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Vipul Medcorp Insurance TPA Pvt. Ltd.

 IRDA licensed TPA since 2004  Cashless Network of over 9000 hospitals
 1500 + Corporate Clients  Processing 2.6 Lakhs claims annually .
 Servicing 6.74 million lives  32 offices pan India, 22 Decentralized offices

Vipul Real Estate Development RTS Rural Technologies solutions

Vipul Group Associate Companies are Pvt Ltd is a leading player in Smart
leading players in real estate Card based Health Delivery services and
development IT based solutions

Vipul Motors Pvt. Ltd. -

One of the largest and top
Maruti & Nexa dealers in India, Vipul Informatics Pvt. Ltd is a
with over 25 outlets in niche player in Software
Gurugram, Faridabad, Noida, Development and IT Solutions
Jaipur, Ballabgarh & Dausa.

Vipul Medcare Pvt. Ltd. is into Vipul Better Care

International Operations and Health Management Services LLC, is
Management Activities in India and the largest local TPA in Oman. Is
runs MedHealth Cards (OPD & also a leading player in Gulf Medical
Discount Card) & H3U (Largest Tourism and IT Solutions
aggregation of wellness activities in
India), and manages Corporate
wellness clinics. Servicing 102 clients ,
Vipul
1 million lives.
Group
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An Introduction to Vipul Medcorp Insurance TPA Pvt. Ltd.

We are an IRDA licensed Third Party Administrator (TPA). Our Processes are ISO 9001:2008, ISO 27001:2013 certified.
We are engaged in the following activities:

Cashless Pre policy Check up

(on behalf of Insurance
Medical Service Facilitation over
Companies)
9000 Network Hospitals
Network Tie ups
Claim processing (for Insurance Companies)
(Reimbursement)
Foreign travel policies &
Enrolment Health Policies
(online/offline/selfcare) (issued by India Insurers covering
medical treatment or Hospitalization
Online assistance outside India)
(Assistance to insured During
Hospitalization) Servicing of foreign
MIS/Reports travel policies
(online/offline to Insurance co., (issued by foreign Insurers for
Insured and hospitals) policy holders travelling to India)

Claims Audit Servicing of Non Insurance

(of Insurance Companies, where Health care schemes
they do in house settlement) (sponsored/approved by Govt /State Govt .)
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Business Highlights 2017-18

No. of lives serviced (Retail + Corporate) • 27.1 Lakhs

No. of lives serviced (Mass Policies) • 40.3 Lakhs

Total Lives Serviced • 67.4 Lakhs

Total Premium Handled • Rs. 1014 Cr.

No. of Claims Processed • 2.68 Lakhs

Amount of Claims Processed • Rs. 841.7 Cr.

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Decentralized Operations

1. Gurugram (Head Office)

2. New Delhi (Reg. Office)
3. Amritsar
4. Ludhiana
5. Chandigarh
6. Noida
7. Faridabad
8. Jaipur
9. Kolkata
10. Patna
11. Ahmedabad
12. Surat
13. Vadodara
14. Indore
15. Mumbai
16. Pune Gurugram (Head Office)
17. Thane Decentralized Office
18. Hyderabad
19. Bangalore
20. Chennai
21. Kochi
22. Guwahati
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 We Work with

16 1500 9072

INSURERS CORPORATE CLIENTS HOSPITALS

About Us 6
Our Esteemed Corporate Clients

Industry Segment Major Clients

Ericsson India, Agilent Technologies, Amerprise India, Aricent Technologies , BA Call Centre, BA Continuum, Bold
IT/BPO/KPO/ Technology, Convergys India, Colt Technology, Comviva Technologies, Cvent India, Fareportal India, Fidelity Information,
E Commerce First Advantage , Hughes Systique, Sandisk India (WD), Incessant Technologies, Naukri.Com, Keysight Technologies,
N.I.I.T., Olam Information, Proptiger, Technosoft Global Services, Just Dial, Xavient Software

