Insurance claims request collection, assessment, submission, tracking, and closure for hospitals are painful for hospitals as well as patients. They also lose patients to other hospitals due to the lack of coverage by all insurance companies and TPA.

We Assist entered to provide various solutions to hospitals to support managing their insurance desk and also extend multiple options for hospitals and patients with their funding partners to choose hospitals of their choice for hospitalization.

After evaluating multiple solutions in the market, they chose ERPNext for the following process:

• Rapid Development: ERPNext was a chosen solution for the fact that it was Easy to start, configure, build, deploy, and adapt to changes.
• Their process had a lot of Masters, Reference Tables, Tracking, and Monitoring which helped them compete with others to offer an extended experience and service to our patients.

They also have multiple partners who support us in making the service delivery in a connected manner and delivery in a completed integrated model. All this and more are required to work in a closed-loop model with strict TAT compliance to ensure customer satisfaction and service delivery to the end customers.

To do this, Wahni, a trusted and authorized Frappe Partner built the following

• Project Stats DocTypes: 185 doctypes to capture different information across the business.
• Workflows: 25 + to review the actions at every stage to ensure efficient and complete claim submission to the Insurance company and TPA.
• Checks: 3 Critical checks that evaluate the Insured/Patient across Finance, Insurance, and medical admissibility for required approvals and consider the case for admission/discharge.
• Unified Cash Ledger (5+ Ledgers) to track and help drive closure of all transactions from Lender, Hospital, Insured / Patient, and any other participating partner.