Fast-track your Reimbursement Claim

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When it comes to reimbursement claims, an endless wait-time for settlement almost comes as a given!  Several challenges may be involved in the processing of claims, which often require additional details and documents on the treatment in question. Multiple back and forth with couriers can add to the hassle and to top it all, the actual processing of the claim can initiate only once all the documents related to the claim have been received in full. Hence, the time taken during the entire process can sometimes disgruntle patients and their families.

But with Medi Assist, all such hassles can instantly be laid to rest!

All you need to do is intimate us of your upcoming claim online before the hospital discharge and upload your documents online on discharge. An advance notification of a reimbursement claim helps us to be ready, and uploading your documents online helps us start working towards your claim processing immediately.

Just follow the steps below:

  • Notify us in advance of your upcoming claim. Go to your MediBuddy portal or app and click the ‘Reimbursement’ tile. Fill in the details and click ‘Intimate’.
  • Fill up the necessary details.
  • For uploading your documents, simply take a picture of them and upload onto the portal.
  • Once you have uploaded your documents online, we will check if we have received all that we need in order to initiate processing of your claim. We will intimate you in case of any missing/additional documents are required, so that you can upload them before you courier us all the documents. This will help you eliminate sending couriers multiple times and stop worrying about unnecessary delays.
  • Medi Assist begins the process of settling your claims once you upload the scanned copies of documents on MediBuddy. However, do not forget to send us the hard copy of all your bills and documents you have uploaded within 15 days from the date of discharge, as claims can be settled only upon receipt and validation of the hard copies.

So, get set to experience super-fast claim reimbursement processing!

Buraa na Maano, Holi Hai!

Holi picHoli, the festival of colours, brings back so many fond memories of our childhood. Remember how our mothers would warn us about safeguarding our eyes? And staying away from those troublesome boys who would smear everyone with those oh-so-difficult-to-remove silver and gold colours?

The kids would have heated debates on which colour should be added into the bucket first, which one for friends, and which ones for the rivals… Teenagers who would stay holed up inside their rooms lest the colours play havoc with their already troubled skin and hair.

And dads couldn’t wait for the kids to first have their share of fun in the early hours before the free flow of special sweets and savouries would begin followed by a hearty family lunch.

In all, every fond memory of holi revolves around two elements – choice and health care. Buraa na maano, but we’d like to tell you how you can make your holi even more enjoyable with your health buddy, MediBuddy. Short of helping you get organic colours, which we strongly recommend that you use, and your mom’s magical recipes, you will find everything else you need on MediBuddy.

Care for your eyes, skin and hair? You will find a specialist doctor who can help you with specific answers that you may seek.

Have a question on managing your medication while you give in to the temptation of the food and sweets around you? Opt for an online consultation with a doctor for some quick tips.

Want a more comprehensive assessment of your health? Choose from a range of health screening packages offered by some of the leading hospitals and medical centres in your city.

And, why lose a minute during your family get together? Opt for doorstep delivery of medicines for the entire family.

Do remember to check out the Offers page on MediBuddy Infiniti to browse through the special discounts available to you.

Happy Holi, all! May you always be in the Pink of health!

2016 – A Rewarding Year!

MediBuddy_corporate-logo2016 has been a great year for MediBuddy, our technology platform that binds the entire health benefits ecosystem together. We received encouraging reviews from our members and recognition from various quarters of the industry, including the following:

  • CIO 100 Information Mastermind award
  • SKOCH Silver Award for Cloud, Mobility and Apps
  • SKOCH Order of Merit Award for Innovation
  • CIO Review India Top 20 most promising medical technology solution providers

2016 was also an important year in the evolution of MediBuddy. From being the most reliable claim management self-help tool, MediBuddy has morphed into a comprehensive one-stop health benefits management platform that gives our members access to inpatient, outpatient, wellness, fitness and preventive care services offered by our curated network of healthcare providers.

We cannot thank you enough for your support and encouragement at every step of the way. As a small token of goodwill, here is an exclusive offer for you.

Sign up on infiniti.medibuddy.in, choose from our wide range of outpatient services such as doctor consults, medicines, health checks, etc.,
Use offer code WELCOME10 to avail additional discounts on select services.

And do let us know how your experience was. Your feedback will go a long way in helping us give our members the best that they deserve.

 

Benefit from Cost Reduction in Stents: Move away from Open Billing towards Package Pricing

CIO PR

In the light of recent notification by National Pharmaceutical Pricing Authority (NPPA) on the reduction of cost of cardiac stents,here is an article on how Medi Assist members can benefit from this notification. The article also touches upon how Medi Assist members can insulate themselves from potential variation in cost of procedure by opting for our exclusive re-priced packages.

Scroll down to read the complete article, or click here.