IIM Rohtak, IIM Ranchi, IDP Education India , IMT Ghaziabad, IIT - Delhi, NIIT Smart serve, Nspira, Pearson India
Education / Media Education , Techbook International, , S Chand And Co., Varsity Education Management , Living Media, Business
/Publication Standard, India Today Group, Press Trust of India, Panorama Television, University of Rajasthan, Fore School of
Management, IIT Indore, University Of Kota, Sharda University, NIT– Kurukshetra,

Telecom Services Mahanagar Telephone Nigam Ltd, Genesys Telecom Labs, Indus Tower, Om Telecom Logistics, Intex Technologies

Glaxo Smithkline(GSK), Alchem International, Artemis Medicare, ELI Research, Dr Ramesh Cardiac And Multispeciality
Pharmaceuticals /
Hospital, Dr. Lal Path Labs, Indian Spinal Injuries Centre, Mata Chanan Devi Hospital, Natural Remedies, Patanjali
Healthcare
Ayurved, Sri Ramachandra Hospital, Sir Ganga Ram Hospital,

Real SpiceJet , FCM Travel Solutions, ITC Hotels, SUCG Infrastructure , Proptiger, ICPA,, CBRE South Asia, Red Bus, Make My
Estate/Hospitality/ Trip, Jaypee Hotels, Air Arabia PJSC, Crowne Plaza, FCM Travel, Taj Sats, Thai Airways, CWT India International Travel
Travel/Aviation House, The Taj Mahal Hotel,
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Our Esteemed Corporate Clients

Industry Segment Major Clients

AU Small Finance Bank, Canara HSBC OBC LIC, EUI Limited, Bank Of America, Hindustan Motors Finance, Mckinsey
Banking/Finance/ Knowledge Centre, Punjab & Sind Bank,, State Bank Of India (SBBJ), Tamilnad Mercantile Bank, RMSI, SCNL, Team Lease,
Insurance/Consulting DSP Merrill Lynch, Sarv Up Gramin Bank, Narmada Jhabua Gramin Bank, SGPC, IFMR Rural, Indore Premier Co-operative
Bank, Shriram Fortune,

Central Warehousing Corporation, Bidhannagar Municipal Corporation, DI & PR Deptt Rajasthan, Hyderabad
PSU/Govt Metropolitan Development Authority, Rajasthan State Road Transport Corporation, South Indian Film Chamber Of
Bodies/Associations/ Commerce, Delhi High Court Bar Association, Delhi Race Club, Lok Sabha Secretariat, National Seeds Corporation, Noida
Chambers Golf Course, ONGC Tripura Power, Phd. Chamber Of Commerce & Industry, Sports Authority Of India, Supreme Court
Bar Association

Delta Power, AMI Manning Services, Air Liquide, Bahwan Cybertek, Renew Power, Bausch & Lomb, Beam Global Spirits
Multinational/ & Wines, CB & I India, Luminous Power, Compass India, Kohler India, Genesis Colours, Huawei Telecommunications, IHS
Diversified Global, JCB India, Markit India Services, Pernod Ricard India Pvt. Ltd., Rattanindia Power Limited, Rio Tinto India, G4S,
Schenker India , Spencers Retail, Walsons Services Pvt. Ltd., Indo-MIM, Delphi , Triburg Sportswear, UT Worldwide

C & S Electric, Benetton India, Asahi India, Carrier Midea, Case New Holland, Ashok Leyland Limited, CLAAS India,
Crystal Crop Protection, Delphi Automotive, Everest Industries, BOSE Corporation, GEA Process Engineering India, GKN
Driveline, Grasim Industries, Havells India, Hilti India, Hindalco, Hindustan Zinc Limited, Hero Motocorp, Humboldt
Manufacturing/
Wedag India, India Glycols Limited, Jindal Stainless (Hisar), Knorr Bremse, Lanco Group, Lucas TVS Ltd., Petronet LNG,
Automotive
Plasser India, Polyplex Corporation, Shakti Pumps (I), Sona Koyo Steering, Sundaram Clayton Ltd., Sundram Fasteners,
Triveni Engineering & Industries Limited, TVS Electronics, Uniproducts Usha International, Varun Beverages, Concorde
Motors .
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 VIPUL NETWORK

Website: www.vipulmedcorp.com 9
Email: info@vipulmedcorp.com
Network : Hospital Empanelment Process

 Vipul MedCorp has empanelled over 9000 hospitals and Nursing Homes as per the minimum norms
prescribed under Health Insurance Schemes.

