authorizations and claim processing at client location A senior Manager heading the team will be present at monthly service meetings A robust system of escalations management directly reporting to the Chief Administrative Officer. shall be established
Authorization of cashless claims within a period of 1 - 3 hours Claims settlement within 7 days of receipt of complete documentation ID Cards issued within 5 days E-cards within 1 day Conformity to any Specific Client requirements Regular client service meetings to analyze feedback. Presentation of claims analyses to predict future trends, take corrective actions and design future covers
www.dhs-india.com