HCX ORBIT

TM

Healthcare Simplified

Premier Healthcare Exchange Connecting All Healthcare Stakeholders

HEALTHCARE INFOXCHANGE INDIA PVT. LTD 1002,1003 IndraPrakash Building Barakhamba Road New Delhi-110001 Tel- 91 11 40100200 www.hcxindia.com

[email protected]

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About HCX

HealthCare InfoXchange India Pvt. Ltd. is a healthcare company and Servicing the healthcare industry with the IT solutions for the robust demanding needs of healthcare industry.

We are promoted by IGI-USA.

IGI operates in US and provides dual shore infrastructure for seamless connectivity in Healthcare process.

IGI USA has been cloud-Computing services and solutions to meet the demands in the healthcare, finance, insurance and technology industry verticals and has been in the field for the past 20 years.

It offers offshore execution expertise with onsite controls and onsite projects and staffing models.

IGI has made unprecedented contributions in the healthcare domain by providing   Technology Solutions in the area of revenue cycle and Clinical Transactions IGI solution portfolio for healthcare organizations has transformed; *Legacy System *Automated Manual Processes *Provided Connect to trading Partners

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Solution Overview

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Pre Auth

 On Line Submission by Hospitals – – – As per ICD Codes Availability of Data from the source View for Verification and audit – in Real Time 

Eligibility Validation

 Hospitals can view Patient Details – – Policy Coverage and Treatment Required Policy Parameters – Co-Pay, Limits, Exclusions 

Claims/Bills

  Submit Claims in Standard format Line- Break up of bills  Payable and Non-Payable segregation

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HCX Platform Provides

For Insurance Company

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Audits and Alerts

 Set Alerts on Real-time data – – – – Trends of Hospitals Particular Region Particular Policy Coverage Treatment Deviation from Policy 

Enterprise Wide View

 Set Audit Alerts across TPAs    View/Track Payments Authentic and On-Line data Interchange Check Case Reports – Including Attachments  

Mobile Application Based Field Verification integrated with Pre-auth Repository of PPN Hospital Rates – Validation against Payments

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Proprietary & Confidential Pre- Auth Approval

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Pre-Approval mechanism helps in keeping track of every detail of the pre-approval with the unique ID.

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With unique ID(Primary key for search), it provides the details of preapproval on various criteria likewise submission date & time, response date & time, status-enhancement /approved/submitted, amount approved.

Proprietary & Confidential Claims Form

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Claim module facilitates online submission of claim form alongwith discharge summary and bill breakup.

Proprietary & Confidential Case Volume Report This EXHIBIT shows:

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Report mechanism generates reports belonging to various categories for example in the above mentioned screen shot “Case Volume Report”.

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Report summary provides figures for no. of pre-approval cases likewise

 Submitted - Approved, Denied, Hold   Enhancement - Approved, Denied, Hold Revaluate- Approved, Denied, Hold 

Report Detail section generates report for the submitted preapproval on the basis of insurance company, TPA, Hospitals .The figures are further provided to have a complete understanding of total cases into approved, enhancement ,denied and so on.

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Graphical representation of the available data gives an analytical understanding of the changing trends.

Proprietary & Confidential Turn Around Time Report This EXHIBIT shows:

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It generates report for trend of turnaround time taken in servicing policy by insurance companies , TPA for settlement of claims.

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Report Summary provides TAT for insurance companies with the TPA, Hospitals likewise

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TOT Pre-Approvals

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TOT Turnaround Average Turnaround (Minutes)

Average Turnaround(Hours)  

Report Detail provides TAT details along with various factors: Preauthorisation Number Response Time First Response Time Submitted Time It helps you in analysing the efficiency of services given by insurance companies ,TPA in settlement of claims .

Proprietary & Confidential Age-Wise Report This Exhibit Shows:

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Agewise billing report give statistics of pre-approvals on the basis of number of pre-approval falling in various age groups, bill details for every age group.

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Broadly speaking it provides details in report summary : Total number of cases Total Bill Value

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The graphical representation helps you in analysing the quantum of bills falling in particular age group i.e 35-50 yrs is the age group where the quantum of bill is higher.

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