Our motto is to ensure you have a smooth and straightforward claim settlement experience. The first step to achieving a seamless claim settlement experience is to fulfil all the basic requisites.
The availability of the discharge summary, a key record of the hospital documentation, is a must for successful claim registration and evaluation.
Understanding the Discharge Summary:
One of the fundamental documents provided by the hospital is the discharge summary. It is proof of hospitalisation and the base for continuity of care after discharge. The record documents everything about the patient, the diagnosis, the treatment, the hospitalisation, the follow-up, and care including:
- Date and time of both, admission and discharge,
- symptoms during admission,
- provisional diagnosis,
- final diagnosis,
- all the investigations,
- every medication,
- summaries of surgeries and interventions performed,
- acute conditions amidst treatment due to primary diagnosis
- discharge advice
The Significance of a Detailed Discharge Summary in Healthcare Claims:
The discharge summary is a comprehensive hospitalisation report documenting details of the patient with all the medical and personal information that becomes an atomic record of the patient’s medical history. With the information in the discharge summary, the individual can receive the recommended care anywhere, in any hospital. The components of the discharge summary include:
- The header: Contains information such as the patient’s name and age, medical record number, date of admission and discharge with time, the treating doctor’s name, the referred doctor’s name if any, and the In-Patient number.
- The body: Contains information on the diagnosis, chief complaints, vitals, past medical history, family medical history, treatment pursued, medications given, and lab investigations performed.
- The footer: Provides advice on discharge and follow-up, and medications prescribed during recovery if any.
The discharge summary is a non-negotiable requisite to a healthcare claim as it validates the appropriateness of the hospital admission & treatment provided and gives insight into any additional documentation that may have been missed, thus aiding in scrutinising the claim’s payability.
What does a discharge summary look like?
Addressing Challenges:
Failure to submit a detailed discharge summary within the stipulated timeframe results in a claim rejection.
Conclusion:
A detailed discharge summary is the most basic claim documentation requirement vital in deciding the admissibility of the claim. The discharge summary is concrete proof of hospitalisation containing complete information including the care to be taken after discharge.
By providing a detailed discharge summary you can help expedite the claim settlement process and ensure a favourable outcome.
