TPA Medassist goes online, launches Medibuddy+ to claims management

Bengaluru: Medi Assist's online cashless claims management portal MediBuddy+ has made a hallmark contribution by bringing on board 4000 hospitals pan india.

A managed care organization headquartered in Bengaluru, it has achieved wonders, for it has "In less than 18 months since its launch, MediBuddy+ has helped more than 4000 hospitals across the country completely eliminate faxes and emails to manage all their p reauthorization requests on-line. That is, in fact, a staggering 67% of the total number of hospitals in our network; and we boast of having one of the strongest network of hospitals in the industry. In some cities, up to 90% of all preauthorization requests daily are routed through our portal. The impact on customer experience has also been phenomenal," says Satish Gidugu, COO, Medi Assist.

Its driving value proposition of all pre authorization requests to be submitted online, is the reason for it becoming a success story. Prior to this hospitals relied on faxes and emails, which was a cumbersome process for patients and a challenge for hospitals to locate within 2-3 hours. The online submission has made things immediate. With users at the insurance desk uploading all documents on the portal; instant notification received by the claim processing team; followed by Medi Assist giving instantaneous approval.

MediBuddy+ in turn gets into action by displaying real time notifications on the hospital user's desktop and dashboard; alerting the insurance coordinator, who in turn downloads the pre authorization approval letter. The claims then move into the finance module where they are tracked in real time, until the sum of money is settled upon between the hospital and the insurer. Medi Buddy+ also handles a range of reports and a dashboard for claims activity at the concerned hospital.

With MediBuddy+ all p reauthorization requests are submitted on-line. Users at the insurance desk at the hospital upload all documents onto the portal. The claim processing team back at Medi Assist gets an instant notification of the request. Once Medi Assist approves the request, MediBuddy+ displays real-time notifications on the hospital user's desktop and dashboard. This alerts the insurance coordinator to immediately download the p reauthorization approval letter. The claims then move into the finance module where they can be tracked in real-time until the monies are settled between the insurer and the hospital. MediBuddy+ also supports a range of reports and a dashboard for a real-time summary of the claims activity at a hospital.

"A lot of thought has gone into designing MediBuddy+, and that is key to its quick adoption in a market where many other players have attempted something similar without as much success. The web-based portal is free and needs no implementation or integration support. We allow hospitals to record requests by their patient name rather than a claim number. It was important for us to put our member at the centre of the experience rather than on the number that we allocate to them. Similarly, we allow finance users to search credits received by UTR number, so they need not spend any additional time on reconciliation – a feature that has received incredibly positive feedback from the market," adds Satish.

MediBuddy+ continues to see increased membership with the advent of features such as eCashless^TM. Not only are hospitals able to help their patients receive a provisional p reauthorization before date of admission, but they are also able to get visibility into the upcoming admissions at their hospitals, resulting in the planning of a more efficient inventory.