Mco- Solapur - Kokilaben Dhirubhai Ambani Hospital

Kokilaben Dhirubhai Ambani Hospital

Verified Company

Solapur, India

3 weeks ago

Posted by:

Deepika Kaur

beBee Recuiter

Description

He will ensure that all required evaluation including diagnostic tests are done free of cost for all beneficiaries and the details of the same along with reports are captured in the Society portal.

He will upload the OP/IP status of the patient.
He will guide the patient in all aspects and sign the investigation request.
He has to cross check whether diagnosis is covered in the scheme. If doubtful about the plan of management then should coordinate with treating specialist along with Package list as specified in the MJPJAY / PMJAY Manual on Surgical & Medical Treatments for Cashless Treatment of BPL Population.
He should facilitate the admission process of Patient without any delay.
After admission He will collect all the necessary investigation reports before sending for approval.
He will upload the admission notes and preoperative clinical notes of the patient.
He/She will ensure that preauthorisation request is sent only for those who are on bed(IP).
He will ensure before sending Preauthorization that all documents like ration/health card, Patient photo and also necessary reports like CT Films, X-Ray films, Biopsy etc. are uploaded in the system.
He will coordinate with insurance and a society doctor as need arises.
Pre-auth kept pending from Insurance and society will be verified on a regular basis and necessary corrections to be done by MCO.
He will furnish daily clinical notes (Pre-operative and Post-operative).
He will upload 3 Photographs of the Patient taken preoperative bedside, immediate post-operative showing operation wound and at the time of discharge. On Letter Head of Hospital requesting for Empanelment.
He will update surgery and discharge details and hand over signed copy of the summary along with follow-up advice in pre printed stationary supplied.
He will ensure free follow - up consultations, routine investigations and distribution of drugs to be supplied by the Society to the beneficiaries.
He should attend to the grievances/complaints of the MJPJAY Beneficiaries and Coordinate with the society if necessary to redresses it within 6 hrs (TAT) through ONLINE MODULE. Further he will counsel the patient accordingly.
He will ensure at the time of discharge the transportation cost to and fro to be reimbursed to the patient.
He will upload the operation notes, post operative details and attach necessary post operative documents (like case sheet etc) for claim submission.
He will ensure that any claim kept pending from insurance for technical or financial reason are be updated immediately.
He will verify that all documents are submitted in order before sending for claims. Also, ready to face MJPJAY monthly or three monthly audit.
Any other responsibility as communicated by the Society / Insurer.
He ensure that the surgeries/therapies are performed as per standard Medical protocols of treatment.
He attend the Training/Re-orientation Programmes conducted by MJPJAY / PMJAY Society/Insurance.
He shall convert MJPJAY registered patients to IP/OP patients and provide treatment to the beneficiaries.