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MA-YOJNA

Hospital Transaction

Operational Manual

Version: 2.1

This document contains information of a proprietary nature.

ALL INFORMATION CONTINED HEREIN SHALL BE KEPT IN CONFIDENCE.

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Abbreviations ................................................................................................... 3

1. Introduction ........................................................................................... 4

2. Login ....................................................................................................... 5

2.1. Login Page .................................................................................. 5

3. Patient Registration ............................................................................... 6

3.1. Patient Verification ....................................................................... 6

3.2. Patient Registration ....................................................................... 8

4. Patient Diagnosis and In-Out Patient ................................................... 9

5. In patient Case Search ......................................................................... 15

6. Preauthorization .................................................................................. 17

7. Additional Preauthorization................................................................ 24

8. Claim Management .............................................................................. 26

9. Dialysis Process .................................................................................... 44

10. Seating Verification ............................................................................. 48

11. Follow-up .............................................................................................. 53

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Abbreviations

MA Mukhyamantri Amrutum

AM Arogya Mitra

HAM Hospital Arogya Mitra

ISA Implementation Support Agency

PRF Preauthorization Request Form

CTF Claim Transmittal Form

MAV Mukhyamantri Amrutum Vatsalya

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1. Introduction

Basic features of this application consist of following modules

Patient Registration and Verification

Patient Diagnosis & In-Out Patient

In-Patient Case Search

Pre Authorization

Additional Pre-Authorization

Claim Management

Billing And Claim

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2. Login

2.1. Login Page

First of all, visit the login page of MA YOJNA and enter the username and password of AM (Arogya Mitra).

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3. Patient Registration

3.1. Patient Verification

Click on the patient Registration and enter the MA URN and card code of beneficiary.

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To verify the patient, capture patients/ relative’s photo and verify fingerprint and click on submit.

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3.2. Patient Registration

Now AM enters the patients details and select patient source and click on submit.

After submitting the details of patients, patient is registered and patient ID is generated. After that patient registration slip is generated.

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4. Patient Diagnosis and In-Out Patient

Enter Username and password of HAM. (Hospital Arogya Mitra)

Go to the cases tab and Click on Registered cases and select particular patient records.

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HAM have to select require tests and click on send to Test if Test is required. (To do the in patient process)

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Diagnosis Test Report Slip is generated for patient medical test.

Next Go to Cases tab, click on Pending for Test Result and select particular patient record.

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Attach test reports and click on Out-Patient if require no more treatment.

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If treatment is not required then outpatient slip is generated.

Attach test reports and click on In-Patient if patient require more treatment.

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If patient require more treatment then In patient Slip is generated.

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5. In patient Case Search Go to Cases tab, click on Case Search

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Click on Inward Status, select In Progress and the particular record status named “In Patient Case Registered”

Above page show patient Information.

Click on Investigation tab and upload diagnosis reports.

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6. Preauthorization

Enter treating doctors and cluster details and click on save.

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Upload pre authorization Documents (Compulsory to Upload).

PRF (Pre Authorization Request Form) is compulsory to upload.

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Enter Remarks and submit details for approval.

After entering approval Details pre authorization slip is generated.

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Enter username and password of Level 1 Approval.

Go to cases tab and then select case search for searching cases in pre auth.

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Select Inward status “Preauth updated” and patient data in pre auth level 1 approval.

Doctor verifies details of patient and will give approval.

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Enter remarks and send case to HAM for query.

Enter Username and password of HAM.

Go to Cases tab, select Inward status “Preauth Approved” and select particular patient record.

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Enter remarks and Submit details for Approval again.

Doctor verify details and given approval for treatment.

After approving Preauth request by doctor level, preauth amount is blocked and beneficiary balance is deducted.

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7. Additional Preauthorization

Go to Cases tab, select “Request for Additional Preauth” and select particular patient record.

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Select new clusters details and click on submit.

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8. Claim Management

Enter Username and password.

