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🏥 Comprehensive RCM Services

Built for Indian Healthcare
Revenue Excellence

From hospital empanelment to final settlement reconciliation — i-Services Alliance Solutions handles every step of the revenue cycle so your team can focus on delivering excellent patient care.

🏛️ Service 01

Empanelment with GIPSA, GIC, Govt Schemes & Private Insurers

We manage the complete empanelment process across all payer categories — ensuring your hospital is recognised as a preferred provider by every major payer in India, including government schemes and PSU health plans.

Our team handles the entire documentation lifecycle, from initial applications and rate negotiations to ongoing renewals and compliance monitoring — so you never miss a renewal deadline or rate revision opportunity.

  • GIPSA empanelment documentation & liaison with General Insurance Council
  • GIC (General Insurance Council) member insurers — all public sector
  • Central Government Health Scheme (CGHS) — full registration support
  • Ex-Servicemen Contributory Health Scheme (ECHS) — defence beneficiaries
  • Private insurers — Star Health, HDFC Ergo, ICICI Lombard, Niva Bupa & more
  • Scientific costing & package rate negotiation using procedure benchmarks
  • Renewal, rate revision & compliance support year-round
  • TPA and insurer representatives brought directly to the hospital
PSUs covered: BEML BHEL SBI ISRO Central PSUs State PSUs

Empanelment Deliverables

Documentation Package
Complete application forms, hospital profile, tariff schedule, facility certifications, and medical staff credentials — all prepared and verified.
Rate Negotiation
Scientific package rate analysis using CGHS benchmarks and market data to negotiate fair, competitive rates for all procedures.
Compliance Monitoring
Renewal tracking, audit support, NABH/NABL compliance alignment, and IRDAI regulatory updates — always ahead of deadlines.
45 DaysAvg Empanelment TAT
50+Payer Networks

Help Desk Setup Includes

Admission Counselling
Real-time eligibility checks, policy benefit explanation, and pre-authorization initiation at the point of admission.
Coverage Clarity
Plain-language explanation of inclusions, exclusions, sub-limits, co-pay, and deductibles — eliminating surprises at discharge.
Discharge Planning
Proactive coordination between treating physician, billing team, and TPA to ensure smooth, dispute-free discharge.
95%Discharge Dispute Reduction
24/7Help Desk Availability
🩺 Service 02

Counselling of Insurance Patients for Eligibility Verification

Our trained insurance counsellors guide insured patients through the intricacies of their policy benefits at admission — reducing confusion, preventing coverage disputes, and ensuring a smooth cashless experience from admission to discharge.

We operate a dedicated Insurance Help Desk within your facility, staffed by specialists who understand the nuances of every TPA and insurer — ensuring every patient receives accurate, complete information about their coverage before treatment begins.

  • Real-time policy eligibility checks via TPA portals and insurer databases
  • Sum insured & sub-limit verification for each procedure
  • Pre-existing disease & waiting period assessment before admission
  • TPA and insurer coordination at the time of admission
  • Coverage clarity — inclusions & exclusions explained in simple language
  • Proactive advisory to eliminate discharge disputes and balance billing
  • Patient query management throughout the hospital stay
  • Post-discharge follow-up for reimbursement claim guidance
📤 Service 03

Claim Submission to Insurance Companies & TPAs

We handle end-to-end claim preparation and submission to all major insurance companies and TPAs — both cashless and reimbursement — ensuring accurate, timely, and complete documentation for faster approvals and minimal rejections.

Our claim specialists review every claim for completeness and accuracy before submission, dramatically reducing first-pass rejection rates and accelerating the path to settlement.

