case_no stringlengths 20 29 | status stringclasses 4
values | lastupdateuser stringclasses 5
values | statusdate stringdate 2019-09-18 00:00:00 2023-11-07 00:00:00 | employee_no stringlengths 8 27 | card_no stringlengths 9 9 | patient_name stringlengths 6 34 | age int64 0 109 | gender stringclasses 2
values | pat_state stringclasses 1
value | contact_no int64 5.33B 10B | c_pat_state stringclasses 2
values | c_district_name stringclasses 12
values | c_mandal_name stringclasses 33
values | c_village_name float64 | patient_ipop stringclasses 1
value | hosp_disp_code stringclasses 144
values | hosp_type stringclasses 2
values | hosp_name stringclasses 144
values | hosp_state stringclasses 6
values | hospdist stringclasses 19
values | reg_hosp_date stringdate 2019-03-06 00:00:00 2020-01-30 00:00:00 | case_regn_date stringdate 2019-03-09 00:00:00 2020-01-30 00:00:00 | reg_biom stringclasses 2
values | procedure_disp_id stringclasses 459
values | dis_main_name stringclasses 23
values | proc_type stringclasses 2
values | procedure_name stringclasses 440
values | auto_approve stringclasses 1
value | cs_adm_dt stringdate 2019-03-06 00:00:00 2020-01-30 00:00:00 | cs_preauth_dt stringdate 2019-03-09 00:00:00 2020-01-30 00:00:00 | preauth_raised_amt int64 171 165k | preauth_aprv_dt stringdate 2019-03-09 00:00:00 2020-01-30 00:00:00 | preauth_pending_remarks stringclasses 360
values | preauth_pending_dt stringclasses 191
values | preauth_pendingupd_remarks stringclasses 290
values | preauth_pendingupd_dt stringclasses 180
values | preauth_apprvd_amt int64 171 250k | approved_remarks stringclasses 108
values | preauth_cancel_dt float64 | preauth_rej_dt float64 | rejected_remarks stringclasses 3
values | cs_surg_dt stringdate 2019-03-06 00:00:00 2020-01-30 00:00:00 | enh_count int64 0 25 | enh_appv_amt float64 840 38.5k ⌀ | dis_biom stringclasses 3
values | cs_dis_dt stringdate 2019-03-11 00:00:00 2020-01-30 00:00:00 ⌀ | cs_death_dt stringclasses 65
values | clm_sub_dt stringdate 2019-06-18 00:00:00 2020-06-15 00:00:00 | actual_clm_sub_dt stringdate 2019-03-11 00:00:00 2020-01-30 00:00:00 | claiminitamt int64 171 250k | claim_pending_remarks stringlengths 22 431 ⌀ | claim_pending_dt stringclasses 204
values | claim_pendingupd_remarks stringlengths 5 781 ⌀ | claim_pendingupd_dt stringclasses 137
values | cpd_aprvd_amt int64 171 165k | claim_apr_dt stringdate 2019-09-02 00:00:00 2020-06-19 00:00:00 | claim_approvd_remarks stringclasses 114
values | reject_date stringclasses 1
value | claim_rej_remarks stringclasses 46
values | shaapvdate stringclasses 4
values | acoapvamt float64 83 20.8k ⌀ | paid_date stringdate 2019-08-29 00:00:00 2020-06-25 00:00:00 | insliableamt int64 171 250k | trustliableamt int64 0 0 | patientliableamt int64 0 0 | rf_amount float64 0 0 ⌀ | tds_amount float64 40 16.2k ⌀ | hosp_amount int64 171 165k | errinitamt float64 1 46.5k ⌀ | errinitdate stringclasses 111
values | errpaiddate stringclasses 16
values | errutr stringclasses 24
values | cpdpendcnt float64 1 7 ⌀ | cpdprocctime float64 31 54.4k ⌀ | revoked stringclasses 2
values | revokeddate stringclasses 23
values | revokedremarks stringclasses 9
values | actualregdate stringlengths 7 16 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
CASE/HS17002017/S127424 | Claim Amount Paid by Bank(Insurance) | Vonga Saradhi SHA_INS | 2019-09-18 | 17S170200401640000016400016 | PLF536IK3 | MINGSE SANGMA | 56 | Female | MEGHALAYA | 8,787,522,696 | MEGHALAYA | EAST GARO HILLS | null | null | IP | HS17002017 | Public | WILLIAMNAGAR CIVIL HOSPITAL | MEGHALAYA | EAST GARO HILLS | 2019-08-13 | 2019-08-14 | N | M123146 | General Medicine | M | VIRAL FEVER | Y | 2019-08-13 | 2019-08-14 | 11,855 | 2019-08-14 | null | null | null | null | 11,855 | Procedure Auto Approved | null | null | null | 2019-08-13 | 0 | null | NB | 2019-08-21 | null | 2019-08-24 | 2019-08-24 | 11,855 | null | null | null | null | 11,855 | 2019-09-04 | Approved.Case has been considered for settlement basis the merit of the details and documents submitted by hospital. The insurance company and/or SHA reserve the right to audit claims and if found discrepant may reclaim the settled | null | null | null | null | 2019-09-09 | 11,855 | 0 | 0 | 0 | null | 11,855 | null | null | null | null | null | null | No | null | null | 2019-08-14 15:05 |
CASE/HS17001032/S134506 | Claim Amount Paid by Bank(Insurance) | Vonga Saradhi SHA_INS | 2019-09-18 | 17S170100201270000013400078 | PSZ310816 | MARCHINA N SANGMA | 26 | Female | MEGHALAYA | 8,732,001,042 | MEGHALAYA | WEST GARO HILLS | RONGRAM | null | IP | HS17001032 | Public | ASANANGRE PHC | MEGHALAYA | WEST GARO HILLS | 2019-08-17 | 2019-08-19 | N | M1123062 | PHC or CHC medical | M | ANAEMIA WITH FEVER | Y | 2019-08-17 | 2019-08-19 | 10,630 | 2019-08-19 | null | null | null | null | 10,629 | Procedure Auto Approved | null | null | null | 2019-08-17 | 0 | null | NB | 2019-08-22 | null | 2019-08-23 | 2019-08-23 | 10,629 | null | null | null | null | 10,629 | 2019-09-04 | Approved,Case has been considered for settlement basis the merit of the details and documents submitted by hospital. The insurance company and/or SHA reserve the right to audit claims and if found discrepant may reclaim the settled cases. | null | null | null | null | 2019-09-09 | 10,630 | 0 | 0 | 0 | null | 10,629 | null | null | null | null | null | null | No | null | null | 2019-08-19 13:45 |
CASE/HS17001039/S125514 | Claim Amount Paid by Bank(Insurance) | Vonga Saradhi SHA_INS | 2020-09-02 | 17S170100103090000042800018 | PJQ8M95ET | ROLLINA SANGMA | 45 | Female | MEGHALAYA | 7,894,561,206 | MEGHALAYA | SOUTH WEST GARO HILLS | null | null | IP | HS17001039 | Public | TURA CIVIL HOSPITAL | MEGHALAYA | WEST GARO HILLS | 2019-08-13 | 2019-08-13 | N | M800006 | Mental Disorders | M | BEHAVIOURAL SYNDROMES ASSOCIATED WITH PHYSIOLOGICAL DISTURBANCES AND PHYSICAL FACTORS per day | Y | 2019-08-13 | 2019-08-13 | 1,500 | 2019-08-13 | null | null | null | null | 1,500 | Procedure Auto Approved | null | null | null | 2019-08-13 | 0 | null | NB | 2019-08-22 | null | 2020-01-27 | 2019-10-12 | 1,500 | Kindly provide the reason for Claim initaition 15days post discharge. | 2019-10-25 | Sir/Madam there was a delay in transaction/claim initiation after the patient discharge from the hospital due to network connectivity issue. We apologize for the delay. The patient has availed the benefits of the scheme for which we have incurred some expenses. So we request you to kindly consider the case and honor th... | 2020-01-27 | 1,500 | 2020-01-29 | Approved. Case has been considered for settlement basis the merit of the details and documents submitted by hospital. The insurance company and/or SHA reserve the right to audit claims and if found discrepant may reclaim the settled cases. | null | null | null | null | 2020-02-10 | 1,500 | 0 | 0 | 0 | null | 1,500 | null | null | null | null | 1 | 3,404 | No | null | null | 2019-08-13 14:53 |
CASE/HS17001039/F147142 | Claim Amount Paid by Bank(Insurance) | Vonga Saradhi SHA_INS | 2020-09-02 | 17F17010427115003420 | PTBFVPNGP | JOHNSON CH MARAK | 72 | Male | MEGHALAYA | 7,629,808,797 | MEGHALAYA | WEST GARO HILLS | null | null | IP | HS17001039 | Public | TURA CIVIL HOSPITAL | MEGHALAYA | WEST GARO HILLS | 2019-08-26 | 2019-08-26 | N | M123104 | General Medicine | M | INSULINDEPENDENT DIABETES MELLITUS | Y | 2019-08-26 | 2019-08-26 | 9,635 | 2019-08-26 | null | null | null | null | 9,635 | Procedure Auto Approved | null | null | null | 2019-08-26 | 0 | null | NB | 2019-09-06 | null | 2020-01-27 | 2019-10-11 | 9,635 | Kindly, provide the clinical notes for all days of LOS for further processing of claims. | 2019-10-23 | As per the query the case sheet till date with LOS date mentioned has been uploaded as case sheet attachments. | 2020-01-27 | 9,635 | 2020-01-29 | Approved. Case has been considered for settlement basis the merit of the details and documents submitted by hospital. The insurance company and/or SHA reserve the right to audit claims and if found discrepant may reclaim the settled cases. | null | null | null | null | 2020-02-10 | 9,635 | 0 | 0 | 0 | null | 9,635 | null | null | null | null | 1 | 3,374 | No | null | null | 2019-08-26 16:48 |
CASE/HS17006071/R107896 | Claim Amount Paid by Bank(Insurance) | Vonga Saradhi SHA_INS | 2020-09-02 | 17R17050253015000609 | PJB8N9QM7 | FLORA MUJAI | 58 | Female | MEGHALAYA | 9,999,999,999 | MEGHALAYA | RI BHOI | null | null | IP | HS17006071 | Public | NORTH EASTERN INDIRA GANDHI REGIONAL INSTITUTE OF HEALTH AND MEDICAL SCIENCES | MEGHALAYA | EAST KHASI HILLS | 2019-07-30 | 2019-08-02 | N | M100054 | General Medicine | M | CEREBROVASCULAR ACCIDENT | Y | 2019-07-30 | 2019-08-02 | 1,320 | 2019-08-02 | Kindly provide supporting diagnostic reports for further processing of the claim. | 2019-08-02 | null | 2019-08-02 | 7,920 | Procedure Auto Approved,Approved. Kindly, provide all the investigations reports done during admission along with post op mandatory reports at the time of patient discharge. | null | null | null | 2019-07-30 | 1 | 6,600 | NB | 2019-09-08 | null | 2020-01-31 | 2019-10-11 | 7,920 | Kindly, specify the reason for claim initiating after 15 days of the discharge of the patient for further processing of claims. | 2019-10-23 | Dear sir case was delayed cause IP file was unavailable in time | 2020-01-31 | 7,920 | 2020-02-03 | Approved. Case has been considered for settlement basis the merit of the details and documents submitted by hospital. The insurance company and/or SHA reserve the right to audit claims and if found discrepant may reclaim the settled cases. | null | null | null | null | 2020-02-14 | 7,920 | 0 | 0 | 0 | null | 7,920 | null | null | null | null | 1 | 4,529 | No | null | null | 2019-08-01 15:05 |
CASE/HS17006076/R301021 | Erroneous Claim Rejected by CPD(Insurance) | Vonga Saradhi SHA_INS | 2020-08-22 | 17R17060313115000124 | PZXLUQUV4 | SHARAIMAPHIIAKI KHARUMNUID | 19 | Female | MEGHALAYA | 8,132,852,391 | MEGHALAYA | EAST KHASI HILLS | null | null | IP | HS17006076 | Private | BETHANY HOSPITAL | MEGHALAYA | EAST KHASI HILLS | 2020-01-16 | 2020-01-18 | N | S400034 | Obstetrics & Gynaecology | S | CAESARIAN DELIVERY | null | 2020-01-16 | 2020-01-18 | 20,180 | 2020-01-18 | null | null | null | null | 20,180 | Approved. Kindly, provide all the investigations reports done during admission along with post op mandatory reports at the time of patient discharge. | null | null | null | 2020-01-16 | 0 | null | NB | 2020-01-18 | null | 2020-01-18 | 2020-01-18 | 20,180 | null | null | null | null | 15,135 | 2020-01-22 | Approved. Case has been considered for settlement basis the merit of the details and documents submitted by hospital. The insurance company and/or SHA reserve the right to audit claims and if found discrepant may reclaim the settled cases. | null | null | null | null | 2020-01-30 | 20,180 | 0 | 0 | null | 1,514 | 13,621 | 5,045 | 2020-08-08 | null | null | null | 5,063 | No | null | null | 2020-01-17 17:38 |
CASE/HS17005008/F300308 | Claim Amount Paid by Bank(Insurance) | Vonga Saradhi SHA_INS | 2020-07-30 | 17F17050236515001171 | P3ZDUJQ86 | KARMEL SYIEMLIEH | 43 | Female | MEGHALAYA | 9,999,999,999 | MEGHALAYA | RI BHOI | null | null | IP | HS17005008 | Public | UMSNING CHC | MEGHALAYA | RI BHOI | 2020-01-14 | 2020-01-16 | N | M1123079 | PHC or CHC medical | M | GENERAL WARD UNSPECIFIED | Y | 2020-01-14 | 2020-01-16 | 924 | 2020-01-16 | null | null | null | null | 2,772 | Procedure Auto Approved,Approved. Kindly, provide all the investigations reports done during admission along with post op mandatory reports at the time of patient discharge. | null | null | null | 2020-01-14 | 1 | 1,848 | NB | 2020-01-16 | null | 2020-01-18 | 2020-01-18 | 2,772 | null | null | null | null | 2,772 | 2020-01-22 | approved. Case has been considered for settlement basis the merit of the details and documents submitted by hospital. The insurance company and/or SHA reserve the right to audit claims and if found discrepant may reclaim the settled cases. | null | null | null | null | 2020-01-30 | 2,772 | 0 | 0 | 0 | null | 2,772 | null | null | null | null | null | 6,327 | No | null | null | 2020-01-15 13:41 |
