i SERVICESALLIANCESOLUTI ONS

Processed Over

4500 Claims

Worth More Than

Rs 13.5 Crores

Here at iServices Alliance Solutions, we are dedicated to you and all your different health insurance needs. We've been around for over 5 years and we've won several accolades for comprehensive health insurance firm. But, our most important win is making you a happy, life-long customer.

iServicesAlliance Solutions Pvt. Ltd (iServices) is a comprehensive solution provider for all health insurance related matters.We cater to both Healthcare providers and insurance holders. Started in 2011 by three visionaries, Mr. Nagaraj Rao, Mrs. Sumitra Rao and Mr.Girish Rao the company’s motto is to ‘Excel in insurance services through innovation, professionalism and customer centric operations’. Our Unique Selling Proposition (USP) is a two-fold combination of cutting edge IT solutions along with precise and efficient processes. With our unique approach we are able to reduce Claim Turn Around Time (TAT) thereby improving cash flow. Our Management Information System (MIS) and reporting provide the right and relevant factors that aid proper and timely decision making.

EligibilityVerification

PreAuthorization

Patient AcctOpening

A/R follow up

CashPosting

Patient follow up

MedicalTranscription

Charge CaptureTranscription

Billing

Claims Generation

HospitalAdmission

Treatment Discharge PostDischarge

iServices responsibility

Healthcare provider responsibility

Patients advised by industry expertsExpertise ReviewEliminate contentions on patient responsibleportions of the bill at the time of discharge

Prepare files

Significant reduction clerical errorEnsures completeness of documentationFaster claim settlement

Follow upFollow up the TPA’s / insurers on filed claimsuntil payment is secured

Back officeEliminates need for in-house insurancedepartment

QuickElectronic communication between partiesguarintees no delay

Gather

iServices experts solicit policy information,gather details and clearly explain inclusionsand exclusions

InformRemove ambiguity on coverage and put out ofpocket expenses

TPASecure pre-authorization from TPA &transmit it electronically to the hospital

iServices Alliance Solutions

An electrical engineer by qualification, Mr. Rao has over 30 years of experience in General insurance industry. He has worked in various capacities including that of Regional Manager of National Insurance co ltd. He is a co-founder of ARC Insurance Broking Pvt ltd, a well-known insurance service provider. A pioneer in implementing health insurance in Karnataka, he was instrumental in devising a policy that provides BPL citizens with cash less insurance cover through a WHO sponsored scheme; a first for Karnataka. A model citizen with a vision to give something back to the community, he is responsible for operating a mobile hospital in one of the remote taluks in north Karnataka, a scheme funded by World Bank. He takes keen interest in insurance education and is a visiting faculty at many the Management colleges.He was a faculty member at the National Insurance Academy, the only institution in Southeast Asia that imparts insurance education

Mr. Nagaraj Rao – Founder and Chief Mentor photo

Mrs. Sumithra worked with Life insurance Corporation for over 20 years and has a vast knowledge of both underwriting and claims. An able administrator and a result oriented person.

Mrs. D.B. Sumithra – Director

Girish is an insurance professional. He holds an MBA in insurance from National Insurance Academy, Pune and is also an Associate member of Insurance Institute of India – AIII. He has over eight years of experience in General insurance industry both in India and overseas and heads our operations division.

Excel in insurance services through innovation, professionalism and customer centric

Mr. Girish Rao - Operations Head

photo

photo

iServices

iDesk -InsuranceHelp Desk& Claimprocessing

iClaims -Backlog Claimsprocessing

iReimburse -Reimbursmentassistance

Team Management

Our Vision

TO HEALTHCARE PROVIDERS:

TO HEALTHCARE PROVIDERS:

Empanelment assistance

Backed by years of experience in the insurance sphere, we assist with getting the hospital empanelled with the TPAs and insurance companies. With our scientific approach to costing we are able to help the hospital arrive at competitive rates for packages that are mutually beneficial to the hospital and insurance companies. We will bring the TPA representatives for hospital visits and negotiate the best possible package rates on behalf of hospitals with the insurance providers.

