Title

Perception of Staff about Issues in Cashless Service in a Multispecialty Teaching Hospital of Pune

Aim
To study the perception of staff about issues in cashless service in a multispecialty teaching hospital
of Pune

Objectives
 To analyze issues in filling and submission of preauthorization request form
 To assess problems during claim processing and approvals.
 To identify issues in document submission.
 To analyze problems with reimbursement process.
 To propose recommendations based on study findings.
 Tool
Age: ___________ Gender: Male / Female Experience in Bharati Hospital: ____________
When was cashless hospitalization service started in your organization? _____________________
How many TPAs do you have tie up for the cashless facility? _____________________
Please rate your opinion.
1- Strongly disagree 2-Disagree 3-Neutral 4-Agree 5-Strongly agree
S.N Question 1 2 3 4 5
1 There are hurdles in filling and submission
of preauthorization request form
1.1 Wrong details or errors
1.2 Wrong entry of details
1.3 Manipulation of patient history
1.4 Supportive documents are not attached

1.5 Others if any: ___________________________________________________________

2 There are problems associated with claim
processing and approvals.
2.1 Higher expectations from patients
2.2 Coverage conditions and terms not clear
2.3 Communication difficulties with call centers
2.4 Delayed claim approval
2.5 Mistakes in pre authorization letter
2.6 Wrong approvals

2.7 Others if any: ______________________________________________________________

3 There are issues in document submission.
3.1 Improper documentation
3.2 Delayed submission of documents
3.3 Admission for investigation
3.5 Excess investigations/ procedures
3.6 More cross consultations

3.7 Others if any: _____________________________________________________________

4 There are problems with reimbursement
process
4.1 Delayed payments
4.2 Short payments
4.3 Short payments because of difference in tariff
4.4 Short payments because of unnecessary
charges
4.5 Short payments because of excess charges

4.6 Others, if any:_____________________________________________________________