CASE/HS17007032/F299346 | Erroneous Claim Rejected by CPD(Insurance) | Vonga Saradhi SHA_INS | 2021-02-18 | 17F17080303415004252 | PSOXINAV4 | EKLEST RYMBAI | 40 | Female | MEGHALAYA | 8,794,827,941 | MEGHALAYA | EAST JAINTIA HILLS | null | null | IP | HS17007032 | Public | CIVIL HOSPITAL KHLIEHRIAT | MEGHALAYA | EAST JAINTIA HILLS | 2020-01-13 | 2020-01-14 | N | M1123079 | PHC or CHC medical | M | GENERAL WARD UNSPECIFIED | Y | 2020-01-13 | 2020-01-14 | 1,050 | 2020-01-14 | null | null | null | null | 6,300 | Procedure Auto Approved,Approved. Kindly, provide all the investigations reports done during admission along with post op mandatory reports at the time of patient discharge. | null | null | null | 2020-01-13 | 1 | 5,250 | NB | 2020-01-17 | null | 2020-01-22 | 2020-01-18 | 6,300 | Kindly, provide detailed delivery notes . | 2020-01-22 | Apologize for this case because this case is not a delivery case its a General ward case | 2020-01-22 | 4,200 | 2020-01-23 | Approved. Case has been considered for settlement basis the merit of the details and documents submitted by hospital. The insurance company and/or SHA reserve the right to audit claims and if found discrepant may reclaim the settled cases. | null | null | null | null | 2020-02-05 | 6,300 | 0 | 0 | 0 | null | 4,200 | 2,100 | 2021-02-09 | null | null | 1 | 7,058 | No | null | null | 2020-01-13 13:23 |
CASE/HS17009005/R300519 | Erroneous Claim Rejected by CPD(Insurance) | Vonga Saradhi SHA_INS | 2020-08-04 | 17R17090150315000527 | PS8B9BUDA | SKULIN MARAK | 37 | Female | MEGHALAYA | 7,005,101,475 | MEGHALAYA | NORTH GARO HILLS | null | null | IP | HS17009005 | Public | DAINADUBI PHC | MEGHALAYA | NORTH GARO HILLS | 2019-10-25 | 2020-01-16 | N | M1123079 | PHC or CHC medical | M | GENERAL WARD UNSPECIFIED | Y | 2019-10-25 | 2020-01-16 | 1,050 | 2020-01-16 | null | null | null | null | 4,200 | Procedure Auto Approved,Approved. Kindly, provide all the investigations reports done during admission along with post op mandatory reports at the time of patient discharge. | null | null | null | 2019-10-25 | 1 | 3,150 | NB | 2019-10-28 | null | 2020-01-22 | 2020-01-17 | 4,200 | Kindly specify the reason for preauth Delay for more than 5 days and claim delay for more than 15days. | 2020-01-21 | the preauth and claim initiation is delayed due to some technical issues | 2020-01-22 | 3,300 | 2020-01-25 | Approved as per actual LOS. Case has been considered for settlement basis the merit of the details and documents submitted by hospital. The insurance company and/or SHA reserve the right to audit claims and if found discrepant may reclaim the settled cases. | null | null | null | null | 2020-02-05 | 4,200 | 0 | 0 | 0 | null | 3,300 | 1 | 2020-07-31 | null | null | 1 | 8,037 | No | null | null | 2019-10-27 18:14 |
CASE/HS17007010/R299925 | Erroneous Claim Rejected by CPD(Insurance) | Vonga Saradhi SHA_INS | 2021-04-19 | 17R17080301315000462 | P4G73DLAB | KYRSHAN RYMBAI | 29 | Female | MEGHALAYA | 7,085,719,168 | MEGHALAYA | EAST JAINTIA HILLS | null | null | IP | HS17007010 | Public | JOWAI CIVIL HOSPITAL | MEGHALAYA | WEST JAINTIA HILLS | 2020-01-13 | 2020-01-15 | N | M123101 | General Medicine | M | GENERAL WARD UNSPECIFIED | Y | 2020-01-13 | 2020-01-15 | 4,800 | 2020-01-15 | null | null | null | null | 10,800 | Procedure Auto Approved,Approved. Kindly, provide all the investigations reports done during admission along with post op mandatory reports at the time of patient discharge. | null | null | null | 2020-01-13 | 1 | 6,000 | NB | 2020-01-16 | null | 2020-01-17 | 2020-01-17 | 10,800 | null | null | null | null | 3,600 | 2020-01-21 | approved. Case has been considered for settlement basis the merit of the details and documents submitted by hospital. The insurance company and/or SHA reserve the right to audit claims and if found discrepant may reclaim the settled cases. | null | null | null | null | 2020-01-29 | 10,800 | 0 | 0 | 0 | null | 3,600 | 7,200 | 2021-04-08 | null | null | null | 6,100 | No | null | null | 2020-01-15 13:36 |
CASE/HS17006034/N293672 | Claim Amount Paid by Bank(Insurance) | Vonga Saradhi SHA_INS | 2020-07-30 | 17N17110509115000010 | P5UJLSEW2 | KYRMEN MYRTHONG | 31 | Female | MEGHALAYA | 9,615,680,599 | MEGHALAYA | SOUTH WEST KHASI HILLS | null | null | IP | HS17006034 | Private | NAZARETH HOSPITAL | MEGHALAYA | EAST KHASI HILLS | 2019-12-27 | 2019-12-28 | N | M123101 | General Medicine | M | GENERAL WARD UNSPECIFIED | Y | 2019-12-27 | 2019-12-28 | 3,025 | 2019-12-28 | null | null | null | null | 38,962 | Procedure Auto Approved,Approved. Kindly, provide all the investigations reports done during admission along with all the mandatory reports at the time of patient discharge. | null | null | null | 2019-12-27 | 7 | 4,356 | NB | 2020-01-10 | null | 2020-01-18 | 2020-01-10 | 38,962 | Kindly, provide NICU in and NICU out transfer notes and with dates mentioned and treatment details for all the admissible LOS for further processing of claims. | 2020-01-16 | null | 2020-01-18 | 32,912 | 2020-01-21 | Approved as per actual LOS. Case has been considered for settlement basis the merit of the details and documents submitted by hospital. The insurance company and/or SHA reserve the right to audit claims and if found discrepant may reclaim the settled cases. | null | null | null | null | 2020-01-30 | 38,962 | 0 | 0 | null | 3,291 | 29,621 | null | null | null | null | 2 | 11,867 | No | null | null | 2019-12-28 02:48 |
CASE/HS17002008/R294085 | Erroneous Claim Rejected by CPD(Insurance) | Vonga Saradhi SHA_INS | 2020-08-09 | 17R17090408515000544 | PHUBMI2ZM | PRAIMIA N MARAK | 18 | Female | MEGHALAYA | 7,638,831,487 | MEGHALAYA | NORTH GARO HILLS | KHARKUTTA | null | IP | HS17002008 | Public | WAGEASI PHC | MEGHALAYA | NORTH GARO HILLS | 2019-12-25 | 2019-12-29 | N | S423126 | Obstetrics & Gynaecology | S | NORMAL DELIVERY WITH EPISIOTOMY AND P REPAIR | Y | 2019-12-25 | 2019-12-29 | 7,000 | 2019-12-29 | null | null | null | null | 7,000 | Procedure Auto Approved | null | null | null | 2019-12-25 | 0 | null | NB | 2019-12-30 | null | 2020-01-05 | 2020-01-05 | 7,000 | null | null | null | null | 6,300 | 2020-01-07 | Approved. Case has been considered for settlement basis the merit of the details and documents submitted by hospital. The insurance company and/or SHA reserve the right to audit claims and if found discrepant may reclaim the settled cases. | null | null | null | null | 2020-01-17 | 7,000 | 0 | 0 | 0 | null | 6,300 | 700 | 2020-08-03 | null | null | null | 2,253 | No | null | null | 2019-12-29 20:07 |
CASE/HS17006034/F293015 | Claim Amount Paid by Bank(Insurance) | Vonga Saradhi SHA_INS | 2020-07-30 | 17F17060224017000346 | PCARI7F76 | SUPARNA KURI | 29 | Female | MEGHALAYA | 8,415,886,139 | MEGHALAYA | EAST KHASI HILLS | null | null | IP | HS17006034 | Private | NAZARETH HOSPITAL | MEGHALAYA | EAST KHASI HILLS | 2019-12-24 | 2019-12-25 | N | S400034 | Obstetrics & Gynaecology | S | CAESARIAN DELIVERY | null | 2019-12-24 | 2019-12-25 | 24,418 | 2019-12-25 | null | null | null | null | 24,418 | Approved. Kindly, provide all the investigations reports done during admission along with post op mandatory reports at the time of patient discharge. | null | null | null | 2019-12-24 | 0 | null | NB | 2019-12-31 | null | 2019-12-31 | 2019-12-31 | 24,418 | null | null | null | null | 18,314 | 2020-01-03 | Approved. Case has been considered for settlement basis the merit of the details and documents submitted by hospital. The insurance company and/or SHA reserve the right to audit claims and if found discrepant may reclaim the settled cases. | null | null | null | null | 2020-01-13 | 24,418 | 0 | 0 | null | 1,831 | 16,483 | null | null | null | null | null | 3,827 | No | null | null | 2019-12-25 17:22 |
CASE/HS17009004/S293118 | Erroneous Claim Rejected by CPD(Insurance) | Vonga Saradhi SHA_INS | 2020-08-09 | 17S170200102530000025500051 | P350OZW89 | HEMALISH MOMIN | 45 | Female | MEGHALAYA | 9,862,412,532 | MEGHALAYA | NORTH GARO HILLS | null | null | IP | HS17009004 | Public | RESUBELPARA CHC | MEGHALAYA | NORTH GARO HILLS | 2019-12-25 | 2019-12-26 | N | M1123079 | PHC or CHC medical | M | GENERAL WARD UNSPECIFIED | Y | 2019-12-25 | 2019-12-26 | 840 | 2019-12-26 | null | null | null | null | 5,040 | Procedure Auto Approved,Approved. Kindly, provide all the investigations reports done during admission along with post op mandatory reports at the time of patient discharge. | null | null | null | 2019-12-25 | 2 | 2,520 | NB | 2019-12-30 | null | 2019-12-30 | 2019-12-30 | 5,040 | null | null | null | null | 5,000 | 2020-01-01 | Approved. Case has been considered for settlement basis the merit of the details and documents submitted by hospital. The insurance company and/or SHA reserve the right to audit claims and if found discrepant may reclaim the settled cases. | null | null | null | null | 2020-01-10 | 5,040 | 0 | 0 | 0 | null | 5,000 | 1 | 2020-08-03 | null | null | null | 2,022 | No | null | null | 2019-12-26 12:51 |
CASE/HS17006048/R293976 | Claim Amount Paid by Bank(Insurance) | Vonga Saradhi SHA_INS | 2020-07-30 | 17R17060137315001024 | PR4MAFL6N | ARPI THABAH | 39 | Female | MEGHALAYA | 9,383,305,109 | MEGHALAYA | EAST KHASI HILLS | MAWPHLANG | null | IP | HS17006048 | Public | MAWPHLANG CHC | MEGHALAYA | EAST KHASI HILLS | 2019-12-26 | 2019-12-28 | N | M1123012 | PHC or CHC medical | M | UTI | Y | 2019-12-26 | 2019-12-28 | 840 | 2019-12-28 | null | null | null | null | 4,200 | Procedure Auto Approved,Approved. Kindly, provide all the investigations reports done during admission along with post op mandatory reports at the time of patient discharge. | null | null | null | 2019-12-26 | 1 | 3,360 | NB | 2019-12-30 | null | 2019-12-30 | 2019-12-30 | 4,200 | null | null | null | null | 4,000 | 2020-01-01 | Approved. Case has been considered for settlement basis the merit of the details and documents submitted by hospital. The insurance company and/or SHA reserve the right to audit claims and if found discrepant may reclaim the settled cases. | null | null | null | null | 2020-01-10 | 4,200 | 0 | 0 | 0 | null | 4,000 | null | null | null | null | null | 1,904 | No | null | null | 2019-12-28 11:31 |
CASE/HS17006076/F292112 | Erroneous Claim Rejected by CPD(Insurance) | Vonga Saradhi SHA_INS | 2021-01-12 | 17F33404 | PQEVOAR8N | IVANSARAH JYRWA | 64 | Female | MEGHALAYA | 8,257,079,373 | MEGHALAYA | EAST KHASI HILLS | null | null | IP | HS17006076 | Private | BETHANY HOSPITAL | MEGHALAYA | EAST KHASI HILLS | 2019-12-21 | 2019-12-21 | N | M123101 | General Medicine | M | GENERAL WARD UNSPECIFIED | Y | 2019-12-21 | 2019-12-21 | 1,200 | 2019-12-21 | null | null | null | null | 7,200 | Procedure Auto Approved,Approved. Kindly, provide all the investigations reports done during admission along with post op mandatory reports at the time of patient discharge. | null | null | null | 2019-12-21 | 1 | 6,000 | NB | 2019-12-23 | null | 2019-12-23 | 2019-12-23 | 7,200 | null | null | null | null | 2,400 | 2019-12-26 | The claim has been settled for actual admissible LOS. Case has been considered for settlement basis the merit of the details and documents submitted by hospital. The insurance company and/or SHA reserve the right to audit claims and if found discrepant may reclaim the settled cases. | null | null | null | null | 2019-12-27 | 7,200 | 0 | 0 | null | 240 | 2,160 | 4,800 | 2020-12-30 | null | null | null | 3,212 | No | null | null | 2019-12-21 13:05 |
CASE/HS17001038/S292035 | Erroneous Claim Rejected by CPD(Insurance) | Vonga Saradhi SHA_INS | 2020-08-27 | 17S170100100620000018200021 | PIDB5LNIW | RENJI SANGMA | 34 | Female | MEGHALAYA | 9,612,270,753 | MEGHALAYA | WEST GARO HILLS | null | null | IP | HS17001038 | Public | MCH HOSPITAL | MEGHALAYA | WEST GARO HILLS | 2019-12-08 | 2019-12-21 | N | S423098 | Obstetrics & Gynaecology | S | HYSTERECTOMY ABDOMINAL | Y | 2019-12-08 | 2019-12-21 | 22,400 | 2019-12-21 | null | null | null | null | 22,400 | Procedure Auto Approved | null | null | null | 2019-12-08 | 0 | null | NB | 2019-12-14 | null | 2020-01-27 | 2019-12-21 | 22,400 | Please provide the USG report for to support the blocked package. | 2019-12-25 | Since it was already ruptured , foital parts were already palpable. Hence, USG NVD was not needed. | 2020-01-27 | 16,800 | 2020-01-30 | Approved. Case has been considered for settlement basis the merit of the details and documents submitted by hospital. The insurance company and/or SHA reserve the right to audit claims and if found discrepant may reclaim the settled cases. | null | null | null | null | 2020-02-10 | 22,400 | 0 | 0 | 0 | null | 16,800 | 5,600 | 2020-08-05 | null | null | 1 | 9,227 | No | null | null | 2019-12-09 14:30 |
