We aim to ensure your goal of a hassle-free claim settlement when registering a claim is a reality. As we ascertain the process is convenient, swift, and seamless, we seek your support in ensuring the availability of every critical component required to evaluate and scrutinise the claim. One such crucial component is the availability of the initial consultation note.
Understanding the Initial Consultation Note:
The “Initial OPD Consultation” is the first consultation with a doctor in an outpatient department (OPD) setting after the onset of the initial symptoms. During this consultation, the doctor diagnoses the current condition justifying the need for hospitalisation and the treatment plan. The Initial Consultation helps to understand how chronic the ailment is and enables our team to conclude on an efficient assessment of the payability of the claim.
The Significance of the Initial Consultation Note in Healthcare Claims:
The initial OPD consultation validates the duration of the patient’s health concerns and records recommendations for further illness management which can include hospitalisation, medication, therapy, or referrals to other specialists if necessary.
The OPD consultation note proves useful when:
- The beneficiary is admitted at a different hospital because the note helps justify the hospitalisation.
- The beneficiary has been undergoing chronic treatment and enrols in a new healthcare policy as the note provides in-depth insights into the patient’s health condition.
- The beneficiary is scheduled for recurring treatment sessions like daycare therapy for dialysis or chemo as the OPD note aids in faster pre-authorisation approval for multiple sessions simultaneously.
What the Initial Consultation looks like?
Addressing Challenges:
Submitting the Initial Consultation note within the designated time can avoid claim rejection.
Conclusion:
The initial consultation note, if requested, is a mandatory claim requirement essential to clarifying the need for hospitalisation and the course of the treatment. By following these guidelines and partnering with us, you can help expedite the claim settlement process and ensure a favourable outcome.