 We also provide customized network solutions as per corporate requirement.

The steps involved in our empanelment process are following:

• Screening of Hospital Profile and Obtaining rate list for negotiation.

• Evaluation of Quality of Service rendered &Patient care background & Infrastructure

• Verifying Management background and past track record

• Verifying IT Infrastructure

• Gradation of Hospitals
• Options of Cost Containment/Package rates.

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Network : Vipul TPA’s Presence

 Vipul MedCorp Jointly with Other TPA’s and various Insurance companies have negotiated
preferred rates at over 1400 hospitals all across the country.

 As on date around 100 surgical Procedures and few non surgical procedures have
been added and further even discounts have been taken on Schedule of Charges

Vipul Med Corp – Nodal TPA

Chandigarh
Indore
Vipul Med Corp – Part of
Technical Committee
Delhi NCR Ahmedabad
Chennai Jaipur

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Vipul Network Reach

Total
=
9072
North West South East
3436 2144 2481 1011

Discounts on total network

4000
hospitals
Packages (PPN) 1624

RSBY 1850

Other 5598

Total 9072 12
Top 50 Hospitals on our Panel
DELHI NCR

MUMBAI

VADODARA
PUNE

HYDERABAD
•Indraprastha •Hinduja •Aditya Birla •Sterling •Apollo
Apollo •Lilavati •Jehangir •Bhailal Amin •Yashoda
•Medanta •Breach candy •Ruby hall •Bankers Heart •Care
•Sir Gangaram •Kokilaben •Columbia Asia •Baroda Heart •Global
•Max Super •Jaslok •Sahyadri •Sunshine •Continental
speaciality
•Fortis Group

BANGALORE
CHENNAI

KOLKATA
COCHIN
AHMEDABAD

•Shalby Hospitals •Apollo •Amrita Institute •Narayana •Rabindranath

•CIMS Hoapital •Global Health City of Medical Hrudayalaya Tagore Cardiac
•Sterling Hospital •Chettinad Sciences •Columbia Asia Institute
•Columbia Asia •Miot •Aster DM Health •Sakra world •Woodland
•Sunrise •Fortis Multispeciality
•Apollo •SRMC Porur
•Lakeshore •Manipal •Medica Super
•Fortis Malar
•Rajgiri Specialty Hospital
•Apollo
•Amri Salt Lake
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•Apollo Gleneagles
•Belle Vue
Accolades in Servicing Mass Policy : RSBY

 We are one of the leading players in servicing mass policies

(RSBY/UHIS).

 Vipul Medcorp received the Best Data Management award for

RSBY in Gujarat in 2010, along with NIA.

 RTS Rural Technologies Solution Pvt. Ltd. ( an associate group

company )provides IT based solution to Govt. bodies, Health
Insurer, TPAs and other Service Providers. RTS is QCI accredited
Smart Card Service Provider, primarily working in rural areas/
RSBY/ Financial inclusion domain.

 We serviced over 4 million lives in 2017-18

State No. of districts Lives

West Bengal 1 398848
Orissa 3 1045509
Himachal 12 1564303
Bihar 3 1027269
Total 19 4035929
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 PROCESS AND TAT

Website: www.vipulmedcorp.com 15
Email: info@vipulmedcorp.com
Online Enrollment Process

• Corporate will give soft data of employees to Vipul Medcorp

• Vipul Medcorp will upload the data in the back end on its Enrollment portal

• Clients will get access to enrollment module user interface employees wise, to allow them online
facility for additions, modification of dependants. They can also upload photos.