CASE/HS17001038/R292118 | Erroneous Claim Rejected by CPD(Insurance) | Vonga Saradhi SHA_INS | 2020-08-27 | 17R17010144815000246 | PGFSX2E6F | SARABINA A SANGMA | 28 | Female | MEGHALAYA | 8,974,973,625 | MEGHALAYA | WEST GARO HILLS | null | null | IP | HS17001038 | Public | MCH HOSPITAL | MEGHALAYA | WEST GARO HILLS | 2019-12-02 | 2019-12-21 | N | S400001 | Obstetrics & Gynaecology | S | HYSTERECTOMY SALPINGOOOPHORECTOMY | null | 2019-12-02 | 2019-12-21 | 33,500 | 2019-12-21 | Kindly provide diagnostic report supporting procedure performed for further processing of the claim. | 2019-12-21 | null | 2019-12-21 | 33,500 | Approved. Kindly, provide all the investigations reports done during admission along with post op mandatory reports at the time of patient discharge. | null | null | null | 2019-12-08 | 0 | null | NB | 2019-12-14 | null | 2019-12-21 | 2019-12-21 | 33,500 | null | null | null | null | 25,125 | 2019-12-25 | Approved. Case has been considered for settlement basis the merit of the details and documents submitted by hospital. The insurance company and/or SHA reserve the right to audit claims and if found discrepant may reclaim the settled case | null | null | null | null | 2020-01-03 | 33,500 | 0 | 0 | 0 | null | 25,125 | 8,375 | 2020-08-05 | null | null | null | 5,130 | No | null | null | 2019-12-04 13:38 |
CASE/HS17006034/R291568 | Claim Amount Paid by Bank(Insurance) | Vonga Saradhi SHA_INS | 2020-07-30 | 17R17060311115006691 | P1FNEWBSD | SENTIMON LYNGDOH PYNGROPE | 42 | Female | MEGHALAYA | 9,612,148,861 | MEGHALAYA | EAST KHASI HILLS | null | null | IP | HS17006034 | Private | NAZARETH HOSPITAL | MEGHALAYA | EAST KHASI HILLS | 2019-12-20 | 2019-12-20 | N | S423110 | Obstetrics & Gynaecology | S | NORMAL DELIVERY | Y | 2019-12-20 | 2019-12-20 | 10,890 | 2019-12-20 | null | null | null | null | 10,890 | Procedure Auto Approved | null | null | null | 2019-12-20 | 0 | null | NB | 2019-12-21 | null | 2019-12-21 | 2019-12-21 | 10,890 | null | null | null | null | 8,168 | 2019-12-24 | Approved. Case has been considered for settlement basis the merit of the details and documents submitted by hospital. The insurance company and/or SHA reserve the right to audit claims and if found discrepant may reclaim the settled cases | null | null | null | null | 2019-12-26 | 10,890 | 0 | 0 | null | 817 | 7,351 | null | null | null | null | null | 4,109 | No | null | null | 2019-12-20 12:13 |
CASE/HS17006060/R291448 | Erroneous Claim Initiated by Medco(Insurance) | Vonga Saradhi SHA_INS | 2023-02-17 | 17R17050234815002285 | PFQYOYFSN | BANRIHUN KYRSIAN | 32 | Female | MEGHALAYA | 9,366,257,567 | MEGHALAYA | RI BHOI | null | null | IP | HS17006060 | Public | GANESH DAS HOSPITAL | MEGHALAYA | EAST KHASI HILLS | 2019-12-18 | 2019-12-19 | N | M123101 | General Medicine | M | GENERAL WARD UNSPECIFIED | Y | 2019-12-18 | 2019-12-19 | 1,200 | 2019-12-19 | null | null | null | null | 4,800 | Procedure Auto Approved,Approved. Kindly, provide all the investigations reports done during admission along with post op mandatory reports at the time of patient discharge. | null | null | null | 2019-12-18 | 1 | 3,600 | NB | 2019-12-20 | null | 2019-12-20 | 2019-12-20 | 4,800 | null | null | null | null | 2,400 | 2019-12-24 | Approved. Case has been considered for settlement basis the merit of the details and documents submitted by hospital. The insurance company and/or SHA reserve the right to audit claims and if found discrepant may reclaim the settled cases. | null | null | null | null | 2019-12-24 | 4,800 | 0 | 0 | 0 | null | 2,400 | 2,400 | 2023-02-17 | null | null | null | 4,788 | No | null | null | 2019-12-19 16:18 |
CASE/HS17002010/R278265 | Erroneous Claim Rejected by CPD(Insurance) | Vonga Saradhi SHA_INS | 2020-10-30 | 17R17020326515000179 | P1PLYGH82 | MANILA M SANGMA | 22 | Female | MEGHALAYA | 8,414,956,230 | MEGHALAYA | EAST GARO HILLS | null | null | IP | HS17002010 | Public | SAMANADA PHC | MEGHALAYA | EAST GARO HILLS | 2019-11-14 | 2019-11-15 | N | S423110 | Obstetrics & Gynaecology | S | NORMAL DELIVERY | Y | 2019-11-14 | 2019-11-15 | 6,300 | 2019-11-15 | null | null | null | null | 6,300 | Procedure Auto Approved | null | null | null | 2019-11-14 | 0 | null | NB | 2019-11-17 | null | 2019-12-22 | 2019-11-22 | 6,300 | As per verification,the claimed beneficiary is a case of Labour pain,which was a LAMA case,Left against medical advice.And no procedure note or delivery note is available.Kindly justify the delivery performed or not as per the blocked package. | 2019-12-16 | null | 2019-12-22 | 4,725 | 2020-02-03 | Approved. Case has been considered for settlement basis the merit of the details and documents submitted by hospital. The insurance company and/or SHA reserve the right to audit claims and if found discrepant may reclaim the settled cases. | null | Hospital has blocked normal delivary packge for False labour pain, mismatch of package, hence, case denied. | null | null | 2019-12-18 | 6,300 | 0 | 0 | 0 | null | 4,725 | 1,575 | 2020-08-07 | null | null | 2 | 35,533 | Yes | 2020-01-31 | null | 2019-11-15 17:50 |
CASE/HS17006034/R280549 | Claim Amount Paid by Bank(Insurance) | Vonga Saradhi SHA_INS | 2020-07-30 | 17R17060409415000406 | PMG6K29DD | AILIN MUKHIM | 38 | Female | MEGHALAYA | 9,383,053,425 | MEGHALAYA | EAST KHASI HILLS | null | null | IP | HS17006034 | Private | NAZARETH HOSPITAL | MEGHALAYA | EAST KHASI HILLS | 2019-11-20 | 2019-11-20 | N | S400017 | Obstetrics & Gynaecology | S | DILATION AND EVACUATION (DE) | Y | 2019-11-20 | 2019-11-20 | 6,050 | 2019-11-20 | null | null | null | null | 6,050 | Procedure Auto Approved | null | null | null | 2019-11-20 | 0 | null | NB | 2019-11-21 | null | 2019-11-21 | 2019-11-21 | 6,050 | null | null | null | null | 4,538 | 2019-12-04 | Approved. Case has been considered for settlement basis the merit of the details and documents submitted by hospital. The insurance company and/or SHA reserve the right to audit claims and if found discrepant may reclaim the settled cases. | null | null | null | null | 2019-12-05 | 6,050 | 0 | 0 | null | 454 | 4,084 | null | null | null | null | null | 18,436 | No | null | null | 2019-11-20 20:37 |
CASE/HS17001039/F253836 | Claim Amount Paid by Bank(Insurance) | Vonga Saradhi SHA_INS | 2020-07-30 | 17F48957 | PR0V1VCW6 | CLEVER I SANGMA | 58 | Male | MEGHALAYA | 8,787,300,072 | MEGHALAYA | WEST GARO HILLS | null | null | IP | HS17001039 | Public | TURA CIVIL HOSPITAL | MEGHALAYA | WEST GARO HILLS | 2019-10-26 | 2019-10-28 | N | S100024 | General Surgery | S | INCISION AND DRAINAGE OF LARGE ABSCESS | Y | 2019-10-26 | 2019-10-28 | 4,440 | 2019-10-28 | null | null | null | null | 4,440 | Procedure Auto Approved | null | null | null | 2019-10-26 | 0 | null | NB | 2019-11-09 | null | 2019-11-21 | 2019-11-21 | 4,440 | null | null | null | null | 3,330 | 2019-12-04 | Approved. Case has been considered for settlement basis the merit of the details and documents submitted by hospital. The insurance company and/or SHA reserve the right to audit claims and if found discrepant may reclaim the settled cases. | null | null | null | null | 2019-12-03 | 4,440 | 0 | 0 | 0 | null | 3,330 | null | null | null | null | null | 18,696 | No | null | null | 2019-10-28 16:27 |
CASE/HS17006034/F276812 | Claim Amount Paid by Bank(Insurance) | Vonga Saradhi SHA_INS | 2020-07-30 | 17F17060822815001593 | PHCRHEMN6 | SANDA MERY MARBANGIANG | 27 | Female | MEGHALAYA | 8,729,887,165 | MEGHALAYA | EAST KHASI HILLS | null | null | IP | HS17006034 | Private | NAZARETH HOSPITAL | MEGHALAYA | EAST KHASI HILLS | 2019-11-11 | 2019-11-13 | N | S423126 | Obstetrics & Gynaecology | S | NORMAL DELIVERY WITH EPISIOTOMY AND P REPAIR | Y | 2019-11-11 | 2019-11-13 | 12,100 | 2019-11-13 | null | null | null | null | 12,100 | Procedure Auto Approved | null | null | null | 2019-11-11 | 0 | null | NB | 2019-11-16 | null | 2019-12-02 | 2019-11-16 | 12,100 | Kindly, provide detailed delivery notes . | 2019-11-28 | null | 2019-12-02 | 9,075 | 2019-12-12 | Approved. Case has been considered for settlement basis the merit of the details and documents submitted by hospital. The insurance company and/or SHA reserve the right to audit claims and if found discrepant may reclaim the settled cases. | null | null | null | null | 2019-12-13 | 12,100 | 0 | 0 | null | 908 | 8,167 | null | null | null | null | 1 | 30,708 | No | null | null | 2019-11-13 07:28 |
CASE/HS17006034/R263730 | Claim Amount Paid by Bank(Insurance) | Vonga Saradhi SHA_INS | 2020-07-30 | 17R17060252315000469 | P5Y8CXP83 | BALARI MAWLONG | 39 | Female | MEGHALAYA | 9,774,136,822 | MEGHALAYA | EAST KHASI HILLS | null | null | IP | HS17006034 | Private | NAZARETH HOSPITAL | MEGHALAYA | EAST KHASI HILLS | 2019-11-02 | 2019-11-04 | N | S400034 | Obstetrics & Gynaecology | S | CAESARIAN DELIVERY | null | 2019-11-02 | 2019-11-04 | 24,418 | 2019-11-04 | null | null | null | null | 24,418 | Approved. Kindly, provide all the investigations reports done during admission along with post op mandatory reports at the time of patient discharge. | null | null | null | 2019-11-02 | 0 | null | NB | 2019-11-12 | null | 2019-11-26 | 2019-11-12 | 24,418 | Please provide the USG report for to support the blocked package. | 2019-11-24 | null | 2019-11-26 | 18,314 | 2019-12-07 | Approved . Case has been considered for settlement basis the merit of the details and documents submitted by hospital. The insurance company and/or SHA reserve the right to audit claims and if found discrepant may reclaim the settled cases | null | null | null | null | 2019-12-13 | 24,418 | 0 | 0 | null | 1,831 | 16,483 | null | null | null | null | 1 | 32,027 | No | null | null | 2019-11-04 12:22 |
CASE/HS17001034/F276184 | Erroneous Claim Rejected by CPD(Insurance) | Vonga Saradhi SHA_INS | 2021-03-22 | 17F55076 | PGYKZVU5C | JELLINA M MARAK | 20 | Female | MEGHALAYA | 7,628,916,789 | MEGHALAYA | SOUTH WEST GARO HILLS | BETASING | null | IP | HS17001034 | Public | GAROBADHA PHC | MEGHALAYA | SOUTH WEST GARO HILLS | 2019-11-09 | 2019-11-11 | N | M1123003 | PHC or CHC medical | M | DYSENTERY | Y | 2019-11-09 | 2019-11-11 | 1,000 | 2019-11-11 | null | null | null | null | 3,001 | Procedure Auto Approved,Approved. Kindly, provide all the investigations reports done during admission along with post op mandatory reports at the time of patient discharge. | null | null | null | 2019-11-09 | 1 | 2,001 | NB | 2019-11-11 | null | 2019-11-11 | 2019-11-11 | 3,001 | null | null | null | null | 1,100 | 2019-11-24 | Approved. Case has been considered for settlement basis the merit of the details and documents submitted by hospital. The insurance company and/or SHA reserve the right to audit claims and if found discrepant may reclaim the settled cases. | null | null | null | null | 2019-11-28 | 3,001 | 0 | 0 | 0 | null | 1,100 | 1,901 | 2021-03-10 | null | null | null | 17,293 | No | null | null | 2019-11-09 15:52 |
CASE/HS17005008/N257954 | Erroneous Claim Rejected by CPD(Insurance) | Vonga Saradhi SHA_INS | 2020-08-04 | 17N17050243615000449 | PP8B71STD | SHALMORIS SHADAP | 22 | Female | MEGHALAYA | 7,777,777,777 | MEGHALAYA | RI BHOI | null | null | IP | HS17005008 | Public | UMSNING CHC | MEGHALAYA | RI BHOI | 2019-10-28 | 2019-10-30 | N | M1123079 | PHC or CHC medical | M | GENERAL WARD UNSPECIFIED | Y | 2019-10-28 | 2019-10-30 | 1,100 | 2019-10-30 | null | null | null | null | 4,401 | Procedure Auto Approved,Approved. Kindly, provide all the investigations reports done during admission along with post op mandatory reports at the time of patient discharge. | null | null | null | 2019-10-28 | 1 | 3,301 | NB | 2019-10-31 | null | 2019-11-01 | 2019-11-01 | 4,401 | null | null | null | null | 3,300 | 2019-11-17 | Approved as per LOS. Case has been considered for settlement basis the merit of the details and documents submitted by hospital. The insurance company and/or SHA reserve the right to audit claims and if found discrepant may reclaim the settled cases. | null | null | null | null | 2019-11-15 | 4,401 | 0 | 0 | 0 | null | 3,300 | 1,101 | 2020-08-01 | null | null | null | 22,993 | No | null | null | 2019-10-29 11:45 |
CASE/HS17001038/R290103 | Erroneous Claim Rejected by CPD(Insurance) | Vonga Saradhi SHA_INS | 2020-08-27 | 17R17010427815001483 | PX8QM9YND | MUNILLINE MARAK | 32 | Female | MEGHALAYA | 8,837,207,840 | MEGHALAYA | WEST GARO HILLS | null | null | IP | HS17001038 | Public | MCH HOSPITAL | MEGHALAYA | WEST GARO HILLS | 2019-12-08 | 2019-12-12 | N | S423110 | Obstetrics & Gynaecology | S | NORMAL DELIVERY | Y | 2019-12-08 | 2019-12-12 | 9,000 | 2019-12-12 | null | null | null | null | 9,000 | Procedure Auto Approved | null | null | null | 2019-12-08 | 0 | null | NB | 2019-12-11 | null | 2019-12-20 | 2019-12-20 | 9,000 | null | null | null | null | 6,750 | 2019-12-24 | Approved. Case has been considered for settlement basis the merit of the details and documents submitted by hospital. The insurance company and/or SHA reserve the right to audit claims and if found discrepant may reclaim the settled cases | null | null | null | null | 2019-12-24 | 9,000 | 0 | 0 | 0 | null | 6,750 | 2,250 | 2020-08-05 | null | null | null | 5,964 | No | null | null | 2019-12-09 11:03 |
