Dr. Claims provides an end-to-end cashless claims management service for hospitals, utilizing digital workflows and health insurance expertise to streamline the claims process from pre-authorization to settlement. This service ensures timely payments and real-time visibility for all claims, enhancing patient satisfaction and operational efficiency.
Funding
Funding not disclosed
Founders
Product
Problem
Hospitals face challenges in managing health insurance claims, leading to delayed payments, reduced case values, and unpredictable approval amounts. Manual processes and lack of expertise in navigating complex insurance procedures contribute to inefficiencies and revenue loss.
Solution
Dr. Claims offers a comprehensive, end-to-end cashless claims management service designed to streamline the entire process for hospitals, from pre-authorization to final settlement. The service leverages a digital platform, QuickOne, combined with health insurance expertise to ensure timely payments and increased case values. By providing real-time visibility into claims status and automating key workflows, Dr. Claims enables hospitals to improve operational efficiency and focus on patient care. The hybrid staff model combines on-site hospital staff with a virtual center to optimize resource allocation and expertise.
Target Audience
The primary target audience is hospitals seeking to optimize their health insurance claims process, improve revenue cycle management, and enhance patient satisfaction.
Features
- Digital platform (QuickOne) for submitting and tracking claims
- Pre-authorization services including tariff mapping, form preparation, and approval prediction
- Discharge services including bill checking, query resolution, and discharge approval
- Settlement services including courier checklist, settlement initiation, and tracking & follow-up
- Reconciliation services to ensure accurate payment processing
- Prediction of approval amounts with 80% accuracy