Dedicated team of industry experts based at our office to manage back end. Engagement with Third Party Administrators (TPA’s), Insurance Companies CGHS, CGHS Allied (like ECHS, DGEHS,) Public Sector Undertakings (PSUs) and Corporates through detailed MIS to track cases and closing them on time using our long-term relationships.Detailed reporting to the hospital using advanced data analytics. Weekly reconciliation of outstanding amount with the relevant team at the hospital to avoid any pendency.Performance driven approach tightly governed by TATs (turnaround time) with provision of reward as well as penalty for us.

**Without an effective monitoring and detailed tracking of MIS, all the above might lead to the hospital to lose money.

Benefits for Hospitals

Save time on the day-to-day monitoring of the process.

Reduce hospital risk to loss the credit revenues

Pre-Audits of Claims to avoid deductions and rejection at later stage.

Avoid delay in settlement of high value claim

Quick resolution of queries raised by TPA’s.

Reduce deductions on claims by the Third Party Administrators (TPA’s), Insurance Companies, CGHS, CGHS Allied (like ECHS, DGEHS), Public Sector Undertakings and Corporates.Better understanding of ailment capping, co-payment, deduction of non-payable items by hospitals and other different clauses in tailor made policies of corporate houses.

Methodology

Collection of complete dockets from hospital

Pre-Audit of Claims (In respect of completion of documents, billing done, discount offered, all NMES and co-payment collected or not etc)

If any discrepancy, report to the hospital for completion and correct submission

Submission of claims docket to respective organization

Submit back the receiving to hospital for record keeping

Tracking of claims through online monitoring and advanced tools

Any query raised report to the hospital and revert within stimulated time frame

Provide reconciliation on weekly basis to hospital based on ECS Shared on daily basis

Provide deduction analysis along with relevant documents

Presentation to the stakeholders for preparing them a pro-active approach for understanding the changing scenario and deductions reasons

Since Nimbi Healthcare Consultants is being in Healthcare Industry for a long time, we have our own network and expertise to monitor the financial claims of Hospitals and recover on time with minimum deductions. The Hospital team can focus on patient care and revenue growth by sharing their claims to us.