CASE/HS17001039/F290868 | Claim Amount Paid by Bank(Insurance) | Vonga Saradhi SHA_INS | 2020-07-30 | 17F45849 | P8ULMR0ZD | DIPAK BISWAS | 44 | Male | MEGHALAYA | 8,259,918,479 | MEGHALAYA | WEST GARO HILLS | null | null | IP | HS17001039 | Public | TURA CIVIL HOSPITAL | MEGHALAYA | WEST GARO HILLS | 2019-12-16 | 2019-12-17 | N | M123101 | General Medicine | M | GENERAL WARD UNSPECIFIED | Y | 2019-12-16 | 2019-12-17 | 1,200 | 2019-12-17 | null | null | null | null | 7,200 | Procedure Auto Approved,Approved.Kindly,provide all the investigations reports done during admission along with the post op mandatory reports at the time of patient discharge. | null | null | null | 2019-12-16 | 1 | 6,000 | NB | 2019-12-20 | null | 2019-12-20 | 2019-12-20 | 7,200 | null | null | null | null | 4,800 | 2019-12-24 | Approved. Case has been considered for settlement basis the merit of the details and documents submitted by hospital. The insurance company and/or SHA reserve the right to audit claims and if found discrepant may reclaim the settled cases. | null | null | null | null | 2019-12-24 | 7,200 | 0 | 0 | 0 | null | 4,800 | null | null | null | null | null | 4,779 | No | null | null | 2019-12-17 13:24 |
CASE/HS17006034/S290289 | Claim Amount Paid by Bank(Insurance) | Vonga Saradhi SHA_INS | 2020-07-30 | 17S170400300680000004700031 | PAUZ1CXCG | LARISUK KHARKYLLIANG | 25 | Female | MEGHALAYA | 9,378,053,649 | MEGHALAYA | WEST KHASI HILLS | null | null | IP | HS17006034 | Private | NAZARETH HOSPITAL | MEGHALAYA | EAST KHASI HILLS | 2019-12-13 | 2019-12-13 | N | S400017 | Obstetrics & Gynaecology | S | DILATION AND EVACUATION (DE) | Y | 2019-12-13 | 2019-12-13 | 6,050 | 2019-12-13 | null | null | null | null | 6,050 | Procedure Auto Approved | null | null | null | 2019-12-13 | 0 | null | NB | 2019-12-14 | null | 2019-12-17 | 2019-12-17 | 6,050 | null | null | null | null | 4,538 | 2019-12-23 | Approved. Case has been considered for settlement basis the merit of the details and documents submitted by hospital. The insurance company and/or SHA reserve the right to audit claims and if found discrepant may reclaim the settled cases. | null | null | null | null | 2019-12-23 | 6,050 | 0 | 0 | null | 454 | 4,084 | null | null | null | null | null | 7,947 | No | null | null | 2019-12-13 18:59 |
CASE/HS17006060/S288051 | Erroneous Claim Initiated by Medco(Insurance) | Vonga Saradhi SHA_INS | 2023-02-17 | 17S170600280040001001700242 | P15DTY841 | DOLI SWER | 21 | Female | MEGHALAYA | 6,909,283,124 | MEGHALAYA | EAST KHASI HILLS | null | null | IP | HS17006060 | Public | GANESH DAS HOSPITAL | MEGHALAYA | EAST KHASI HILLS | 2019-12-02 | 2019-12-07 | N | S400034 | Obstetrics & Gynaecology | S | CAESARIAN DELIVERY | null | 2019-12-02 | 2019-12-07 | 20,180 | 2019-12-07 | null | null | null | null | 20,180 | Approved. Kindly, provide all the investigations reports done during admission along with post op mandatory reports at the time of patient discharge. | null | null | null | 2019-12-02 | 0 | null | NB | 2019-12-09 | null | 2019-12-21 | 2019-12-10 | 20,180 | please provide USG abdomen. to support the procedure performed. | 2019-12-19 | USG REPORT ATTACHED | 2019-12-21 | 15,135 | 2019-12-25 | Approved. Case has been considered for settlement basis the merit of the details and documents submitted by hospital. The insurance company and/or SHA reserve the right to audit claims and if found discrepant may reclaim the settled cases. | null | null | null | null | 2019-12-26 | 20,180 | 0 | 0 | 0 | null | 15,135 | 5,045 | 2023-02-17 | null | null | 1 | 18,597 | No | null | null | 2019-12-07 13:42 |
CASE/HS17006060/S285152 | Erroneous Claim Initiated by Medco(Insurance) | Vonga Saradhi SHA_INS | 2023-02-17 | 17S170600400480000006200037 | PJRE8O6B0 | THRELIN LONGSHIANG | 34 | Female | MEGHALAYA | 8,258,059,696 | MEGHALAYA | EAST KHASI HILLS | null | null | IP | HS17006060 | Public | GANESH DAS HOSPITAL | MEGHALAYA | EAST KHASI HILLS | 2019-11-26 | 2019-11-30 | N | S423110 | Obstetrics & Gynaecology | S | NORMAL DELIVERY | Y | 2019-11-26 | 2019-11-30 | 9,000 | 2019-11-30 | null | null | null | null | 9,000 | Procedure Auto Approved | null | null | null | 2019-11-26 | 0 | null | NB | 2019-12-07 | null | 2019-12-07 | 2019-12-07 | 9,000 | null | null | null | null | 6,750 | 2019-12-18 | Approved. Case has been considered for settlement basis the merit of the details and documents submitted by hospital. The insurance company and/or SHA reserve the right to audit claims and if found discrepant may reclaim the settled cases | null | null | null | null | 2019-12-19 | 9,000 | 0 | 0 | 0 | null | 6,750 | 2,250 | 2023-02-17 | null | null | null | 15,975 | No | null | null | 2019-11-30 17:12 |
CASE/HS17006034/N285234 | Claim Amount Paid by Bank(Insurance) | Vonga Saradhi SHA_INS | 2020-07-30 | 17N17060629417000022 | PS194O2OY | PRATIMA BISWAS | 19 | Female | MEGHALAYA | 9,366,853,287 | MEGHALAYA | EAST KHASI HILLS | null | null | IP | HS17006034 | Private | NAZARETH HOSPITAL | MEGHALAYA | EAST KHASI HILLS | 2019-11-26 | 2019-11-30 | N | S400034 | Obstetrics & Gynaecology | S | CAESARIAN DELIVERY | null | 2019-11-26 | 2019-11-30 | 24,418 | 2019-11-30 | null | null | null | null | 24,418 | Approved. Kindly, provide all the investigations reports done during admission along with post op mandatory reports at the time of patient discharge. | null | null | null | 2019-11-26 | 0 | null | NB | 2019-12-04 | null | 2019-12-04 | 2019-12-04 | 24,418 | null | null | null | null | 18,314 | 2019-12-18 | Approved. Case has been considered for settlement basis the merit of the details and documents submitted by hospital. The insurance company and/or SHA reserve the right to audit claims and if found discrepant may reclaim the settled cases | null | null | null | null | 2019-12-17 | 24,418 | 0 | 0 | null | 1,831 | 16,483 | null | null | null | null | null | 19,030 | No | null | null | 2019-11-30 22:55 |
CASE/HS17006034/R285246 | Claim Amount Paid by Bank(Insurance) | Vonga Saradhi SHA_INS | 2020-07-30 | 17R17070309715000787 | PGXC63LUC | PYNPHAILANG KASSAR | 41 | Female | MEGHALAYA | 7,005,534,528 | MEGHALAYA | WEST JAINTIA HILLS | null | null | IP | HS17006034 | Private | NAZARETH HOSPITAL | MEGHALAYA | EAST KHASI HILLS | 2019-11-29 | 2019-12-01 | N | S423110 | Obstetrics & Gynaecology | S | NORMAL DELIVERY | Y | 2019-11-30 | 2019-12-01 | 10,890 | 2019-12-01 | null | null | null | null | 10,890 | Procedure Auto Approved | null | null | null | 2019-11-30 | 0 | null | NB | 2019-12-03 | null | 2019-12-03 | 2019-12-03 | 10,890 | null | null | null | null | 8,168 | 2019-12-13 | Approved. Case has been considered for settlement basis the merit of the details and documents submitted by hospital. The insurance company and/or SHA reserve the right to audit claims and if found discrepant may reclaim the settled cases | null | null | null | null | 2019-12-16 | 10,890 | 0 | 0 | null | 817 | 7,351 | null | null | null | null | null | 14,616 | No | null | null | 2019-11-30 00:32 |
CASE/HS17001039/R93736 | Claim Amount Paid by Bank(Insurance) | Vonga Saradhi SHA_INS | 2020-07-30 | 17R17100703715001073 | PMJ1KC04V | SALSENG B MARAK | 24 | Male | MEGHALAYA | 9,366,560,498 | MEGHALAYA | SOUTH WEST GARO HILLS | null | null | IP | HS17001039 | Public | TURA CIVIL HOSPITAL | MEGHALAYA | WEST GARO HILLS | 2019-07-24 | 2019-07-24 | N | S523179 | Orthopaedics | S | WOUND DEBRIDIMENT | Y | 2019-07-24 | 2019-07-24 | 11,100 | 2019-07-24 | null | null | null | null | 11,100 | Procedure Auto Approved | null | null | null | 2019-07-27 | 0 | null | NB | 2019-08-05 | null | 2019-12-14 | 2019-12-03 | 11,100 | Kindly provide reason for Claim delay more than 15 days for further claim processing. | 2019-12-13 | Sir/Madam there was a delay in transaction/claim initiation after the patient discharge from the hospital due to shortage of manpower of operator handling TMS in the hospital. We apologize for the delay. The patient has availed the benefits of the scheme for which we have incurred some expenses. So we request you to ki... | 2019-12-14 | 8,325 | 2019-12-23 | Approved. Case has been considered for settlement basis the merit of the details and documents submitted by hospital. The insurance company and/or SHA reserve the right to audit claims and if found discrepant may reclaim the settled cases. | null | null | null | null | 2019-12-23 | 11,100 | 0 | 0 | 0 | null | 8,325 | null | null | null | null | 1 | 26,429 | No | null | null | 2019-07-24 14:47 |
CASE/HS17006060/F283968 | Erroneous Claim Rejected by CPD(Insurance) | Vonga Saradhi SHA_INS | 2023-04-10 | 17F26010 | PC7GI4UTF | EVANYLLA PHANKON | 29 | Female | MEGHALAYA | 9,862,853,314 | MEGHALAYA | EAST KHASI HILLS | null | null | IP | HS17006060 | Public | GANESH DAS HOSPITAL | MEGHALAYA | EAST KHASI HILLS | 2019-11-27 | 2019-11-28 | N | S423110 | Obstetrics & Gynaecology | S | NORMAL DELIVERY | Y | 2019-11-27 | 2019-11-28 | 9,000 | 2019-11-28 | null | null | null | null | 9,000 | Procedure Auto Approved | null | null | null | 2019-11-27 | 0 | null | NB | 2019-11-30 | null | 2019-11-30 | 2019-11-30 | 9,000 | null | null | null | null | 6,750 | 2019-12-11 | Approved. Case has been considered for settlement basis the merit of the details and documents submitted by hospital. The insurance company and/or SHA reserve the right to audit claims and if found discrepant may reclaim the settled cases | null | null | null | null | 2019-12-12 | 9,000 | 0 | 0 | 0 | null | 6,750 | 2,250 | 2023-02-17 | null | null | null | 15,743 | No | null | null | 2019-11-28 12:57 |
CASE/HS17004011/N281801 | Claim Amount Paid by Bank(Insurance) | Vonga Saradhi SHA_INS | 2020-07-30 | 17N17040318215000056 | PIZKV6CRK | GREATSTAR MAWLONG | 6 | Male | MEGHALAYA | 9,366,742,787 | MEGHALAYA | WEST KHASI HILLS | null | null | IP | HS17004011 | Public | TIROT SINGH MEMORIAL HOSPITAL | MEGHALAYA | WEST KHASI HILLS | 2019-11-22 | 2019-11-23 | N | M123075 | General Medicine | M | ACUTE GASTRITIS | Y | 2019-11-22 | 2019-11-23 | 5,750 | 2019-11-23 | null | null | null | null | 5,750 | Procedure Auto Approved | null | null | null | 2019-11-22 | 0 | null | NB | 2019-11-26 | null | 2019-12-27 | 2019-11-26 | 5,750 | Kindly provide the reason for mismatch of package blocked and Diagnosis for further claim processing. | 2019-12-06 | null | 2019-12-27 | 4,800 | 2019-12-28 | upon verification of documents provided, a case of CBD worms for conservative management was claimed under ACUTE GASTRITIS. Hence the claim is approved as per General ward - Unspecified package for claimed LOS. Case has been considered for settlement basis the merit of the details and documents submitted by hospital. T... | null | null | null | null | 2020-01-08 | 5,750 | 0 | 0 | 0 | null | 4,800 | null | null | null | null | 1 | 16,887 | No | null | null | 2019-11-23 13:40 |
CASE/HS17001059/R259511 | Erroneous Claim Rejected by CPD(Insurance) | Vonga Saradhi SHA_INS | 2021-02-17 | 17R17090124215001282 | PL8KUECXG | ROUSILLA MOMIN | 65 | Female | MEGHALAYA | 8,787,509,426 | MEGHALAYA | NORTH GARO HILLS | null | null | IP | HS17001059 | Private | HOLY CROSS TURA HOSPITAL | MEGHALAYA | WEST GARO HILLS | 2019-10-31 | 2019-10-31 | N | M123101 | General Medicine | M | GENERAL WARD UNSPECIFIED | Y | 2019-10-31 | 2019-10-31 | 2,500 | 2019-10-31 | null | null | null | null | 17,500 | Procedure Auto Approved,Approved. Kindly, provide all the investigations reports done during admission along with op mandatory reports at the time of patient discharge. | null | null | null | 2019-10-31 | 2 | 7,500 | NB | 2019-11-07 | null | 2019-12-05 | 2019-11-08 | 17,500 | Kindly provide justification for Direct discharge from ICU for further processing of claim. | 2019-12-03 | null | 2019-12-05 | 16,200 | 2019-12-16 | Approved. Case has been considered for settlement basis the merit of the details and documents submitted by hospital. The insurance company and/or SHA reserve the right to audit claims and if found discrepant may reclaim the settled cases. | null | null | null | null | 2019-12-17 | 17,500 | 0 | 0 | null | 1,620 | 14,580 | 1,300 | 2021-02-07 | null | null | 2 | 48,197 | No | null | null | 2019-10-31 17:06 |
