Description
rocessing the cashless claims from initial level approval and discharge time final
approval on TAT basis. Need to verify the policy T&C whether Co pay is applicable
and need to check room rent eligibility if insured not applicable for room rent
need to apply the incremental charges.& need to check ailment capping. Need to
verify the hospital tariff with final bill. In case excess amount charges from
hospital side, need to deduct tariff deduction and also need to deduct Nonmedical
expenses and other eligible deductions as per policy T&C. If tariff related issues
or tariff not matched, need to send mail to provider team and then case need to
be process as per their reply. If policy T&C not uploaded in system need to send
mail to CRM team.