If the healthcare facility is not in-network with the TPA / Insurance company, we provide re-imbursement assistance to the insurance holder. We willreview the available documentation, point out any necessary corrections and / or missing documents (if any) to ensure smooth claim processing. We will fill and file the insurance claim on the patient’s behalf; and follow-up with the insurance company to secure payment.iServices will charge a nominal fee for this service. �e patient / insurance holder is explained that reimbursement assistance is a service offered by iServices and not by the hospital. �e fee for this service is directly borne by the patient / insurance holder.

Insurance Help Desk

Patient advisory services provided by industry experts with a passion for healthcare resulting in improved hospitalization experience and increased goodwill towards the hospital.iServices experts gather policy information, glean details therein and clearly explain inclusions and exclusions to patients / policy holder.Expert advice removes ambiguity on coverage and out of pocket expenses and eliminates/minimizes contentions on patient responsible portions of the bill at the time of discharge.

Metrics

We enable better decision making using quality metrics provided at the right timeOur reports are customized to meet the needs of people at various levels in the hospital’s management hierarchyMeaningful and better MIS provided at the right time will enable the management to better negotiate with TPAs, planning equipment upgrades and infrastructure improvementsReports that we will provide are below. We are open to discussion regarding any additional reports required by the hospital

Health Insurance claim processing

We will secure Pre-authorizationand Pre-Authorization enhancement for the medical procedure from the TPA / insurance company using electronic communication using technological tools whichguarantees no transmission delay or loss of transmission We determine the amount to be collected from the patient based on the final bill. �is is communicated to the billing staff thereby eliminating the burden to determine patient responsible portion of the bill.We prepare the claim packet after the patient is dischargedOur QC expert reviews the claim packet to ensure completeness of documentationWe file the claim with the TPA/insurance company, and follow-up with the TPA/insurance company to secure approval / payment. Our insurance expertize and efficient processing methods will result in

Smooth discharge with minimal or no issues for/from insurance patientsSignificant reduction of clerical errors Completeness of documentationFaster claim settlement

Services

Eliminate/reduce your claim settlement backlog by entrusting your problem claims to our experts

Reimbursement assistance provided to the insured party wherein iServices prepares and files a reimbursement claim on behalf of the insured (when the hospital is out-of-network)

iServices experts analyze hospital’s claim backlog and

device a road map to secure payment

Get hospital executive

management input and prioritize

backlog

Rectify paperwork (provice missing

document, clarifications etc.) for

these claims

follow up with TPAs / Insurers to get the

backlog cleared

iClaims

iReimburse

Direct contact between iServices and the insured

Alleviates the insured’s claim preparation burden

Prepared by experts with up-to-date knowledge of the claim preparation requirements

QC’d to ensure defect free claim package

Tracked by iServices until payment is secured

HEALTH INSURANCE INDUSTRY

Health Insurance Business” or “Health Cover” means the effecting of contracts which provide sickness benefits or medical, surgical or hospital expense benefits, whether in-patient or out-patient, on indemnity, reimbursement, service, prepaid, hospital or other plans basis, including assured benefits and long term care.- IRDA (Registration of Indian Insurance Companies) Regulations,2000

Health insurance has been the fastest growing segment in the non-life insurance industry in India over the last few years, having grown from RS 700 Cr in the Year 2001-2002 TO RS 17624 Crs in the year 2013-2014 which reflects a compounded annual growth rate of over 28.16% during this period.

Health Insurance Business” or “Health Cover” means the effecting of contracts which provide sickness benefits or medical, surgical or hospital expense benefits, whether in-patient or out-patient, on indemnity, reimbursement, service, prepaid, hospital or other plans basis, including assured benefits and long term care.- IRDA (Registration of Indian Insurance Companies) Regulations,2000

Health insurance has been the fastest growing segment in the non-life insurance industry in India over the last few years, having grown from RS 700 Cr in the Year 2001-2002 TO RS 17624 Crs in the year 2013-2014 which reflects a compounded annual growth rate of over 28.16% during this period.

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HEALTH INSURANCE GROWTH

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HEALTHInsuranceClaims

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4500000

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CLAIMS REPORTED

STAY IN TOUCHiServices Alliance SolutionsSri Shankara Cancer Foundation, 1st Cross, Shankarapuram, Basavanagudi, Bangalore - 560004+91.9448139836+91 8105597672Email: seh.idesk@gmail.comWebsite: www.i-services.co.in