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Role guide

Insurance desk guide

Pre-authorisations, claims and denials; sees the money and what the pre-auth cites from the chart.

The demo opens as Neha Kulkarni, with invented patients. Pre-authorisations, claims in three states, and the denials to chase.
  • Pre-auths sent within the hour of admission
  • Claims submitted with every document
  • Denials worked before the appeal window closes
Your front door

Where the insurance desk lands

Signing in as a insurance desk opens Claims first. The sidebar keeps the screens below one click away; what you can open is whatever your practice’s role for you allows.

  • Claims /claimsTrack insurance claims from pre-auth to payment
  • Claim denials /denialsWork rejected claims to appeal and recovery
  • Estimates /quotesGive patients written cost estimates
  • Government panels /panelsHandle CGHS, ECHS, ESIC and state scheme panel billing
  • Ayushman Bharat /pmjayRun Ayushman Bharat cases from eligibility to claim
  • Payer Tariffs /payer-tariffsKeep every payer’s rate list current and versioned
Everyday apps

Apps a insurance desk uses

ClaimsLineTrack insurance claims from pre-auth to paymentDenialWorksWork rejected claims to appeal and recoveryPriceQuoteGive patients written cost estimatesCGHSDeskHandle CGHS, ECHS, ESIC and state scheme panel billingPMJAYDeskRun Ayushman Bharat cases from eligibility to claimTariffDeskKeep every payer’s rate list current and versioned
Rain

What to ask Rain

Rain is the assistant in every screen, by voice or text. These are requests the assistant is taught for this role. It reads only what you may read, and anything that changes a record comes back as a card you confirm.

  • “Open claims”
  • “How many pre-auths are pending?”
  • “Show denials to work”
  • “Make an estimate”
  • “Show government panels”
  • “Open Ayushman Bharat”
  • “Check the payer tariffs”
  • “Which claims have waited more than 30 days for settlement?”
  • “Kitne pre-auth pending hain?”
  • “क्लेम खोलो”
  • “Denials ki list dikhao”

What Rain prepares for a insurance desk to confirm: create a to-do for yourself, a colleague or a team; mark one of your to-dos (or your team’s) done; make a price quote (estimate) for a patient from the clinic’s price list.

Say “Brief me” for a spoken summary of your day. More in the Rain guide and on what each role says.

More roles

Other role guides

Next: Records clerk →