MA-YOJNA. Hospital Transaction. Operational Manual. Version: 2.1

Transcription

1 MA-YOJNA Hospital Transaction Operational Manual Version: 2.1 This document contains information of a proprietary nature. ALL INFORMATION CONTINED HEREIN SHALL BE KEPT IN CONFIDENCE. Operational Manual 1

2 Abbreviations Introduction Login Login Page Patient Registration Patient Verification Patient Registration Patient Diagnosis and In-Out Patient In patient Case Search Preauthorization Additional Preauthorization Claim Management Dialysis Process Seating Verification Follow-up Operational Manual 2

3 Abbreviations MA AM HAM ISA PRF CTF MAV Mukhyamantri Amrutum Arogya Mitra Hospital Arogya Mitra Implementation Support Agency Preauthorization Request Form Claim Transmittal Form Mukhyamantri Amrutum Vatsalya Operational Manual 3

4 1. Introduction Basic features of this application consist of following modules Patient Registration and Verification Patient Diagnosis & In-Out Patient In-Patient Case Search Pre Authorization Additional Pre-Authorization Claim Management Billing And Claim Operational Manual 4

5 2. Login 2.1. Login Page First of all, visit the login page of MA YOJNA and enter the username and password of AM (Arogya Mitra). Operational Manual 5

6 3. Patient Registration 3.1. Patient Verification Click on the patient Registration and enter the MA URN and card code of beneficiary. Operational Manual 6

7 To verify the patient, capture patients/ relative s photo and verify fingerprint and click on submit. Operational Manual 7

8 3.2. Patient Registration Now AM enters the patients details and select patient source and click on submit. After submitting the details of patients, patient is registered and patient ID is generated. After that patient registration slip is generated. Operational Manual 8

9 4. Patient Diagnosis and In-Out Patient Enter Username and password of HAM. (Hospital Arogya Mitra) Go to the cases tab and Click on Registered cases and select particular patient records. Operational Manual 9

10 HAM have to select require tests and click on send to Test if Test is required. (To do the in patient process) Operational Manual 10

11 Diagnosis Test Report Slip is generated for patient medical test. Next Go to Cases tab, click on Pending for Test Result and select particular patient record. Operational Manual 11

12 Attach test reports and click on Out-Patient if require no more treatment. Operational Manual 12

13 If treatment is not required then outpatient slip is generated. Attach test reports and click on In-Patient if patient require more treatment. Operational Manual 13

14 If patient require more treatment then In patient Slip is generated. Operational Manual 14

15 5. In patient Case Search Go to Cases tab, click on Case Search Operational Manual 15

16 Click on Inward Status, select In Progress and the particular record status named In Patient Case Registered Above page show patient Information. Click on Investigation tab and upload diagnosis reports. Operational Manual 16

17 6. Preauthorization Enter treating doctors and cluster details and click on save. Operational Manual 17

18 Upload pre authorization Documents (Compulsory to Upload). PRF (Pre Authorization Request Form) is compulsory to upload. Operational Manual 18

19 Enter Remarks and submit details for approval. After entering approval Details pre authorization slip is generated. Operational Manual 19

20 Enter username and password of Level 1 Approval. Go to cases tab and then select case search for searching cases in pre auth. Operational Manual 20

21 Select Inward status Preauth updated and patient data in pre auth level 1 approval. Doctor verifies details of patient and will give approval. Operational Manual 21

22 Enter remarks and send case to HAM for query. Enter Username and password of HAM. Go to Cases tab, select Inward status Preauth Approved and select particular patient record. Operational Manual 22

23 Enter remarks and Submit details for Approval again. Doctor verify details and given approval for treatment. After approving Preauth request by doctor level, preauth amount is blocked and beneficiary balance is deducted. Operational Manual 23

24 7. Additional Preauthorization Go to Cases tab, select Request for Additional Preauth and select particular patient record. Operational Manual 24

25 Select new clusters details and click on submit. Operational Manual 25

26 8. Claim Management Enter Username and password. Operational Manual 26

27 Go to Cases tab, select Inward status Preauth Approved and select particular patient record Operation Notes Click on operation notes tab and update doctor details Select No changes if there is a no change in cluster decided for operation. If HAM finds that there is a partial change in cluster then HAM have to select Partial change. If HAM finds that there is complete change in cluster selection (all cluster changes) then HAM has to select Full change. Operational Manual 27

