1. TPA ( THIRD PARTY ADMINISTRATOR ) CLAIM PROCESS WITH SPECIAL EMPHASIS ON CASHLESS FACILITY 2.

Conversion of management problem into measurement question

Management problem: STUDY OF TPA ( THIRD PARTY ADMINISTRATOR ) CLAIM PROCESS WITH SPECIAL EMPHASIS ON CASHLESS FACILITY. Research problem: To convert this management problem into research problem, first of all we need to understand what the problem is and also need to know, what are the factors that can be considered while availing cashless. For this purpose we need to prepare questions related to these factors which can be measured in terms of numerical value and analyzed.

3. Measurement questions / Questionnaire:

1. WHICH AGE-GROUP DO YOU BELONG? 20 - 30 years 30 40 years 40 - 50 years 50 + years

2. HOW EDUCATED ARE YOU?? Matriculate XIIth Pass Graduate Post Graduate

3. . Do you have the PHS ID Cards? ? Yes No

4. If no, then are you aware of Instant E- Card?

Yes 5. How do you find the network hospital? Paramount Website From HR of Company From Broker Directly calling PHS

No

6. Do the hospitals have a well equipped support staff to provide cashless facility? Yes No Cant Say

7. Do PHS has a well equipped call centre where the calls are picked and patients are able to convey their intimation about hospitalization? Yes No Cant Say

8. Are you able to easily fax the documents to PHS from TPA helpdesk in hospitals? Yes No Cant Say

9. Does scrutiny of documents takes a lot of time in PHS, thus causing delay in treatment? Yes No Cant Say

10. Are the queries raised by PHS during verification , Justifiable? Yes No Cant Say

11. . How much time PHS takes in giving 1st Approval during cashless?

Less than 1 hours 1 2 hours

2 3 hours

3 & Above

12. . In how many hours the cashless is delivered. Less than 1 hours

1 2 hours

2 3 hours

3 & Above

13. Do PHS maintain the TAT time in delivering cashless facility? Yes No Cant Say

14. Are the deduction in the final bill, justified? Yes No Cant Say

15. If sum insured is exhausted then are you aware of corporate floater? Yes No Cant Say

16. . How much time it takes to avail the facility of corporate floater? Yes No Cant Say

17. How do you rate the services provided by Paramount TPA?

Excellent Good

Average Poor