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Go to Cases tab, select Inward status “Preauth Approved” and select particular patient record.

8.1. Operation Notes

Click on operation notes tab and update doctor details

Select No changes if there is a no change in cluster decided for operation.

If HAM finds that there is a partial change in cluster then HAM have to select Partial change.

If HAM finds that there is complete change in cluster selection (all cluster changes) then HAM has to select Full change.

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Upload documents and Post Operation photo of patient.

Update operation notes and click on Submit

Upload post investigation reports and click on Submit.

8.2. Patient Discharge

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Click on Discharge Summary tab to do discharge process.

Discharge Summery Documents are compulsory.

Satisfaction letter and Transportation cost Acknowledgement is essential for discharge.

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Taking a picture of patient and give him/her as a transportation cost of Rs. 300.

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8.3. Patient Discharge Verification

Enter Username and Password of AM

Go to cases tab and select Discharge Verification for discharge verification.

Select particular patient for discharge verification.

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Capture Photo, Verify Fingerprint and click on Submit.

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Enter Username and Password of HAM.

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Go to Cases tab and Select Case search. And select inward status as In Progress.

Now click submit to discharge Patient.

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Discharge Summary Slip of Patient.

Click on save billing to generate invoice.

Add MA Invoice and Hospital Invoice in Add/View Attachment and Submit claim.

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Invoice of patient.

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Go to Claim Status to Submit Physical file.

Physical File pending for Submit by HAM. Select file and Submit.

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Enter Username and password of ISA.

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Go to Cases tab and click on claim status.

Select claim status “Physical File Pending for Receive” and select particular patient record and Click on Receive Button.

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Select claim status “Physical File Received” and select particular patient record by click on inward number.

ISA can select particular case if the case is of Dialysis. Status of rest of the cases will remain as visit done.

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Enter approved amount, remarks and process the claim. ISA can send claim to HAM if any query.

Claim Approval Certificate will get generated.

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Go to Claim Status and Select “Claims pending for Submit” Select patients records and submit.

Go to Claim Status and Select “Claim Submitted by ISA1” Select patient record to generate CTF Report. ISA1 to ISA2 CTF Report will get generated.

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9. Dialysis Process

After getting patient verified from AM, in particular HAM’s Login select cluster 5.142 (Haemodialysis work for this cluster only).

Complete the process flow as similar in normal cases till discharge tab.

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Do not go to the billing process after that.

After getting patient verified from AM, Login with HAM and go to the Register Cases tab.

Fill the details and Select Is Dialysis Treatment and Inward number of last Dialysis before submitting in Patient.

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After submitting in patient, Complete the process flow as similar as in normal cases till Investigation tab.

Add Post Investigation Reports and submit it .

Preauth Details and Operation Notes tabs will remain filled as it is and Stay disabled i.e. there is no need to fill that tab.

After Investigation tab, Only discharge tab is need to get submitted.

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Go to the billing tab only when the whole dialysis process gets completed.

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10. Seating Verification

Go to the Cases and Select Seating Verification Search tab.

After selecting that,In Seating Verification status select Pending with HAM and select

specific case.

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When the case get selected ,Message of seating verified from HAM will get generated.

After getting Verified from HAM, Login with AM.

Select Cases and in that Select Seating Verification Search in that.

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After selecting that,In Seating Verification status select Pending with AM and select

specific case and verify that case.

Add FP verify and Photo and submit the case.

After Submition,Verification Done message will get displayed.

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Again Go to the HAM , and in Seating verification , Verified case will get displayed.

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11. Follow-up

Login with AM, Go to the Cases and select Follow-up.

In that select specific case.

After that Follow-up Verification Slip will get generated.

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Login with HAM, and go to the Followup case search tab.

In that select specific case in Case Registered.

Fill Details, Save details and Submit it.

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After Submission, Followup Saisfactory Letter will get generated.

When Followup of specific case will be done, it will be displayed in Visit done.

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THANK YOU