 

This Valentine’s Day brought unexpected happiness to millions of Indian hearts. The National Pharmaceutical Pricing Authority (NPPA) announced their far-reaching notification that capped the prices of drug eluting stents at INR 29,600/- and that of bare metal stents at INR 7,260/-, resulting in a reduction of cost of stents by as much as 85 percent. This heralds an important step towards making healthcare truly affordable for the millions of angioplasty patients, who have borne witness to as much as 1,000 percent increase in the cost of stents from production till it reaches them.

But just as patients in need of an angioplasty were beginning to cheer the welcome move, there were news of how some hospitals were trying to balance the drastic reduction in pricing of thePTCA (Percutaneous Transluminal Coronary Angioplasty) procedure by increasing other charges involved in the surgery. This would effectively mean that the benefit of cost reduction in stents would be cancelled out by the increase in other components of the open bill for the procedure, and that the cost benefit of the notification would not reach the patient.

This underlines the power of the packaged pricing structure contracted by third party administrators (TPAs) on behalf of their insurer partners. Unlike an open bill, a package price for PTCA defines a fixed price encompassing all medical expenses related to the procedure, except the cost of stents. So unlike in the case of open billing, where the cost of certain line items in the bill can potentially be changed on case to case basis, package pricing insulates the patient from any such circumstantial vagaries. The benefit of reduction in cost of stents would be passed on to the patient in full and translate into significant reduction in the overall cost of treatment. This would go a long way in reducing the financial impact of hospitalization on the family and also helps safeguard their sum insured for future medical requirements.

Medi Assist, for example, currently has negotiated packages for 120 common procedures contracted with over 3400network hospitals. Among these, 62 percent of the network hospitals that offer PTCA are covered by packages. Members planning a PTCA at any of these network hospitals, can further benefit by opting for an eCashless hospitalization using their MediBuddy app. This allows them to get a clear estimate of the cost of treatment and also obtain a provisional preauthorization for cashless hospitalization, from the comfort of their home. On the date of admission, the member is assured of green channel walk-in and the reassurance of benefitting from optimal pricing on account of choosing a package pricing contracted exclusively to safeguard their interests.

 

 

 

How MediBuddy turned Rajni into a Celebrity!

 

MediBuddy_corporate-logoRajni had been noticing that her boss, Jagdish, had seemed preoccupied the past couple of weeks. He was missing important deadlines, and was generally keeping aloof. Not one to meddle in others’ business, Rajni kept out of his way but the sudden change in her boss’s demeanor concerned her.

 

As Jagdish approached her cubicle that day to enquire on a pending task, she mustered courage and asked him if everything was alright.  He laughed off her concern, and then eventually opened up.

 

Jagdish’s father was an artist, whose rapidly failing eyesight had ultimately led to the diagnosis of a cataract. It pained Jagdish to watch his father struggle with his canvas and easel every day, and he wished he could convince him somehow for the surgery. But his father, keeping into perspective Jagdish’s busy life, didn’t want to burden him with the complexities around his surgery. Helplessness was slowly beginning to set in, and Jagdish didn’t know whom to turn to.

 

Rajni was fast to react, and let loose a flurry of common knowledge, which, as it turned out, was not so common after all. “Sir, with all due respect, are you aware of MediBuddy?” She saw the hesitation on Jagdish’s face, and didn’t want to put him in a spot. So she went on.

 

”MediBuddy is a self-help online platform that lets you be totally in control of all your healthcare needs. We can use MediBuddy to manage our health insurance and wellness benefits from wherever we are, on-the-go! In your father’s case Sir, you can opt for eCashless, where you can make his cataract surgery completely cashless and get a provisional preauthorization even before you step into the hospital! You can locate network hospitals, track claims in real-time, apply for reimbursements online, view your e-card, access electronic medical records 24×7, order medicines and….whew! That’s just the tip of the iceberg!  So, you can easily assure your father, that all you need to do is make a couple of clicks, and his hospitalization will be taken care of! Sir, I’d suggest you download the MediBuddy app and try out these awesome features right away!” She finally breathed.

 

There was pin-drop silence. She looked around. All eyes were on her. She began to say something, but her words drowned in applause! Jagdish looked like he had received the highest form of enlightenment, and clearly, Rajni, in his eyes, was the hero who had saved the day.

 

An eager colleague pointed his pen and mock-interviewed her, “Anything you’d like to say on your new-found celeb-status?”– “Well”, said Rajni, “MediBuddy is the real star, not I!”

If you can relate to the story, or know someone who can identify with it, share now!

 

The Heart of the Matter

stent-mailer-for-stakeholdersIn our previous blog, we shared the announcement made by the National Pharmaceutical Pricing Authority (NPPA) on the reduction of stent prices by up to 85%, reducing the financial impact of hospitalization on the families of patients undergoing an angioplasty surgery. Here is a follow up

Recent news articles seem to suggest that hospitals and medical centres are balancing the financial impact of the cost reduction in stents by increasing other charges that are usually involved in an angioplasty surgery. This practice could potentially render the new ruling ineffective, and would not allow the overall benefit of the price reduction to reach the patients.

