---
title: Revenue Cycle Management | Insta by Practo
description: Insta's Revenue Cycle Management software streamlines hospital operations and finances. Improve billing accuracy, minimize claim rejections, and boost staff productivity.
---

# Revenue Cycle Management

**Insta’s acclaimed Revenue Cycle Management module is the bedrock on which the provider’s core administration, operational and financial processes run on. It ensures that you are able to run your organization with high levels of adherence to regulatory needs, manage your cash flow/accounts receivables, lower claim rejection rates, boost employee productivity/staff collaboration and high quality outcomes.

**

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![host-htv2](https://www.instahms.com/hubfs/host-htv2.png "host-htv2")

 Rate Determination

- Manage complex rate-discount structures with Insta’s Rate Sheet/Rate Plan model which can be configured for setting up your base price tariffs for all services you offer as a provider.
- Setup cash/sponsor/HAAD/DHA/insurance company/corporate company/government agency/policy holder/HMO based negotiated rates and inclusions with applicable price/discount factors.
- Setup base and derived rate structures as you scale and negotiate rates for easier rate management.

 Taxation

- Support for VAT and single/dual GST taxation rules.
- Setup the C-GST, S-GST, and i-GST model of India’s dual GST taxation model.
- Automated UAE-VAT Taxation rules.
- Automated KSA Citizen VAT Exempt rules.
- Support for the single GST model of taxation as applicable in South East Asian countries.

 Insurance Plan / Sponsor based Contract Management

- Setup sponsor based contract management rules, such as validity and default rate/discount structures applicable.
- Define visit/encounter or episodic insurance limit rules.
- Define visit/insurance category based copay% (min/max), deductibles and limits.
- Define exclusions, pre-authorization rules, and setup Fee for Service/DRG/Per Diem billing configurations.

 Billing

- Place orders from pending prescriptions, approved pre-authorization requests, multi-visit packages, or direct orders with appropriate user controls.
- Define cash/credit-based billing rules with none, single or multiple (up to 2) sponsors
- Define bill and claim statuses to recognize revenue for cash, track sponsor receivables, and inpatient patient revenue management.
- Manage discount tracking from default definition of rates/discount plans, provisional discounts based on user limit controls.
- Deposit collection, tracking for utilization, set offs, and refunds.
- Manage collections with multiple payment modes such as cash, credit card, debit card, digital wallets, cheque, etc as configured.
- Manage patient/sponsor write-offs
- Inpatient credit billing financial discharge controls.
- Receipt based charge allocation for reporting.
- Automated Doctor/Outhouse Payout management based on a customizable rules engine.
- Item cancellation and refunds by payment mode/credit notes with user controls.
- Adherence to India’s 2 Lakh cash collection rules.
- Reports to tally the day book, collections, revenue and payouts.
- Configurable bill, receipt, patient statement prints.
- Email bill to the patient.
- Audit Controls to plug revenue leakage and ensure transparency of system usage.

 Pre-Authorization

- Prescription to pre-auth request flow.
- Manual and online pre-authorization request creation, approval tracking, cancellation, and resubmissions.
- Pre-Auth to Billing-Order Management.
- Integration with Shafafiya/eClaimLink platforms as per HAAD/DHA standards.

 Claim Submissions/Resubmissions

- Claim form documentation.
- Medical coding and claims scrubbing by the encounter, E&M, ICD, CPT, LOINC, Dental, Drug, HCPCS, DRG, Per Diem codes with adherence to Waseel/DHS/DHA/HAAD standards.
- Integration with Waseel/DHS/Shafafiya and eClaimLink platforms for claim submissions.
- Coder claim review features to ensure tracking of changes and liaising of changes between the medical coder, clinician, and administrative staff.
- Claim management, batch creation, denial management, resubmission batch management by correction or internal complaint.
- Claim History Tracking.
- Accumed Integration ready.

 Remittance Reconciliation

- Sponsor Receivables tracking against outstanding Remittances
- HAAD/DHA Integration ready for online remittances.
- Denial management, Batch/Claim resubmission flow.

 Packages

- Define one-time pre-defined health check packages or order sets.
- Predefined multi-visit package management.
- Customize packages per patient.
- Setup controls for ordering packages by the center, department, age, gender, sponsor, etc.
- Support for inventory inclusions.
- Surgical inpatient credit bill packages with cash/sponsor coverage control with item category limits/exclusions defined by amount or quantity.

 Financial Accounting Integration

- Use standard APIs to transpose accounting journal voucher entries for billing and inventory vouchers from Insta to a third party financial accounting application such as Tally, Focus, Microsoft NAV, Microsoft GP, Microsoft A/X, SAP, Odoo, etc.