Hospital Insurance and TPA Management Software
An insured patient costs a hospital twice — once in treatment, and again in the weeks of follow-up before the money arrives. Most of that second cost is documentation that was never captured at the right moment.
TechMediz captures insurance details, policy numbers, TPA information and coverage limits at admission, and links corporate patients to their negotiated scheme automatically. Credit is enabled for the patients entitled to it, and package plans are priced and billed against the bundle rather than line by line.
Pre-authorisation requests carry the diagnosis, the estimated cost and the treatment plan; claim status is tracked in the patient record as it is approved, queried or rejected. Claim forms, bills and discharge summaries come out in the shape the insurer asks for, and reporting breaks down by insurer, corporate client, package and claim status.
Capabilities
What Insurance and TPA Management Covers
Listed exactly as published by Mescope Solutions.
Patient Insurance Registration
Corporate Scheme Management
Credit Enablement for Eligible Patients
Package Patient Handling
Pre-authorization Request Management
Real-time Claim Status Tracking
Claim Form Generation & Documentation
Cashless & Reimbursement Modes
TPA & Corporate Reporting
Audit & Compliance Support
Insurance & TPA Management — common questions
Does it handle both cashless and reimbursement claims?
Both, with covered and out-of-pocket amounts kept separate on the bill, so the patient sees what they owe and the claim carries what the insurer owes. Nothing has to be reconstructed at discharge.
How are corporate and package patients handled?
Corporate agreements are held with their negotiated rates, and eligible patients are linked to their scheme automatically. Package plans bundle a treatment or procedure at a fixed price, and the bill is calculated against the package rather than assembled from individual charges.
Can we see where a claim has reached?
Claim status — approved, queried or rejected — is visible in the patient record itself, and TPA and corporate reporting groups outstanding claims by insurer, client and status, so follow-up is worked from a list rather than from memory.
What is kept for audit?
Pre-authorisation logs, claim documents and the bills they were raised against are stored with the record, which is the documentation an insurer audit and an NABH assessment both ask to see.
Works with