28 Upload documents and Post Operation photo of patient. Update operation notes and click on Submit Upload post investigation reports and click on Submit Patient Discharge Operational Manual 28

29 Click on Discharge Summary tab to do discharge process. Discharge Summery Documents are compulsory. Satisfaction letter and Transportation cost Acknowledgement is essential for discharge. Operational Manual 29

30 Taking a picture of patient and give him/her as a transportation cost of Rs Operational Manual 30

31 8.3. Patient Discharge Verification Enter Username and Password of AM Go to cases tab and select Discharge Verification for discharge verification. Select particular patient for discharge verification. Operational Manual 31

32 Capture Photo, Verify Fingerprint and click on Submit. Operational Manual 32

33 Enter Username and Password of HAM. Operational Manual 33

34 Go to Cases tab and Select Case search. And select inward status as In Progress. Now click submit to discharge Patient. Operational Manual 34

35 Discharge Summary Slip of Patient. Click on save billing to generate invoice. Add MA Invoice and Hospital Invoice in Add/View Attachment and Submit claim. Operational Manual 35

36 Invoice of patient. Operational Manual 36

37 Go to Claim Status to Submit Physical file. Physical File pending for Submit by HAM. Select file and Submit. Operational Manual 37

38 Enter Username and password of ISA. Operational Manual 38

39 Go to Cases tab and click on claim status. Select claim status Physical File Pending for Receive and select particular patient record and Click on Receive Button. Operational Manual 39

40 Select claim status Physical File Received and select particular patient record by click on inward number. ISA can select particular case if the case is of Dialysis. Status of rest of the cases will remain as visit done. Operational Manual 40

41 Enter approved amount, remarks and process the claim. ISA can send claim to HAM if any query. Claim Approval Certificate will get generated. Operational Manual 41

42 Go to Claim Status and Select Claims pending for Submit Select patients records and submit. Go to Claim Status and Select Claim Submitted by ISA1 Select patient record to generate CTF Report. ISA1 to ISA2 CTF Report will get generated. Operational Manual 42

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44 9. Dialysis Process After getting patient verified from AM, in particular HAM s Login select cluster (Haemodialysis work for this cluster only). Complete the process flow as similar in normal cases till discharge tab. Operational Manual 44

45 Do not go to the billing process after that. After getting patient verified from AM, Login with HAM and go to the Register Cases tab. Fill the details and Select Is Dialysis Treatment and Inward number of last Dialysis before submitting in Patient. Operational Manual 45

46 After submitting in patient, Complete the process flow as similar as in normal cases till Investigation tab. Add Post Investigation Reports and submit it. Preauth Details and Operation Notes tabs will remain filled as it is and Stay disabled i.e. there is no need to fill that tab. After Investigation tab, Only discharge tab is need to get submitted. Operational Manual 46

47 Go to the billing tab only when the whole dialysis process gets completed. Operational Manual 47

48 10. Seating Verification Go to the Cases and Select Seating Verification Search tab. After selecting that,in Seating Verification status select Pending with HAM and select specific case. Operational Manual 48

49 When the case get selected,message of seating verified from HAM will get generated. After getting Verified from HAM, Login with AM. Select Cases and in that Select Seating Verification Search in that. Operational Manual 49

50 After selecting that,in Seating Verification status select Pending with AM and select specific case and verify that case. Add FP verify and Photo and submit the case. After Submition,Verification Done message will get displayed. Operational Manual 50

51 Again Go to the HAM, and in Seating verification, Verified case will get displayed. Operational Manual 51

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53 11. Follow-up Login with AM, Go to the Cases and select Follow-up. In that select specific case. After that Follow-up Verification Slip will get generated. Operational Manual 53

54 Login with HAM, and go to the Followup case search tab. In that select specific case in Case Registered. Fill Details, Save details and Submit it. Operational Manual 54

55 After Submission, Followup Saisfactory Letter will get generated. When Followup of specific case will be done, it will be displayed in Visit done. Operational Manual 55

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57 THANK YOU Operational Manual 57