Medi Assist members, however, would remain insulated from such situations on account of the exclusive package tariffs contracted by us with our network hospitals. These ailment-specific packages are available at negotiated rates, and when a member chooses a package, the hospitals cannot charge more than the agreed package pricing. Not only does this ensure a hassle-free cashless hospitalization for our member, but also helps them safeguard their sum insured. Corporate decision makers and insurers also benefit from the overall reduction in cost of hospitalization.

Medi Assist currently has negotiated packages for 120 common procedures, which can be availed at 3400+ network hospitals. Importantly, 62% of our network hospitals that offer PTCA (Percutaneous Transluminal Coronary Angioplasty), are covered by our exclusive packages.

So opt for packaged tariffs, protect your sum insured, and be worry-free with Medi Assist!

Read the detailed note on the NPPA notification in our previous blog here.

 

Valentine’s Day made Special for the Heart

Now here’s an unexpected Valentine’s Day gift for angioplasty patients. The National Pharmaceutical Pricing Authority (NPPA) has, with immediate effect from 14 February 2017, capped the prices of drug eluting stent at INR 29,600/- and that of bare metal stents at INR 7,260/- — slashing costs by as much as 85 percent. All stent manufacturers and importers would now have to price their products below the notified ceiling price.

This is a welcome move that would go a long way in making healthcare truly affordable for the millions of heart patients in the country. Even as the incidences of heart diseases continue to increase at an alarming rate, the data shared by the NPPA notes an exponential jump in prices of stents by as much as 1,000 percent from production till the time it reaches patients.

Heart patients in need of an angioplasty would now have to spend considerably lesser on their treatment, significantly reducing the financial impact of hospitalization on their family.

What does this mean for you, dear Medi Assist member?

If you / your family member has only recently undergone an angioplasty, do make it a point to check your bill and reconfirm the amount billed against the stent. You could expect some temporary glitches in the billing – this is after all a significant change that has been made effective immediately without much prior notice.

If you are planning an angioplasty in the coming days / weeks, consider opting for an eCashless hospitalization using your MediBuddy app. This will allow you to identify the estimated cost of treatment under the new notification and as per your policy terms and conditions, without having to step out of your home or make multiple calls to the hospital. Not to mention the sheer comfort of a green channel walk-in on the date of admission.

For those of you who have just undergone the treatment just before the announcement of the slashed rates, do take heart. As you plan your post-hospitalization check-ups, medicines, etc., do make sure to avail the exclusive discounts available to Medi Assist members on services booked on MediBuddy Infiniti. Use offer code WELCOME10 for exclusive additional discounts on select services such as health check packages. After all nothing means more to us than your speedy recovery and happy heart.

Happy Valentine’s Week to all!

 

Get visibility into your hospitalization expenses, with eCashless!

All of us leCashless gives visibility into out-of-pocket hospitalization expensesove surprises, but not when they come wrapped in hospital bills!

When you have planned to utilize your insurance policy to make your hospitalization cashless, there are often times when you are faced with ‘additional expenses’ that you have to pay out of your pocket. Since most of us may not be fully informed of the minute details that make up our insurance policy, there is a chance that we expect a particular cost to be covered by the policy, when in fact it is not.

eCashless bails you out of such painful and ‘unpredictable’ situations when we are caught unawares and are therefore not in a position to bear the costs for non-admissible expenses during hospitalization.  It gives you visibility into the estimated cost of treatment ahead of hospitalization, which means that you can plan your out-of-pocket expenses in advance.

An eCashless request needs to be raised at least 48 hours in advance from the time of hospitalization, and can be availed via the MediBuddy portal and app, from the comfort of your home! Through eCashless, you get a provisional preauthorization based on your insurance policy. You are therefore able to get the estimated cost of treatment based on the coverage as mentioned in your policy, even before you step into the hospital.

eCashless, in essence, enables patient choice, better cost of care, green channel admission, real-time visibility and optimal use of health benefits.

So, don’t remain in the dark regarding your out-of-pocket expenses resulting from your cashless hospitalization. Opt for visibility, choose eCashless on MediBuddy !

How Managed Care helps Optimize Medical Spend

Prashant Jhaveri, Chief BusManaged_Careiness Officer, Medi Assist  recently wrote an article for the Silicon India in which he discussed about the concept of Managed Care Organisation (MCO) and its importance in the Indian Healthcare Ecosystem. He also discussed about the various techniques deployed by MCOs to promote informed decision making and reduce overall cost of care for consumers.
Scroll down to read the complete article, or click here.

