Treatment costs of an insured patient visiting your hospital is normally paid direct by the insurance company and the payment is based on the agreements between his/her insurer and the hospital. The insurance processing in a medical office should well integrate with the front office/OPD modules and other billing and finance modules in order to reduce data entry errors, to meet the validation and requirement constraints and to generate claims according to the insurance company’s policies and rules.
Mediware’s Insurance Desk module works with hospitals that are under cashless insurance network as well as the ones that offer reimbursement facility to patients. This module deals with transactions such as insurance scheme settings, claim generation, billing, claim submission, tracking of submitted claims and reports , claim status updating etc . Rates can be set based on various insurance schemes of insurance companies and TPA’s( third party administrators). It supports co-payment and deductible amount settings also.