CASE/HS17006034/F259543 | Claim Amount Paid by Bank(Insurance) | Vonga Saradhi SHA_INS | 2020-07-30 | 17F17060311517000186 | PNHZIM5KS | DIYET NONGSPUNG | 70 | Female | MEGHALAYA | 9,378,184,372 | MEGHALAYA | EAST KHASI HILLS | null | null | IP | HS17006034 | Private | NAZARETH HOSPITAL | MEGHALAYA | EAST KHASI HILLS | 2019-10-31 | 2019-10-31 | N | S123470 | General Surgery | S | TRACHEOSTOMY | Y | 2019-10-31 | 2019-10-31 | 6,958 | 2019-10-31 | null | null | null | null | 6,958 | Procedure Auto Approved | null | null | null | 2019-10-31 | 0 | null | NB | 2019-11-07 | null | 2019-11-07 | 2019-11-07 | 6,958 | null | null | null | null | 5,218 | 2019-11-27 | Approved. Case has been considered for settlement basis the merit of the details and documents submitted by hospital. The insurance company and/or SHA reserve the right to audit claims and if found discrepant may reclaim the settled cases | null | As the patient is Left against medical advice before surgery performed,the claim blocked for Surgery cannot be considered.As the system is not accepting Zero as approval amount,the claim will be Rejected. | null | null | 2019-11-20 | 6,958 | 0 | 0 | null | 522 | 4,696 | null | null | null | null | null | 22,545 | Yes | 2019-11-25 | null | 2019-10-31 17:22 |
CASE/HS17002007/S260863 | Erroneous Claim Rejected by CPD(Insurance) | Vonga Saradhi SHA_INS | 2020-10-05 | 17S170200500970000009700004 | PIVCFWTDC | SANCHILLA SANGMA | 24 | Female | MEGHALAYA | 8,014,240,541 | MEGHALAYA | EAST GARO HILLS | null | null | IP | HS17002007 | Public | BANSAMGRE PHC | MEGHALAYA | EAST GARO HILLS | 2019-10-30 | 2019-11-01 | N | S423110 | Obstetrics & Gynaecology | S | NORMAL DELIVERY | Y | 2019-10-30 | 2019-11-01 | 6,300 | 2019-11-01 | null | null | null | null | 6,300 | Procedure Auto Approved | null | null | null | 2019-10-30 | 0 | null | NB | 2019-10-31 | null | 2019-11-05 | 2019-11-05 | 6,300 | null | null | null | null | 4,725 | 2019-11-16 | Approved. Case has been considered for settlement basis the merit of the details and documents submitted by hospital. The insurance company and/or SHA reserve the right to audit claims and if found discrepant may reclaim the settled cases. | null | null | null | null | 2019-11-19 | 6,300 | 0 | 0 | 0 | null | 4,725 | 1,575 | 2020-08-17 | null | null | null | 15,098 | No | null | null | 2019-11-01 15:19 |
CASE/HOSP17P84324/R262787 | Erroneous Claim Rejected by CPD(Insurance) | Vonga Saradhi SHA_INS | 2020-12-22 | 17R17060245917000867 | PX6157X76 | BREAM ROSE WAR | 47 | Female | MEGHALAYA | 9,402,346,039 | MEGHALAYA | EAST KHASI HILLS | null | null | IP | HOSP17P84324 | Private | WOODLAND HOSPITAL | MEGHALAYA | EAST KHASI HILLS | 2019-11-02 | 2019-11-03 | N | M123101 | General Medicine | M | GENERAL WARD UNSPECIFIED | Y | 2019-11-02 | 2019-11-03 | 1,320 | 2019-11-03 | null | null | null | null | 6,600 | Procedure Auto Approved,Approved. Kindly, provide all the investigations reports done during admission along with post op mandatory reports at the time of patient discharge. | null | null | null | 2019-11-02 | 1 | 5,280 | NB | 2019-11-05 | null | 2019-11-20 | 2019-11-05 | 6,600 | Kindly mention the Indication for Inpatient admission for further processing | 2019-11-16 | DOCUMENT ATTACHED | 2019-11-20 | 3,960 | 2019-11-30 | Approved as per claimed LOS. Case has been considered for settlement basis the merit of the details and documents submitted by hospital. The insurance company and/or SHA reserve the right to audit claims and if found discrepant may reclaim the settled cases. | null | null | null | null | 2019-12-03 | 6,600 | 0 | 0 | null | 396 | 3,564 | 2,640 | 2020-12-10 | null | null | 1 | 29,830 | No | null | null | 2019-11-02 18:07 |
CASE/HS17001038/S261313 | Erroneous Claim Rejected by CPD(Insurance) | Vonga Saradhi SHA_INS | 2020-08-27 | 17S170100500290000007000027 | PN0S8KZIM | KRISMA A MARAK | 25 | Female | MEGHALAYA | 9,874,123,456 | MEGHALAYA | SOUTH WEST GARO HILLS | null | null | IP | HS17001038 | Public | MCH HOSPITAL | MEGHALAYA | WEST GARO HILLS | 2019-10-15 | 2019-11-01 | N | S400034 | Obstetrics & Gynaecology | S | CAESARIAN DELIVERY | null | 2019-10-15 | 2019-11-01 | 20,180 | 2019-11-01 | null | null | null | null | 20,180 | Approved. Kindly, provide all the investigations reports done during admission along with post op mandatory reports at the time of patient discharge. | null | null | null | 2019-10-19 | 0 | null | NB | 2019-11-01 | null | 2019-11-22 | 2019-11-01 | 20,180 | Kindly Specify the Reason for Preauth delay beyond 5 days for further processing | 2019-11-14 | Sir/Madam, There was a delay in TMS transaction/claim initiation after the patient discharge from the hospital due to a shortage of manpower of operator handlling the TMS in the hospital. We apologize for the delay. The patient has availe the benefits of the scheme in our hospital for which we have incurred some expenc... | 2019-11-22 | 15,135 | 2019-11-30 | Approved.Case has been considered for settlement basis the merit of the details and documents submitted by hospital. The insurance company and/or SHA reserve the right to audit claims and if found discrepant may reclaim the settled. | null | null | null | null | 2019-12-13 | 20,180 | 0 | 0 | 0 | null | 15,135 | 5,045 | 2020-08-05 | null | null | 1 | 29,272 | No | null | null | 2019-10-16 11:33 |
CASE/HS17006034/N288052 | Claim Amount Paid by Bank(Insurance) | Vonga Saradhi SHA_INS | 2020-07-30 | 17N17060253715000552 | P2D4PW8A5 | RASING SOHTUN | 29 | Male | MEGHALAYA | 9,756,669,476 | MEGHALAYA | EAST KHASI HILLS | null | null | IP | HS17006034 | Private | NAZARETH HOSPITAL | MEGHALAYA | EAST KHASI HILLS | 2019-12-06 | 2019-12-07 | N | S523179 | Orthopaedics | S | WOUND DEBRIDIMENT | Y | 2019-12-06 | 2019-12-07 | 13,431 | 2019-12-07 | null | null | null | null | 13,431 | Procedure Auto Approved | null | null | null | 2019-12-06 | 0 | null | NB | 2019-12-09 | null | 2019-12-09 | 2019-12-09 | 13,431 | null | null | null | null | 10,073 | 2019-12-19 | Approved. Case has been considered for settlement basis the merit of the details and documents submitted by hospital. The insurance company and/or SHA reserve the right to audit claims and if found discrepant may reclaim the settled cases. | null | null | null | null | 2019-12-20 | 13,431 | 0 | 0 | null | 1,007 | 9,066 | null | null | null | null | null | 14,132 | No | null | null | 2019-12-07 00:44 |
CASE/HS17006034/R209721 | Claim Amount Paid by Bank(Insurance) | Vonga Saradhi SHA_INS | 2020-07-30 | 17R17060129915002119 | PUH8YFEUN | AIMIDALIN SADD | 33 | Female | MEGHALAYA | 8,414,061,593 | MEGHALAYA | EAST KHASI HILLS | null | null | IP | HS17006034 | Private | NAZARETH HOSPITAL | MEGHALAYA | EAST KHASI HILLS | 2019-10-01 | 2019-10-01 | N | M123101 | General Medicine | M | GENERAL WARD UNSPECIFIED | Y | 2019-10-01 | 2019-10-01 | 3,025 | 2019-10-01 | Kindly provide case notes, progress notes till date supporting enhancement and also specify need for extended stay of the patient. | 2019-10-06 | null | 2019-10-06 | 13,310 | Procedure Auto Approved,Approved. Kindly, provide all the investigations reports done during admission along with post op mandatory reports at the time of patient discharge. | null | null | null | 2019-10-01 | 3 | 4,356 | NB | 2019-10-06 | null | 2019-11-26 | 2019-10-06 | 13,310 | Kindly, provide ICU in and out transfer notes with dates mentioned for further processing of claims. | 2019-11-21 | null | 2019-11-26 | 10,406 | 2019-12-06 | Approved as per LOS I2G3 . Case has been considered for settlement basis the merit of the details and documents submitted by hospital. The insurance company and/or SHA reserve the right to audit claims and if found discrepant may reclaim the settled cases. | null | null | null | null | 2019-10-23 | 13,310 | 0 | 0 | null | 1,041 | 9,365 | null | null | null | null | null | null | Yes | 2019-11-07 | Change the action,claim to be queried with same remark. | 2019-10-01 14:33 |
CASE/HS17007010/R180159 | Erroneous Claim Rejected by CPD(Insurance) | Vonga Saradhi SHA_INS | 2021-02-18 | 17R17070116615000817 | PAFVWTP0B | ARDAMANKI LAMARE | 10 | Female | MEGHALAYA | 9,366,956,632 | MEGHALAYA | WEST JAINTIA HILLS | null | null | IP | HS17007010 | Public | JOWAI CIVIL HOSPITAL | MEGHALAYA | WEST JAINTIA HILLS | 2019-09-13 | 2019-09-13 | N | M123101 | General Medicine | M | GENERAL WARD UNSPECIFIED | Y | 2019-09-13 | 2019-09-13 | 1,200 | 2019-09-13 | null | null | null | null | 7,200 | Procedure Auto Approved,Approved. Kindly, provide all the investigations reports done during admission along with post op mandatory reports at the time of patient discharge. | null | null | null | 2019-09-13 | 1 | 6,000 | NB | 2019-09-18 | null | 2019-12-05 | 2019-10-01 | 7,200 | Please let us know reason for transaction delay in initiating claim. | 2019-10-16 | DUE TO A VERY SLOW INTERNET CONNECTIVITY WITH HIGH PATIENT LOADS ( MORE REGISTRATION AND DISCHARGE) PER DAYS | 2019-12-05 | 6,000 | 2019-12-17 | Approved as per LOS. Case has been considered for settlement basis the merit of the details and documents submitted by hospital. The insurance company and/or SHA reserve the right to audit claims and if found discrepant may reclaim the settled cases. | null | null | null | null | 2019-12-09 | 7,200 | 0 | 0 | 0 | null | 6,000 | 1,200 | 2021-02-10 | null | null | 1 | 16,569 | No | null | null | 2019-09-13 19:21 |
CASE/HS17001059/F193576 | Erroneous Claim Rejected by CPD(Insurance) | Vonga Saradhi SHA_INS | 2021-02-23 | 17F17030220715000293 | PAN4NZ6V8 | SILNAME A SANGMA | 26 | Female | MEGHALAYA | 8,837,243,115 | MEGHALAYA | SOUTH GARO HILLS | null | null | IP | HS17001059 | Private | HOLY CROSS TURA HOSPITAL | MEGHALAYA | WEST GARO HILLS | 2019-09-19 | 2019-09-21 | N | S423110 | Obstetrics & Gynaecology | S | NORMAL DELIVERY | Y | 2019-09-19 | 2019-09-21 | 9,000 | 2019-09-21 | null | null | null | null | 9,000 | Procedure Auto Approved | null | null | null | 2019-09-19 | 0 | null | NB | 2019-09-25 | null | 2019-09-29 | 2019-09-29 | 9,000 | null | null | null | null | 6,750 | 2019-10-14 | Approved. Case has been considered for settlement basis the merit of the details and documents submitted by hospital. The insurance company and/or SHA reserve the right to audit claims and if found discrepant may reclaim the settled cases. | null | null | null | null | 2019-10-16 | 9,000 | 0 | 0 | null | 675 | 6,075 | 2,250 | 2021-02-06 | null | null | null | null | No | null | null | 2019-09-21 12:37 |
CASE/HS17004026/S201822 | Claim Amount Paid by Bank(Insurance) | Vonga Saradhi SHA_INS | 2020-07-30 | 17S170400470060001000200102 | PTRLNL0EF | LURSHAI MARBANIANG | 11 | Male | MEGHALAYA | 9,774,483,596 | MEGHALAYA | WEST KHASI HILLS | null | null | IP | HS17004026 | Private | HOLY CROSS MAIRANG | MEGHALAYA | WEST KHASI HILLS | 2019-09-25 | 2019-09-26 | N | M123101 | General Medicine | M | GENERAL WARD UNSPECIFIED | Y | 2019-09-25 | 2019-09-26 | 1,200 | 2019-09-26 | null | null | null | null | 7,200 | Procedure Auto Approved,Approved. Kindly, provide all the investigations reports done during admission along with all mandatory reports and documents at the time of patient discharge. | null | null | null | 2019-09-25 | 1 | 6,000 | NB | 2019-09-28 | null | 2019-09-28 | 2019-09-28 | 7,200 | null | null | null | null | 3,600 | 2019-10-13 | Approved as per actual LOS. | null | null | null | null | 2019-10-16 | 7,200 | 0 | 0 | null | 360 | 3,240 | null | null | null | null | null | null | No | null | null | 2019-09-26 10:26 |
CASE/HS17004026/R188756 | Claim Amount Paid by Bank(Insurance) | Vonga Saradhi SHA_INS | 2020-07-30 | 17R17040323315000279 | PVR5EJ2F0 | KYNTIEWRILIN JARAIN | 35 | Female | MEGHALAYA | 7,005,905,463 | MEGHALAYA | WEST KHASI HILLS | null | null | IP | HS17004026 | Private | HOLY CROSS MAIRANG | MEGHALAYA | WEST KHASI HILLS | 2019-09-18 | 2019-09-18 | N | M123101 | General Medicine | M | GENERAL WARD UNSPECIFIED | Y | 2019-09-18 | 2019-09-18 | 1,200 | 2019-09-18 | kindly re upload initial Clinical assessment sheets with presenting complaints and clinical examination papers , diagnosis and proposed line of treatment ,as uploaded documents are not opening in portal | 2019-09-19 | null | 2019-09-19 | 6,000 | Procedure Auto Approved,Approved. Kindly, provide all the investigations reports done during admission along with post op mandatory reports at the time of patient discharge. | null | null | null | 2019-09-18 | 1 | 4,800 | NB | 2019-09-20 | null | 2019-09-20 | 2019-09-20 | 6,000 | null | null | null | null | 2,400 | 2019-10-06 | Case has been considered for settlement as per claimed LOS and basis the merit of the details and documents submitted by hospital. The insurance company and/or SHA reserve the right to audit claims and if found discrepant may reclaim the settled cases. | null | null | null | null | 2019-10-10 | 6,000 | 0 | 0 | null | 240 | 2,160 | null | null | null | null | null | null | No | null | null | 2019-09-18 18:02 |