• Authority will be given for Corporate HR/Admin to authorize/compile the data

• The above process would also be followed for monthly additions /Deletion data. Insurer will release an
endorsement covering the members in the compiled portal data

• Once the data enrollment is complete, E-cards can be downloaded from our portal/Mobile App

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Online Enrollment Screen

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Cashless Process
•Insured to approach network hospital
with doctor prescription and ID card
•Insured to fill up Part 1 & 3 of pre
authorization form
•Hospital will fill part 2 and fax/ email/
upload to Vipul Medcorp
Authorization
•Vipul Medcorp’s Doctor assesses the
pre-authorization request based on
eligibility.
•Query if any, is sent to hospital. Insured is
also informed on phone/SMS/Email.
•Authorization is given
Discharge
•Insured to pay for all non-covered services
like, registration fees, telephone bills etc.
•Insured to verify and sign hospital bill and
claim form and leave all original documents
at hospital.
• Xerox of relevant documents can be taken
by the patient

Network Hospitals

Emergency Planned
Hospitalization Claim Process Hospitalization

Non Network Hospitals

Reimbursement Claims
Insured will submit claims for non network hospitals and pre
and post hospitalization claims arising out of cashless hospitalization 18
Cost Containment Strategy

PREVENTIVE MANAGEMENT
CLAIMS CONTROL
1. Preventive Health check up programs
1. Original Bills are verified & scrutinized
2. H3U OPD Med Health Card against Standard Discounted Tariff

3. Health Risk Assessment 2. Medical procedure audit & bill scrutiny

4. Health newsletter 3. 2nd Medical opinion taken for

Cost complicated cases and re-pricing done on
5. Health camp/ Wellness camp case to case basis
Containment
6. Claims analysis – Introduce changes in policy 4. Implementation of package rates for
conditions/ Mid tem policy review surgical procedures

6. Orientation of how to optimize the policy and 5. Spot Investigation of cashless cases and
reduce claim outflow Investigation of Indoor records for
doubtful cases
7. Endorsement of blacklisted hospitals in the
policy 6. Trend analysis on the basis of seasonal and
industrial impact on claims.

7. Scrutiny of all red flag cases.

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 CLIENT ASSISTANCE SERVICE ( CAS)

Website: www.vipulmedcorp.com 20
Email: info@vipulmedcorp.com
Corporate Employee assistance services

 Employee interface through online dedicated portal: Employees can access our SelfCare, and various wellness
services through this portal.
Portal Highlights:
 Single window login to access enrollment, TPA and wellness services
 Login is mapped as per employee ID; Password can be personalized by the employees
 Portal offers facility of online claim submission with soft copy upload, facility of e-card download, policy
T&C check, sum insured balance update and real time claim/cashless status check
 E-mailer alerts and SMS alerts for cashless/ claims status
 Same Portal gives access to all services of wellness

 Mobile app : All features of the SelfCare can also be viewed /obtained on our mobile App, on Android and IOS

 24/7 IVR based call center : The call center can be accessed for assistance and real time query resolution . We
also back this up with 24/7 mobile helpline at all locations .

 Short SMS service for real time update of all transactions. Auto SMS is also sent for all transactions on the
registered mobile number.

 We also provide Dedicated Relationship Matrix for Personalized Assistance. A three tier escalation matrix is
provided for any escalations. 21
Web Access – Self Care Features

Submit
Send Queries
Download E-card reimbursement
Sum Insured claim form View Previous Claim
Vipul ID Card no. Member Names
details

PPN List (cashless) Almost 9000 cashless Photo upload option

Vipul Contact details FAQs
hospitals list

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Web Access – Login screen for MIS

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Web Access – Login screen for MIS

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Vipul Self Care Mobile App

Download “Vipul Self-care” App from Apple / Android Play Store

 Download E-Card
 Claim Intimation
 Cashless Status, Claims Status
 View Profile
 View Policy Details
 View Enrolled Profile/s
 Search PPN and Non PPN network Hospitals
 Vipul Medcorp SPOC details
 Branch Locator
 Query and General FAQs

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Vipul Medcorp Insurance TPA -

Thank You
Website: www.vipulmedcorp.com 26
Email: info@vipulmedcorp.com