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HCX ORBIT TM Healthcare Simplified - PowerPoint PPT Presentation

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HCX ORBIT TM Healthcare Simplified Premier Healthcare Exchange Connecting All Healthcare Stakeholders. HEALTHCARE INFOXCHANGE INDIA PVT. LTD 1002,1003 Indra Prakash Building Barakhamba Road New Delhi-110001 Tel- 91 11 40100200 www.hcxindia.com sales@hcxindia.com. About HCX.

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Hcx orbit tm healthcare simplified


Healthcare Simplified

Premier Healthcare Exchange Connecting All Healthcare Stakeholders


1002,1003 IndraPrakash Building

Barakhamba Road

New Delhi-110001

Tel- 91 11 40100200



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


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

Hcx platform provides
HCX Platform Provides

  • 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

For insurance company
For Insurance Company

  • 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

Pre auth approval
Pre- Auth Approval

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

  • 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.

Claims form
Claims Form

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

Case volume report
Case Volume Report

This EXHIBIT shows:

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

  • 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.

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

  • Turn around time report
    Turn Around Time Report

    This EXHIBIT shows:

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

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

      • TOT Pre-Approvals

      • 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.

  • Age wise report
    Age-Wise Report

    This Exhibit Shows:

    • 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.

    • Broadly speaking it provides details in report summary :

      Total number of cases

      Total Bill Value

    • 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.