CASE/HS17004010/R177488 | Claim Amount Paid by Bank(Insurance) | Vonga Saradhi SHA_INS | 2020-07-30 | 17R17040239215000399 | PEPOTFBAM | SHAIDALIN WAHLANG | 15 | Female | MEGHALAYA | 8,119,009,315 | MEGHALAYA | WEST KHASI HILLS | null | null | IP | HS17004010 | Public | NONGSTOIN CIVIL HOSPITAL | MEGHALAYA | WEST KHASI HILLS | 2019-09-11 | 2019-09-12 | N | M123101 | General Medicine | M | GENERAL WARD UNSPECIFIED | Y | 2019-09-12 | 2019-09-12 | 1,200 | 2019-09-12 | kindly re upload initial Clinical assessment sheets with presenting complaints and clinical examination papers , diagnosis and proposed line of treatment as uploaded documents are not opening in portal | 2019-09-12 | null | 2019-09-14 | 7,200 | Procedure Auto Approved,Approved. Kindly, provide all the investigations reports done during admission along with all mandatory reports and documents at the time of patient discharge. | null | null | null | 2019-09-12 | 1 | 6,000 | NB | 2019-09-13 | null | 2019-09-17 | 2019-09-17 | 7,200 | null | null | null | null | 1,200 | 2019-10-02 | Approved as per actual LOS. Case has been considered for settlement basis the merit of the details and documents submitted by hospital. The insurance company and/or SHA reserve the right to audit claims and if found discrepant may reclaim the settled cases. | null | null | null | null | 2019-10-10 | 7,200 | 0 | 0 | 0 | null | 1,200 | null | null | null | null | null | null | No | null | null | 2019-09-12 15:50 |
CASE/HS17007010/N163328 | Erroneous Claim Rejected by CPD(Insurance) | Vonga Saradhi SHA_INS | 2021-02-18 | 17N17070115315001014 | PMSPWFN0H | TRUSTFUL LYMMIN | 16 | Male | MEGHALAYA | 9,856,784,157 | MEGHALAYA | WEST JAINTIA HILLS | null | null | IP | HS17007010 | Public | JOWAI CIVIL HOSPITAL | MEGHALAYA | WEST JAINTIA HILLS | 2019-09-03 | 2019-09-04 | N | M123101 | General Medicine | M | GENERAL WARD UNSPECIFIED | Y | 2019-09-03 | 2019-09-04 | 1,200 | 2019-09-04 | null | null | null | null | 7,200 | Procedure Auto Approved,Approved. Kindly, provide all the investigations reports done during admission along with post op mandatory reports at the time of patient discharge. | null | null | null | 2019-09-03 | 1 | 6,000 | NB | 2019-09-05 | null | 2019-11-30 | 2019-09-14 | 7,200 | please provide the clinical notes of all days of LOS. Claimed days are less than the claim initiated. | 2019-10-09 | ALL AVAILABLE DOCUMENT HAS BEEN UPLOADED KINDLY CHECK YOUR TMS | 2019-11-30 | 2,400 | 2019-12-10 | Approved as per Actual LOS. Case has been considered for settlement basis the merit of the details and documents submitted by hospital. The insurance company and/or SHA reserve the right to audit claims and if found discrepant may reclaim the settled cases. | null | null | null | null | 2019-10-04 | 7,200 | 0 | 0 | 0 | null | 2,400 | 4,800 | 2021-02-06 | null | null | 1 | null | Yes | 2019-09-28 | Please check the remarks added | 2019-09-04 12:30 |
CASE/HS17006034/F135946 | Claim Amount Paid by Bank(Insurance) | Vonga Saradhi SHA_INS | 2020-07-30 | 17F17050234815000552 | PFY9HSPK0 | ROBANSON NONGBET | 25 | Male | MEGHALAYA | 9,366,354,601 | MEGHALAYA | RI BHOI | null | null | IP | HS17006034 | Private | NAZARETH HOSPITAL | MEGHALAYA | EAST KHASI HILLS | 2019-08-19 | 2019-08-20 | N | M123101 | General Medicine | M | GENERAL WARD UNSPECIFIED | Y | 2019-08-20 | 2019-08-20 | 4,235 | 2019-08-20 | Kindly provide the enhancement details for further processing of the claim. | 2019-09-05 | null | 2019-09-05 | 37,026 | Procedure Auto Approved,Approved as per the declaration given by the hospital. | null | null | null | 2019-08-20 | 6 | 7,260 | NB | 2019-09-05 | null | 2019-09-22 | 2019-09-05 | 37,026 | Kindly, provide ICU and HDU in and ICU and HDU out transfer notes with dates mentioned for further processing of claims. | 2019-09-19 | null | 2019-09-22 | 13,860 | 2019-10-06 | Case has been considered for settlement basis the merit of the details and documents submitted by hospital. The insurance company and/or SHA reserve the right to audit claims and if found discrepant may reclaim the settled cases. | null | null | null | null | 2019-10-10 | 37,026 | 0 | 0 | null | 1,386 | 12,474 | null | null | null | null | 1 | null | No | null | null | 2019-08-20 07:25 |
CASE/HS17002018/R151649 | Erroneous Claim Rejected by CPD(Insurance) | Vonga Saradhi SHA_INS | 2020-08-27 | 17R17020130515002455 | PGI4GJYRU | JENGME SANGMA | 23 | Female | MEGHALAYA | 9,383,272,254 | MEGHALAYA | EAST GARO HILLS | null | null | IP | HS17002018 | Public | RONGJENG CHC | MEGHALAYA | EAST GARO HILLS | 2019-08-24 | 2019-08-28 | N | M1123079 | PHC or CHC medical | M | GENERAL WARD UNSPECIFIED | Y | 2019-08-24 | 2019-08-28 | 1,000 | 2019-08-28 | null | null | null | null | 6,001 | Procedure Auto Approved,Approved. Kindly, provide all the investigations reports done during admission along with post op mandatory reports at the time of patient discharge. | null | null | null | 2019-08-24 | 1 | 5,001 | NB | 2019-08-28 | null | 2019-10-03 | 2019-09-03 | 6,001 | Kindly, provide clinical notes for all the days for further processing of claims. | 2019-09-16 | null | 2019-10-03 | 4,000 | 2019-10-14 | Approved as per actual LOS. | null | null | null | null | 2019-10-16 | 6,001 | 0 | 0 | 0 | null | 4,000 | 2,001 | 2020-08-03 | null | null | 1 | null | No | null | null | 2019-08-24 15:17 |
CASE/HS17001039/R514 | Claim Amount Paid by Bank(Insurance) | Vonga Saradhi SHA_INS | 2020-07-30 | 17R17040161715000071 | PHN0GAMJT | BRENALLIN MARAK | 50 | Female | MEGHALAYA | 9,862,344,057 | MEGHALAYA | WEST KHASI HILLS | null | null | IP | HS17001039 | Public | TURA CIVIL HOSPITAL | MEGHALAYA | WEST GARO HILLS | 2019-03-11 | 2019-03-11 | null | M123101 | General Medicine | M | GENERAL WARD UNSPECIFIED | Y | 2019-03-11 | 2019-03-11 | 1,200 | 2019-03-11 | Kindly provide the details of discharge. | 2019-05-25 | Case Sheet till date uploaded as Support Documents | 2019-08-26 | 13,200 | Procedure Auto Approved,Approved. Kindly, provide all the investigations reports done during admission along with post op mandatory reports at the time of patient discharge. | null | null | null | 2019-03-11 | 2 | 6,000 | null | 2019-03-20 | null | 2020-01-23 | 2019-09-02 | 13,200 | Clinical notes provided is illegible and irredable.Kindly provide the clear clinical notes. | 2019-09-16 | Sir/Madam, this particular patient had left the hospital taking along all her Case sheets and other documents. The documents could not be retreived as the patient stays in a district far from Tura. The documents uploaded by us was sent back to us by Whatsapp by the patient that is the reason that it is not clear. We ar... | 2020-01-23 | 13,200 | 2020-01-26 | Approved. Case has been considered for settlement basis the merit of the details and documents submitted by hospital. The insurance company and/or SHA reserve the right to audit claims and if found discrepant may reclaim the settled cases. | null | null | null | null | 2020-02-06 | 13,200 | 0 | 0 | 0 | null | 13,200 | null | null | null | null | 1 | 3,509 | No | null | null | 2019-03-11 14:11 |
CASE/HS17006034/F92916 | Claim Amount Paid by Bank(Insurance) | Vonga Saradhi SHA_INS | 2020-07-30 | 17F17060238715000663 | PSWFM3WLS | HYNRET ANDRA KHARWANLANG | 93 | Female | MEGHALAYA | 7,085,400,789 | MEGHALAYA | EAST KHASI HILLS | null | null | IP | HS17006034 | Private | NAZARETH HOSPITAL | MEGHALAYA | EAST KHASI HILLS | 2019-07-23 | 2019-07-23 | N | M123101 | General Medicine | M | GENERAL WARD UNSPECIFIED | Y | 2019-07-23 | 2019-07-23 | 3,025 | 2019-07-23 | null | null | null | null | 27,225 | Procedure Auto Approved,Approved. Kindly, provide all the investigations reports done during admission along with post op mandatory reports at the time of patient discharge. | null | null | null | 2019-07-23 | 4 | 4,235 | NB | null | 2019-07-30 | 2019-08-28 | 2019-07-30 | 27,225 | Kindly provide the clinical notes of all days of LOS. | 2019-08-25 | null | 2019-08-28 | 21,175 | 2019-09-06 | Approved. Case has been considered for settlement basis the merit of the details and documents submitted by hospital. The insurance company and/or SHA reserve the right to audit claims and if found discrepant may reclaim the settled cases. | null | null | null | null | 2019-10-31 | 27,225 | 0 | 0 | null | 2,118 | 19,057 | null | null | null | null | 2 | null | No | null | null | 2019-07-23 16:25 |
CASE/HS17001039/F19900 | Erroneous Claim Rejected by CPD(Insurance) | Vonga Saradhi SHA_INS | 2020-12-09 | 17F17030137915000272 | PKC54SYRD | EPILDA SANGMA | 37 | Female | MEGHALAYA | 7,005,410,821 | MEGHALAYA | SOUTH GARO HILLS | null | null | IP | HS17001039 | Public | TURA CIVIL HOSPITAL | MEGHALAYA | WEST GARO HILLS | 2019-05-17 | 2019-05-17 | N | M123101 | General Medicine | M | GENERAL WARD UNSPECIFIED | Y | 2019-05-17 | 2019-05-17 | 1,200 | 2019-05-17 | Kindly provide the indication for extended hospital stay of the patient with progress sheets and treatment given till date. | 2019-05-28 | We are already uploaded case sheet and Investigations till date kindly contact the treating doctor for further information of the patient here contact no. of treating doctor 9612680557 | 2019-05-28 | 13,200 | Procedure Auto Approved,approved | null | null | null | 2019-05-17 | 2 | 6,000 | NB | 2019-05-27 | null | 2019-10-14 | 2019-06-21 | 13,200 | Kindly specify the reason for transcaton delay of more than 15days where the claim is initiated more than 15 days after the discharge. | 2019-08-28 | Due to network connectivity and lack of staff the claim has been delayed for more than 15 days and initiated after the discharge | 2019-10-14 | 12,000 | 2019-10-26 | Approved as per actual LOS. Case has been considered for settlement basis the merit of the details and documents submitted by hospital. The insurance company and/or SHA reserve the right to audit claims and if found discrepant may reclaim the settled cases but this cannot be considered from next time.prior intimation i... | null | null | null | null | 2019-08-29 | 13,200 | 0 | 0 | 0 | null | 12,000 | 1,200 | 2020-12-05 | null | null | 2 | null | Yes | 2019-08-28 | Please check | 2019-05-17 13:45 |
CASE/HOSP10P10866/F248170 | Claim Amount Paid by Bank(Insurance) | Dr.Shruthi Suddala SHA_INS | 2020-08-03 | 17F45857 | PNZINZK8U | UDAYA PRASAD | 88 | Male | MEGHALAYA | 7,061,138,617 | BIHAR | ROHTAS | null | null | IP | HOSP10P10866 | Private | narayan Medical college and Hospital | BIHAR | ROHTAS | 2019-10-24 | 2019-10-24 | N | M100001 | General Medicine | M | ACUTE GASTROENTERITIS WITH MODERATE DEHYDRATION | Y | 2019-10-24 | 2019-10-24 | 1,800 | 2019-10-24 | null | null | null | null | 12,600 | Procedure Auto Approved,Approved. Kindly, provide all the investigations reports done during admission along with post op mandatory reports at the time of patient discharge. | null | null | null | 2019-10-24 | 1 | 10,800 | NB | null | 2019-10-26 | 2020-01-18 | 2019-10-30 | 12,600 | Kindly provide ICU monitoring sheet for further processing of claim. | 2019-11-13 | AS PER PATIENT REQUESTED DOCUMENT UPLOADED KINDLY FIND AND GIVE APPROVAL | 2020-01-18 | 12,600 | 2020-01-20 | Kindly provide ICU monitoring sheet for further processing of claim. | null | null | null | null | 2020-01-31 | 12,600 | 0 | 0 | null | 1,260 | 11,340 | null | null | null | null | 1 | 24,106 | No | null | null | 2019-10-24 10:32 |
CASE/HOSP29P90337/F281388 | Claim Amount Paid by Bank(Insurance) | Dr.Shyam Sunder SHA_INS | 2020-08-03 | 17F17030217815001250 | PGHUQUELU | KHRISHNA MANDAL | 52 | Male | MEGHALAYA | 9,383,340,365 | MEGHALAYA | SOUTH GARO HILLS | null | null | IP | HOSP29P90337 | Private | VYDEHI HOSPITAL | KARNATAKA | BENGALURU URBAN | 2019-11-22 | 2019-11-22 | N | M600004 | Radiation Oncology | M | LINEAR ACCELERATOR EXTERNAL BEAM RADIOTHERAPY 3D CRT2D PLANNING (RADICALADJUVANT NEOADJUVANT) | null | 2019-11-22 | 2019-11-22 | 50,000 | 2019-11-25 | Kindly provide the consultation sheets and plan of treatment for further processing of the case. | 2019-11-22 | null | 2019-11-25 | 50,000 | Approved. Kindly, provide all the investigations reports done during admission along with post op mandatory reports at the time of patient discharge. | null | null | null | 2019-11-28 | 0 | null | NB | 2020-01-17 | null | 2020-01-18 | 2020-01-18 | 50,000 | null | null | null | null | 50,000 | 2020-01-20 | Approved. Case has been considered for settlement basis the merit of the details and documents submitted by hospital. The insurance company and/or SHA reserve the right to audit claims and if found discrepant may reclaim the settled cases. | null | null | null | null | 2020-02-26 | 50,000 | 0 | 0 | null | 5,000 | 45,000 | null | null | null | null | null | 2,986 | No | null | null | 2019-11-22 15:24 |