 

 

The concept of managed care, aimed at reducing cost of providing quality healthcare, is still in its nascent stage in India. A popular concept in the United States, the need for managed care organizations is perhaps far more acute among developing nations such as India. Medical inflation in India stands at 12-15 percent as against a global average of 6-7 percent. Despite the steep rise in cost of healthcare, the IRDA Annual Report 2014-2015 indicates that only two percent of the Indian population is covered by individual health insurance policies; and only another four percent are covered under group medical policies. In the absence of any medical cover, the average Indian family today grapples with high out-of-pocket expenses on account of healthcare.

A recent report by FICCI suggests that primary healthcare accounts for over 70 percent of all medical spend and that the per capita spend of urban households on outpatient care is approximately Rs. 4,250 per person, a typical urban family of four adults, therefore, spends an average of Rs. 17,000/- per month on doctor consults, medicines and diagnostic labs. Add to this the inherent lack of transparency within the healthcare ecosystem. While it is, for example, easy for one to compare myriad options, choose and book holidays, travel, stay and so on, consumers do not have such deep visibility into the options available to them when planning their medical spend. Managed Care Organizations (MCO), therefore, have a significant role to play in the Indian healthcare ecosystem. Not only do they bring all the stakeholders of the ecosystem together, they also work towards deploying techniques to promote informed decision making and reduce overall cost of care for consumers.

MCOs Negotiate Early

Managed care organizations partner with healthcare providers to obtain preferred tariffs and discounts for their members. While the preferred pricing helps increase visibility and footfalls for the provider, it helps reduce cost of care for the individual. MCOs also deploy various loss control measures to ensure that, in the event of a hospitalization, members are provided most optimal care at the most optimal price point at their chosen network medical centre.

MCOs Tech-enable early

Managed care organizations, which collaborate with all stakeholders in the healthcare ecosystem, are best placed to invest in technology for transformation. Technology allows all stakeholders to come onto a common platform to improve speed of access and quality of delivery. Our technology platform, MediBuddy, for example, allows hospitals to provide seamless cashless access to in-patient and outpatient services to their patients; it gives insurers and corporate decision makers deep visibility into the performance of their health benefits portfolio; and importantly, it gives every individual member the power to compare, choose, and schedule healthcare services using just their mobile phone from the comfort of their home. The predictive analytics capabilities help decision makers spot trends and take informed product and service delivery decisions for the future.

MCOs Help Plan Early

Planning is the key to optimal decision making. For example, a planned maternity can help the family ensure greater comfort for the mom-to-be and also help the young couple reduce their out of pocket spend by optimally utilizing their health benefits. Similarly, a managed care organization can help senior members planning an elective surgery to opt for cashless hospitalization at a preferred network, at a discounted preferred pricing. Innovations such as e-Cashless allow members to choose their preferred network medical center and obtain a provisional preauthorization using a mobile app for a cashless hospitalization. E-Cashless also gives the family full visibility into the expected cost of treatment, amount covered under their policy and the corresponding out of pocket spend, if any.

MCOs Intervene Early

Fraud and abuse control is critical to the success of any health benefits program. Managed care organizations play a significant role in ensuring that the benefits are availed by genuine beneficiaries and as per the terms and conditions defined by the benefits policy. New-gen MCOs use a combination of technology and professional expertise for risk detection and mitigation. MCOs have been credited with generating significant savings for the industry on account of their diligent interventions. Managed care organizations are poised to play a crucial role in these transformative years of the Indian healthcare industry. With deep understanding of the often divergent needs of all stakeholders in the industry, technology leadership and an optimistic vision for the future, MCOs are here to bring about disruptive change in how we think about healthcare spend.

Budget should enhance limits available under Section 80D

Prashant Jhaveri, ChieUnion Budgetf Business Officer, Medi Assist, shared his thoughts on the various reforms to be considered with regard to the Health Benefits industry in the upcoming 2017-’18 budget.

Scroll down to read the complete article, or click here.

The Union Budget will be a crucial one in the light of reform initiatives undertaken by the present Government. It is expected that there will be a slew of changes on the taxation front and policies for financial services sector. When it comes to health insurance sector, the Budget should take into consideration the below reforms.
a) With rising insurance costs, the budget should actively look at enhancing the limits available under Section 80D for deduction of Insurance Premium.b) Online healthcare aggregators do not get benefit of the provisions of “aggregator” under service tax Act as healthcare is an exempt service. For new innovative business models to thrive it will be important to take a consistent view on applicability of service tax.c) More clarity should be provided on applicability of service tax on auxiliary healthcare services rendered by service providers. While healthcare services are exempt from service tax, if the same services are rendered by a non-clinical establishments, it is subject to service tax. This presents a disparity in levy of service tax on essential services like healthcare diagnostics and preventive healthcare.