  • Cashless pre-authorization requests — submitted within 2 hours of admission
  • Reimbursement claim filing with complete documentation support
  • Document compilation & medical record support from treating team
  • Follow-up with TPA / insurer for approval status every 24 hours
  • Denial root-cause analysis & re-submissions with supporting clinical evidence
  • 24–48 hour submission TAT commitment — industry leading
  • Coding accuracy review against IRDA and TPA guidelines
  • Deficiency management — query responses within the same working day

Claim Submission Process

1
Document Collection
Medical records, bills, discharge summary, investigation reports
2
Quality Review
Coding verification, completeness check, compliance validation
3
TPA Submission
Electronic or physical submission within 24–48 hours
4
Follow-up & Settlement
Daily follow-up until payment received and credited
98%First-Pass Acceptance
48 hrsSubmission TAT

Reconciliation Deliverables

Monthly MIS Reports
Comprehensive reconciliation reports with claim-wise settlement analysis, deduction breakdowns, and recovery status for your finance team.
Dispute Escalation
Formal dispute documentation aligned with IRDAI guidelines for short-paid claims — including grievance filing and escalation to Ombudsman if required.
Recovery Tracking
Real-time recovery dashboard showing pending amounts by insurer, TPA, claim age, and dispute stage — complete financial visibility.
Our benchmarks: 22 Working Days — Settlement TAT <0.5% Short Settlement Rate
📊 Service 04

Reconciliation of Settled Claims

We perform meticulous reconciliation of all settled insurance claims against original billed amounts — identifying short payments, disallowances, deductions, and discrepancies so your facility recovers every rupee it is entitled to receive.

Our reconciliation specialists analyze each settled claim down to the procedure level, identifying patterns of under-payment and building evidence-based dispute cases that maximize recovery while maintaining positive insurer relationships.

  • Claim-wise settlement vs. billed amount matching at procedure level
  • Deduction analysis & formal dispute escalation with documentation
  • Shortfall & balance billing management per IRDAI guidelines
  • Monthly reconciliation MIS reports for hospital finance teams
  • IRDAI-aligned dispute documentation and Ombudsman support
  • Recovery follow-up with insurer / TPA until final resolution
  • Write-off analysis and approval workflow with finance department
  • Insurer-wise performance scorecards and trend reporting
Our Network

TPAs & Insurance Companies We Work With

Fully integrated with all IRDAI-regulated insurance companies, registered TPAs, government health schemes, and PSU health programmes operating across India.

Medi Assist India TPA Pvt Ltd
Registered TPA · Bengaluru
TPA
Vipul MedCorp TPA Pvt Ltd
Registered TPA · Gurugram
TPA
Health India Insurance TPA
Registered TPA · Mumbai
TPA
Family Health Plan (FHPL)
Registered TPA · Hyderabad
TPA
Paramount Health Services TPA
Registered TPA · Mumbai
TPA
MD India Health Insurance TPA
Registered TPA · Pune
TPA
Vidal Health Insurance TPA Pvt Ltd
Registered TPA · Chennai
TPA
Good Health Insurance TPA
Registered TPA · Hyderabad
TPA
Volo Health Insurance TPA Pvt. Ltd
Registered TPA · New Delhi
TPA
New India Assurance Co. Ltd
PSU General Insurer · Est. 1919
Public
United India Insurance Co. Ltd
PSU General Insurer · Est. 1938
Public
Oriental Insurance Co. Ltd
PSU General Insurer · Est. 1947
Public
National Insurance Co. Ltd
PSU General Insurer · Est. 1906
Public
Star Health & Allied Insurance
Private Health Insurer · Chennai
Private
HDFC ERGO Health Insurance
Private Health Insurer · Mumbai
Private
ICICI Lombard General Insurance
Private General Insurer · Mumbai
Private
Niva Bupa Health Insurance
Private Health Insurer · Delhi
Private
Reliance General Insurance
Private General Insurer · Mumbai
Private
Tata AIG General Insurance
Private General Insurer · Mumbai
Private
Central Government Health Scheme (CGHS)
Central Govt Scheme · Pan India
Govt
Ex-Servicemen Contributory Health Scheme (ECHS)
Defence Health Scheme · Pan India
Govt
Ayushman Bharat – PM-JAY
National Health Protection Mission
Govt
BEML Limited Health Plan
Central PSU · Bengaluru
PSU
BHEL Employee Health Scheme
Central PSU · Bhopal
PSU
State Bank of India Group Health
Central PSU · Mumbai
PSU
ISRO Employee Health Scheme
Central PSU · Bengaluru
PSU
ℹ️i-Services Alliance Solutions works with ALL IRDAI-registered TPAs and insurance companies operating in India. The above is not an exhaustive list. Contact us to confirm coverage for any specific payer in your network.
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