CASE/HOSP29P90337/F292741 | Claim Amount Paid by Bank(Insurance) | Dr.Shyam Sunder SHA_INS | 2020-08-03 | 17F17030217815001250 | PGHUQUELU | KHRISHNA MANDAL | 52 | Male | MEGHALAYA | 9,383,340,365 | MEGHALAYA | SOUTH GARO HILLS | null | null | IP | HOSP29P90337 | Private | VYDEHI HOSPITAL | KARNATAKA | BENGALURU URBAN | 2019-12-24 | 2019-12-24 | N | M500010 | Medical Oncology | M | (CERVIX)CISPLATINCARBOPLATIN (AUC2) ALONG WITH RT MAX 6 CYCLES (PER CYCLE) per week | null | 2019-12-24 | 2019-12-24 | 5,000 | 2019-12-24 | null | null | null | null | 5,000 | Approved. Kindly, provide all the investigations reports done during admission along with post op mandatory reports at the time of patient discharge. | null | null | null | 2020-01-08 | 0 | null | NB | 2020-01-09 | null | 2020-03-03 | 2020-01-09 | 5,000 | Kindly provide the ChemoTherapy expiry and batch code chart for further processing. | 2020-03-02 | null | 2020-03-03 | 5,000 | 2020-03-04 | Approved. Case has been considered for settlement basis the merit of the details and documents submitted by hospital. The insurance company and/or SHA reserve the right to audit claims and if found discrepant may reclaim the settled cases. | null | null | null | null | 2020-03-13 | 5,000 | 0 | 0 | null | 500 | 4,500 | null | null | null | null | null | 3,114 | Yes | 2020-03-02 | null | 2019-12-24 12:43 |
CASE/HOSP29P90337/F281405 | Claim Amount Paid by Bank(Insurance) | Dr.Shyam Sunder SHA_INS | 2020-08-03 | 17F17030217815001250 | PGHUQUELU | KHRISHNA MANDAL | 52 | Male | MEGHALAYA | 9,383,340,365 | MEGHALAYA | SOUTH GARO HILLS | null | null | IP | HOSP29P90337 | Private | VYDEHI HOSPITAL | KARNATAKA | BENGALURU URBAN | 2019-11-22 | 2019-11-22 | N | M500010 | Medical Oncology | M | (CERVIX)CISPLATINCARBOPLATIN (AUC2) ALONG WITH RT MAX 6 CYCLES (PER CYCLE) per week | null | 2019-11-22 | 2019-11-22 | 5,000 | 2019-11-25 | Kindly provide the consultation sheets and plan of the treatment for further processing of the claim. | 2019-11-22 | null | 2019-11-25 | 5,000 | Approved. Kindly, provide all the investigations reports done during admission along with post op mandatory reports at the time of patient discharge. | null | null | null | 2019-11-28 | 0 | null | NB | 2019-11-28 | null | 2019-12-07 | 2019-12-07 | 5,000 | null | null | null | null | 5,000 | 2019-12-10 | Kindly, provide chemotherapy drug batch number ,bar code and expiry dates for further processing of claims. | null | null | null | null | 2020-02-26 | 5,000 | 0 | 0 | null | 500 | 4,500 | null | null | null | null | null | 3,645 | No | null | null | 2019-11-22 15:40 |
CASE/HS17006034/N227168 | Claim Amount Paid by Bank(Insurance) | Vonga Saradhi SHA_INS | 2020-07-30 | 17N17060620215000339 | PZISINDT2 | PYNSUKLANG LYNGWI | 29 | Female | MEGHALAYA | 7,005,257,224 | MEGHALAYA | EAST KHASI HILLS | null | null | IP | HS17006034 | Private | NAZARETH HOSPITAL | MEGHALAYA | EAST KHASI HILLS | 2019-10-07 | 2019-10-11 | N | S723164 | Urology | S | CYSTILITHOTOMY | null | 2019-10-07 | 2019-10-11 | 20,389 | 2019-10-12 | Kindly upload initial consultations , clinical assessment notes, clinical examination papers along with diagnosis , and treatment plan, with investigation report supporting diagnosis along with detailed procedure notes, as the same not found uploaded | 2019-10-11 | null | 2019-10-12 | 20,389 | Approved. Kindly, provide all the investigations reports done during admission along with op mandatory reports at the time of patient discharge. | null | null | null | 2019-10-07 | 0 | null | NB | 2019-10-24 | null | 2019-10-24 | 2019-10-24 | 20,389 | null | null | null | null | 15,292 | 2019-11-07 | Claim considered for approval as per policy terms and conditions for discharge against medical advice after surgery. | null | null | null | null | 2019-11-11 | 20,389 | 0 | 0 | null | 1,529 | 13,763 | null | null | null | null | null | null | No | null | null | 2019-10-11 17:29 |
CASE/HS17010001/R240622 | Erroneous Claim Rejected by CPD(Insurance) | Vonga Saradhi SHA_INS | 2020-10-09 | 17R17100704115000399 | P2R407DFC | PRINGCHI CH MOMIN | 20 | Female | MEGHALAYA | 8,419,864,131 | MEGHALAYA | SOUTH WEST GARO HILLS | null | null | IP | HS17010001 | Public | AMPATI CIVIL HOSPITAL | MEGHALAYA | SOUTH WEST GARO HILLS | 2019-10-16 | 2019-10-19 | N | S423126 | Obstetrics & Gynaecology | S | NORMAL DELIVERY WITH EPISIOTOMY AND P REPAIR | Y | 2019-10-16 | 2019-10-19 | 10,000 | 2019-10-19 | null | null | null | null | 10,000 | Procedure Auto Approved | null | null | null | 2019-10-16 | 0 | null | NB | 2019-10-20 | null | 2019-10-22 | 2019-10-22 | 10,000 | null | null | null | null | 7,500 | 2019-11-04 | Approved. Case has been considered for settlement basis the merit of the details and documents submitted by hospital. The insurance company and/or SHA reserve the right to audit claims and if found discrepant may reclaim the settled cases. | null | null | null | null | 2019-11-06 | 10,000 | 0 | 0 | 0 | null | 7,500 | 2,500 | 2020-10-02 | null | null | null | null | No | null | null | 2019-10-19 18:59 |
CASE/HS17002018/R228455 | Erroneous Claim Paid by Bank(Insurer) | Vonga Saradhi SHA_INS | 2020-08-26 | 17R17020130415000254 | POFIJSJEB | RAKEN MARAK | 32 | Male | MEGHALAYA | 9,612,154,296 | MEGHALAYA | EAST GARO HILLS | null | null | IP | HS17002018 | Public | RONGJENG CHC | MEGHALAYA | EAST GARO HILLS | 2019-10-11 | 2019-10-18 | N | M700004 | Emergency Room Packages (Care requiring less than 12 hrs stay) | M | ANIMAL BITES (PAYMENT AFTER COMPLETION OF 5TH DOSE) | Y | 2019-10-11 | 2019-10-18 | 1,400 | 2019-10-18 | null | null | null | null | 1,400 | Procedure Auto Approved | null | null | null | 2019-10-11 | 0 | null | NB | 2019-10-13 | null | 2019-12-23 | 2019-10-21 | 1,400 | Kindly provide the details of 5 doses of vaccine as per package blocked is PAYMENT AFTER COMPLETION OF 5TH DOSE for further claim processing | 2019-11-23 | null | 2019-12-23 | 400 | 2019-12-25 | Approved as per actual Package-ANIMAL BITE (DOG/CAT/RAT) PER DOSE. Case has been considered for settlement basis the merit of the details and documents submitted by hospital. The insurance company and/or SHA reserve the right to audit claims and if found discrepant may reclaim the settled cases. | null | null | 2020-08-14 | 1,000 | 2019-12-26 | 1,400 | 0 | 0 | 0 | null | 400 | 1,000 | 2020-08-03 | 2019-12-26 | 9.12E+11 | 2 | 19,868 | No | null | null | 2019-10-12 14:24 |
CASE/HS17005020/R229750 | Erroneous Claim Paid by Bank(Insurer) | Vonga Saradhi SHA_INS | 2020-08-26 | 17R17050240915001453 | P47MDMO0Q | JOYCY KURBAH | 1 | Female | MEGHALAYA | 8,111,111,111 | MEGHALAYA | RI BHOI | null | null | IP | HS17005020 | Private | HOLY CROSS HEALTH CENTRE UMSAWKHAN | MEGHALAYA | RI BHOI | 2019-10-12 | 2019-10-14 | N | M123107 | General Medicine | M | LRTI | Y | 2019-10-12 | 2019-10-14 | 13,520 | 2019-10-14 | null | null | null | null | 13,520 | Procedure Auto Approved | null | null | null | 2019-10-12 | 0 | null | NB | 2019-10-17 | null | 2019-10-17 | 2019-10-17 | 13,520 | null | null | null | null | 11,855 | 2019-10-31 | Case has been considered for settlement basis the merit of the details and documents submitted by hospital. The insurance company and/or SHA reserve the right to audit claims and if found discrepant may reclaim the settled cases. | null | null | 2020-08-14 | 1,665 | 2019-11-05 | 13,520 | 0 | 0 | null | 1,186 | 10,669 | 1,665 | 2020-08-07 | 2019-11-05 | N309190972889847 | null | null | No | null | null | 2019-10-14 08:59 |
CASE/HS17007020/S172094 | Erroneous Claim Rejected by CPD(Insurance) | Vonga Saradhi SHA_INS | 2021-01-26 | 17S170700300360000004300060 | PIN9ROSTZ | DERILA SUMER | 26 | Female | MEGHALAYA | 7,005,262,900 | MEGHALAYA | WEST JAINTIA HILLS | null | null | IP | HS17007020 | Public | PDENGSHAKAP PHC | MEGHALAYA | WEST JAINTIA HILLS | 2019-09-04 | 2019-09-10 | N | M1123001 | PHC or CHC medical | M | ACUTE GASTROENTERITIS WITH MODERATE DEHYDRATION | Y | 2019-09-09 | 2019-09-10 | 1,000 | 2019-09-10 | Kindly reupload initial consultations , clinical assessment notes, clinical examination papers as uploaded documents are not opening in portal | 2019-09-10 | null | 2019-09-11 | 5,001 | Procedure Auto Approved,Approved. Kindly, provide all the investigations reports done during admission along with post op mandatory reports at the time of patient discharge. | null | null | null | 2019-09-09 | 1 | 4,001 | NB | 2019-09-09 | null | 2020-01-23 | 2019-09-18 | 5,001 | Please provide the clearly scanned discharge summary as the one provided earlier is blur and partially legibfor further processing of claims. | 2019-12-18 | DC SLIP HAS BEEN UPLOADED | 2020-01-23 | 3,000 | 2020-01-26 | Approved as per actual LOS. Case has been considered for settlement basis the merit of the details and documents submitted by hospital. The insurance company and/or SHA reserve the right to audit claims and if found discrepant may reclaim the settled cases. | null | null | null | null | 2019-12-17 | 5,001 | 0 | 0 | 0 | null | 3,000 | 2,000 | 2021-01-25 | null | null | 2 | 21,939 | No | null | null | 2019-09-08 23:58 |
CASE/HS17001059/R181081 | Erroneous Claim Rejected by CPD(Insurance) | Vonga Saradhi SHA_INS | 2021-02-18 | 17R17100707015000365 | PPLX9IEHM | MEDINA SANGMA | 46 | Female | MEGHALAYA | 8,965,491,865 | MEGHALAYA | SOUTH WEST GARO HILLS | null | null | IP | HS17001059 | Private | HOLY CROSS TURA HOSPITAL | MEGHALAYA | WEST GARO HILLS | 2019-09-13 | 2019-09-14 | N | M123101 | General Medicine | M | GENERAL WARD UNSPECIFIED | Y | 2019-09-13 | 2019-09-14 | 1,200 | 2019-09-14 | null | null | null | null | 6,000 | Procedure Auto Approved,Approved. Kindly, provide all the investigations reports done during admission along with post op mandatory reports at the time of patient discharge. | null | null | null | 2019-09-13 | 1 | 4,800 | NB | 2019-09-16 | null | 2019-09-18 | 2019-09-18 | 6,000 | null | null | null | null | 3,000 | 2019-10-04 | Approved as per actual LOS.Case has been considered for settlement basis the merit of the details and documents submitted by hospital. The insurance company and/or SHA reserve the right to audit claims and if found discrepant may reclaim the settled. | null | null | null | null | 2019-10-10 | 6,000 | 0 | 0 | null | 300 | 2,700 | 3,000 | 2021-02-06 | null | null | null | null | No | null | null | 2019-09-14 14:08 |
CASE/HS17007020/F178222 | Erroneous Claim Rejected by CPD(Insurance) | Vonga Saradhi SHA_INS | 2021-01-25 | 17F17070309615001264 | PT4OS2S1A | OLWING MULAD | 37 | Male | MEGHALAYA | 8,787,498,038 | MEGHALAYA | WEST JAINTIA HILLS | null | null | IP | HS17007020 | Public | PDENGSHAKAP PHC | MEGHALAYA | WEST JAINTIA HILLS | 2019-09-09 | 2019-09-12 | N | M1123001 | PHC or CHC medical | M | ACUTE GASTROENTERITIS WITH MODERATE DEHYDRATION | Y | 2019-09-09 | 2019-09-12 | 1,000 | 2019-09-12 | null | null | null | null | 6,001 | Procedure Auto Approved,Approved. Kindly, provide all the investigations reports done during admission along with post op mandatory reports at the time of patient discharge. | null | null | null | 2019-09-09 | 1 | 5,001 | NB | 2019-09-14 | null | 2019-09-18 | 2019-09-18 | 6,001 | null | null | null | null | 5,000 | 2019-10-04 | Approved.Case has been considered for settlement basis the merit of the details and documents submitted by hospital. The insurance company and/or SHA reserve the right to audit claims and if found discrepant may reclaim the settled | null | null | null | null | 2019-10-10 | 6,001 | 0 | 0 | 0 | null | 5,000 | 1,001 | 2021-01-25 | null | null | null | null | No | null | null | 2019-09-12 20:40 |
