• 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.
  • 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.
  • 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.
  • 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.
    • Pinelabs EDC machine integration ready.
  • Manage patient/sponsor write-offs
  • Inpatient credit billing financial discharge controls.
    • Automated bed charge calculations by the hour, half-day, full day.
      • Shift with the option to retain or release/previous bed
      • Assign bystander bed
      • Bed View by status
  • 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.
  • 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 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.
  • Sponsor Receivables tracking against outstanding Remittances
  • HAAD/DHA Integration ready for online remittances.
  • Denial management, Batch/Claim resubmission flow.
  • 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.
  • 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.