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TPA management systems
TPA is a Management Information System for TPA - Third Party Assurance, having work of Mediclaim Processing.
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Marketing Strategy
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TPA Management System |
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- Complete N- Tier architecture
- Implemented using Microsoft ASP.Net 1.1 and C#
- SQL Server 2000 as back end
- Pages designed using HAL (HTML Auto Layout) standards
- Exclusive ISA Certified "ICD10 code" integration
- Reporting/Statistics like Yearly, Monthly, Agent wise, Hospital wise, ICD10 code wise, Age group wise etc.
- Full text Index Search implementation
Unified Modeling Language (UML) has
- Product Requirement Analysis
- Reports
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Product Details
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- TPA is quick and easy to learn , at the same time has the power and flexibility of a sophisticated TPA system
- TPA uses a Menu and Window driven User Interface with mouse support
- Advanced password security system is provided to allow users' limited access to TPA features (Like Admin, Data Entry Operator (Policy/Claim), Data Entry Operator (Doctor's Study/Approval/Rejection), Stat. Report Manager, Advance Data Entry Operator etc)
- Search ICD10 Code. Search ICD10 code using keyword also, like search with 'eye' as description, will return all ICD10 code for which description contains word 'eye'.
- Search on Hospital name, Hospital UPIN MCI No , Policy ID, Policy No, Policy development officer agent, Receipt no, Insurance office, Policy holder etc. of any item is provided
- Supports Multi users environment and multi location Web Interface
- Particular attention has been paid to the smoothness, speed and ease of use while issuing, returning, renewing and reserving items.
- Log Register to record uncontrollable errors.
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Modules |
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Insurance Company |
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- Add Delete, Modify, Search, View etc. functionalities to manage Insurance Company and Insurance company branch details.
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Manage Hospital |
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- Add Delete, Modify, Search, View etc functionality to manage hospital details.
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Policy Information |
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- Add Delete, Modify, Search, View etc functionality to manage Policy details.
- Search policy using Policy number, Policy holder, Policy ID, Policy development office agent, Insurance office, Receipt no etc.
- Manage Insured Person detail.
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Search ICD10 Code |
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- Search Using ICD10 code or keyword of description.
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Claim Information |
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- This modules contains details of Provider billing form, Patient claim form etc.
- User can add modify, search, view, delete the Provider billing form and so is true with Patient claim form.
- Claim type can be Pre-Authorized Claims or Reimbursement Claims.
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Reporting |
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Following is a list of few Reports TPA system provides : |
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- Management Information System (MIS) Report to be obtained from TPA for Submission to Ministry
- Management Information System Report to be obtained from TPA for Submission to Insurance Company (Branch)
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Report on Enrolment Information |
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Claims and Reimbursement Analysis Report |
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Hospital - Wise Claims Report |
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Outstanding Claims Report |
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Claims Paid Details Report |
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Annual Hospital-Wise Stay Analysis Report |
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Annual Agent wise Analysis Report |
- Management Information System Report to be obtained from TPA for Submission to Insurance Company
(Head Office)
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Claim Analysis Report - Age GroupWise (Disbursement Break UP) |
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Claims and Reimbursement Analysis Report |
- Management Information System Report to be obtained from TPA for Submission to IRDA
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Analysis Of Claims Handled for the Year Ending |
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