CASE/HS17006076/R182521 | Erroneous Claim Rejected by CPD(Insurance) | Vonga Saradhi SHA_INS | 2020-12-31 | 17R17060234015002599 | PUXCQ5NEF | DAMESHWA WARJRI | 20 | Male | MEGHALAYA | 8,794,727,143 | MEGHALAYA | EAST KHASI HILLS | null | null | IP | HS17006076 | Private | BETHANY HOSPITAL | MEGHALAYA | EAST KHASI HILLS | 2019-09-14 | 2019-09-15 | N | M123101 | General Medicine | M | GENERAL WARD UNSPECIFIED | Y | 2019-09-15 | 2019-09-15 | 1,200 | 2019-09-15 | Kindly reupload initial consultations , clinical assessment notes, clinical examination papers along with diagnosis and treatment plan as uploaded documents are not opening in portal | 2019-09-15 | KINDLY FIND RE UPLOADED ATTACHMENTS IN SUPPORTING DOCUMENTS | 2019-09-16 | 7,200 | Procedure Auto Approved,Approved. Kindly, provide all the investigations reports done during admission along with post op mandatory reports at the time of patient discharge. | null | null | null | 2019-09-15 | 1 | 6,000 | NB | 2019-09-16 | null | 2019-09-17 | 2019-09-17 | 7,200 | null | null | null | null | 2,400 | 2019-10-02 | Approved. Case has been considered for settlement basis the merit of the details and documents submitted by hospital. The insurance company and/or SHA reserve the right to audit claims and if found discrepant may reclaim the settled cases. | null | null | null | null | 2019-10-10 | 7,200 | 0 | 0 | null | 240 | 2,160 | 4,800 | 2020-12-29 | null | null | null | null | No | null | null | 2019-09-15 15:43 |
CASE/HS17007032/R152377 | Erroneous Claim Rejected by CPD(Insurance) | Vonga Saradhi SHA_INS | 2021-02-04 | 17R17080304615002565 | PNBRP50WE | DEILANGKI NONGTDU | 25 | Female | MEGHALAYA | 7,629,903,850 | MEGHALAYA | EAST JAINTIA HILLS | null | null | IP | HS17007032 | Public | CIVIL HOSPITAL KHLIEHRIAT | MEGHALAYA | EAST JAINTIA HILLS | 2019-08-29 | 2019-08-29 | N | S423081 | Obstetrics & Gynaecology | M | 2ND ANC CHECKUP (USG SCREENING MEDICINES) 1 VISIT | Y | 2019-08-29 | 2019-08-29 | 1,943 | 2019-08-29 | null | null | null | null | 1,943 | Procedure Auto Approved | null | null | null | 2019-08-29 | 0 | null | NB | 2019-08-29 | null | 2019-10-10 | 2019-08-31 | 1,943 | Kindly provide USG report along with other evaluation reports for further processing of the claim. | 2019-10-10 | SHE DIDNT HAVE DONE THE USG | 2019-10-10 | 1,223 | 2019-10-16 | Claim approved as per services provided. Case has been considered for settlement basis the merit of the details and documents submitted by hospital. The insurance company and/or SHA reserve the right to audit claims and if found discrepant may reclaim the settled cases. | null | null | null | null | 2019-10-07 | 1,943 | 0 | 0 | 0 | null | 1,223 | 720 | 2021-01-29 | null | null | 2 | null | Yes | 2019-09-28 | Please query for USG abdomen. | 2019-08-29 13:23 |
CASE/HS17006036/S187908 | Erroneous Claim Rejected by CPD(Insurance) | Vonga Saradhi SHA_INS | 2020-08-04 | 17S170600200970000006100058 | PZHC7OXP3 | TEILISHA SOHTUN | 5 | Female | MEGHALAYA | 9,876,543,210 | MEGHALAYA | EAST KHASI HILLS | null | null | IP | HS17006036 | Public | POMLUM PHC | MEGHALAYA | EAST KHASI HILLS | 2019-09-18 | 2019-09-18 | N | M1123058 | PHC or CHC medical | M | AGE WITH LRTI | Y | 2019-09-18 | 2019-09-18 | 9,464 | 2019-09-18 | null | null | null | null | 9,464 | Procedure Auto Approved | null | null | null | 2019-09-18 | 0 | null | NB | 2019-09-19 | null | 2019-12-09 | 2019-09-19 | 9,464 | Consider as final intimation. Kindly provide Investigated reports for package blocked further claim processing | 2019-11-20 | null | 2019-12-09 | 1,000 | 2019-12-21 | The case is of AGE with LRTI specfic package but No INV reports available and LOS was 1 day referred to higher center. | null | null | null | null | 2019-12-20 | 9,464 | 0 | 0 | 0 | null | 1,000 | 500 | 2020-07-31 | null | null | 4 | 38,941 | No | null | null | 2019-09-18 13:41 |
CASE/HOSP17P84324/F145518 | Erroneous Claim Rejected by CPD(Insurance) | Vonga Saradhi SHA_INS | 2020-12-22 | 17F17040327215000890 | PIBX5WRQH | PHESSTONEWEL DKHAR | 67 | Male | MEGHALAYA | 9,612,799,877 | MEGHALAYA | WEST KHASI HILLS | null | null | IP | HOSP17P84324 | Private | WOODLAND HOSPITAL | MEGHALAYA | EAST KHASI HILLS | 2019-08-24 | 2019-08-25 | N | M123101 | General Medicine | M | GENERAL WARD UNSPECIFIED | Y | 2019-08-24 | 2019-08-25 | 1,320 | 2019-08-25 | null | null | null | null | 6,600 | Procedure Auto Approved,Approved. Kindly, provide all the investigations reports done during admission along with all mandatory reports and documents at the time of patient discharge. | null | null | null | 2019-08-24 | 1 | 5,280 | NB | 2019-08-27 | null | 2019-09-20 | 2019-08-27 | 6,600 | Please provide the clinical notes of all days of LOS. | 2019-09-19 | null | 2019-09-20 | 3,960 | 2019-09-20 | Approved as per actual LOS.Case has been considered for settlement basis the merit of the details and documents submitted by hospital. The insurance company and/or SHA reserve the right to audit claims and if found discrepant may reclaim the settled | null | null | null | null | 2019-09-26 | 6,600 | 0 | 0 | null | 396 | 3,564 | 2,640 | 2020-09-28 | null | null | 1 | null | Yes | 2019-09-10 | Please check | 2019-08-24 16:46 |
CASE/HS17007010/R103478 | Erroneous Claim Rejected by CPD(Insurance) | Vonga Saradhi SHA_INS | 2021-02-17 | 17R17070212715001453 | PCFN1THKJ | DAMANG ALPHONSUS SUCHIANG | 0 | Male | MEGHALAYA | 9,612,355,730 | MEGHALAYA | WEST JAINTIA HILLS | null | null | IP | HS17007010 | Public | JOWAI CIVIL HOSPITAL | MEGHALAYA | WEST JAINTIA HILLS | 2019-07-28 | 2019-07-30 | N | M123101 | General Medicine | M | GENERAL WARD UNSPECIFIED | Y | 2019-07-28 | 2019-07-30 | 1,200 | 2019-07-30 | null | null | null | null | 7,200 | Procedure Auto Approved,Approved. Kindly, provide all the investigations reports done during admission along with all mandatory reports and documents at the time of patient discharge. | null | null | null | 2019-07-28 | 1 | 6,000 | NB | 2019-07-31 | null | 2019-11-21 | 2019-08-16 | 7,200 | Kindly specify the reason for transcaton delay of 16 days where the claim is initiated 16 days after the discharge. | 2019-08-28 | DUE TO VERY SLOW INTERNET CONNECTIVITY WITH HIGH PATIENTS LOADS (NEW REGISTRATION AND DISCHARGE) PER DAYS | 2019-11-21 | 3,600 | 2019-11-30 | Approved as per claimed LOS. Case has been considered for settlement basis the merit of the details and documents submitted by hospital. The insurance company and/or SHA reserve the right to audit claims and if found discrepant may reclaim the settled cases. | null | null | null | null | 2019-08-29 | 7,200 | 0 | 0 | 0 | null | 3,600 | 3,600 | 2021-02-04 | null | null | 1 | null | Yes | 2019-08-28 | Please check | 2019-07-30 14:54 |
CASE/HS17006071/F102432 | Claim Amount Paid by Bank(Insurance) | Vonga Saradhi SHA_INS | 2020-07-30 | 17F17080300615000510 | PEAWCNOIY | LAWANRI BAREH | 17 | Female | MEGHALAYA | 9,774,499,624 | MEGHALAYA | EAST JAINTIA HILLS | null | null | IP | HS17006071 | Public | NORTH EASTERN INDIRA GANDHI REGIONAL INSTITUTE OF HEALTH AND MEDICAL SCIENCES | MEGHALAYA | EAST KHASI HILLS | 2019-07-30 | 2019-07-30 | N | M1023072 | OPD Diagnostics | M | C.T. SCAN CHEST WITH CONTRAST | null | 2019-07-30 | 2019-07-30 | 3,663 | 2019-07-30 | null | null | null | null | 3,663 | Approved. Kindly, provide all the investigations reports done during admission along with post op mandatory reports at the time of patient discharge. | null | null | null | 2019-07-30 | 0 | null | NB | 2019-07-30 | null | 2020-01-13 | 2019-07-31 | 3,663 | Kindly, provide supporting diagnostic report for which claim has initiated for further processing of claims. | 2019-08-08 | null | 2020-01-13 | 3,663 | 2020-01-21 | Approved. Case has been considered for settlement basis the merit of the details and documents submitted by hospital. The insurance company and/or SHA reserve the right to audit claims and if found discrepant may reclaim the settled cases. | null | null | null | null | 2020-01-27 | 3,663 | 0 | 0 | 0 | null | 3,663 | null | null | null | null | 1 | 11,914 | No | null | null | 2019-07-30 10:59 |
CASE/HS17002018/R304165 | Erroneous Claim Paid by Bank(Insurer) | Vonga Saradhi SHA_INS | 2020-08-26 | 17R17020130515001588 | P5EOXCASJ | TAJERA SANGMA | 24 | Female | MEGHALAYA | 8,753,977,080 | MEGHALAYA | EAST GARO HILLS | null | null | IP | HS17002018 | Public | RONGJENG CHC | MEGHALAYA | EAST GARO HILLS | 2020-01-24 | 2020-01-25 | N | S423110 | Obstetrics & Gynaecology | S | NORMAL DELIVERY | Y | 2020-01-24 | 2020-01-25 | 6,300 | 2020-01-25 | null | null | null | null | 6,300 | Procedure Auto Approved | null | null | null | 2020-01-24 | 0 | null | NB | 2020-01-26 | null | 2020-01-29 | 2020-01-29 | 6,300 | null | null | null | null | 4,725 | 2020-01-31 | Approved. Case has been considered for settlement basis the merit of the details and documents submitted by hospital. The insurance company and/or SHA reserve the right to audit claims and if found discrepant may reclaim the settled cases. | null | null | 2020-08-14 | 1,575 | 2020-02-12 | 6,300 | 0 | 0 | 0 | null | 4,725 | 1,575 | 2020-08-03 | 2020-02-12 | 2120622429 | null | 2,703 | No | null | null | 2020-01-25 15:25 |
CASE/HS17002018/F302261 | Erroneous Claim Paid by Bank(Insurer) | Vonga Saradhi SHA_INS | 2020-08-26 | 17F17020136415000698 | PQDX086TC | GORETI N SANGMA | 29 | Female | MEGHALAYA | 9,863,536,898 | MEGHALAYA | EAST GARO HILLS | null | null | IP | HS17002018 | Public | RONGJENG CHC | MEGHALAYA | EAST GARO HILLS | 2020-01-20 | 2020-01-21 | N | S423110 | Obstetrics & Gynaecology | S | NORMAL DELIVERY | Y | 2020-01-20 | 2020-01-21 | 6,300 | 2020-01-21 | null | null | null | null | 6,300 | Procedure Auto Approved | null | null | null | 2020-01-20 | 0 | null | NB | 2020-01-22 | null | 2020-01-25 | 2020-01-25 | 6,300 | null | null | null | null | 4,725 | 2020-02-01 | Approved. Case has been considered for settlement basis the merit of the details and documents submitted by hospital. The insurance company and/or SHA reserve the right to audit claims and if found discrepant may reclaim the settled cases. | null | null | 2020-08-14 | 1,575 | 2020-02-07 | 6,300 | 0 | 0 | 0 | null | 4,725 | 1,575 | 2020-08-03 | 2020-02-07 | 2076006398 | null | 9,935 | No | null | null | 2020-01-21 13:24 |
CASE/HS17007010/R300974 | Erroneous Claim Rejected by CPD(Insurance) | Vonga Saradhi SHA_INS | 2021-04-19 | 17R17070118715000307 | P8KFHJH3Y | MOR PHAWA | 71 | Male | MEGHALAYA | 7,638,931,006 | MEGHALAYA | WEST JAINTIA HILLS | null | null | IP | HS17007010 | Public | JOWAI CIVIL HOSPITAL | MEGHALAYA | WEST JAINTIA HILLS | 2020-01-16 | 2020-01-17 | N | M123101 | General Medicine | M | GENERAL WARD UNSPECIFIED | Y | 2020-01-16 | 2020-01-17 | 1,200 | 2020-01-17 | null | null | null | null | 7,200 | Procedure Auto Approved,Approved. Kindly, provide all the investigations reports done during admission along with all the mandatory reports at the time of patient discharge. | null | null | null | 2020-01-16 | 1 | 6,000 | NB | 2020-01-21 | null | 2020-01-24 | 2020-01-24 | 7,200 | null | null | null | null | 6,000 | 2020-01-26 | Approved. Case has been considered for settlement basis the merit of the details and documents submitted by hospital. The insurance company and/or SHA reserve the right to audit claims and if found discrepant may reclaim the settled cases. | null | null | null | null | 2020-02-07 | 7,200 | 0 | 0 | 0 | null | 6,000 | 1,200 | 2021-04-10 | null | null | null | 2,226 | No | null | null | 2020-01-17 12:05 |
CASE/HS17006024/R298079 | Claim Amount Paid by Bank(Insurance) | Vonga Saradhi SHA_INS | 2020-07-30 | 17R17080300315002228 | P7P8KNHEE | SHWA BANG | 49 | Female | MEGHALAYA | 9,612,647,749 | MEGHALAYA | EAST JAINTIA HILLS | null | null | IP | HS17006024 | Public | CIVIL HOSPITAL SHILLONG | MEGHALAYA | EAST KHASI HILLS | 2020-01-06 | 2020-01-10 | N | M123101 | General Medicine | M | GENERAL WARD UNSPECIFIED | Y | 2020-01-06 | 2020-01-10 | 1,200 | 2020-01-10 | null | null | null | null | 16,800 | Procedure Auto Approved,Approved. Kindly, provide all the investigations reports done during admission along with all the mandatory reports at the time of patient discharge. | null | null | null | 2020-01-06 | 3 | 4,800 | NB | 2020-01-18 | null | 2020-01-21 | 2020-01-21 | 16,800 | null | null | null | null | 14,400 | 2020-01-23 | Approved. Case has been considered for settlement basis the merit of the details and documents submitted by hospital. The insurance company and/or SHA reserve the right to audit claims and if found discrepant may reclaim the settled cases. | null | null | null | null | 2020-02-05 | 16,800 | 0 | 0 | 0 | null | 14,400 | null | null | null | null | null | 2,310 | No | null | null | 2020-01-07 12:38 |
CASE/HS17007032/F299509 | Erroneous Claim Rejected by CPD(Insurance) | Vonga Saradhi SHA_INS | 2021-02-18 | 17F17080308317000119 | PLCJ6IUPF | SAVIOUR SHADAP | 2 | Male | MEGHALAYA | 8,837,202,627 | MEGHALAYA | EAST JAINTIA HILLS | null | null | IP | HS17007032 | Public | CIVIL HOSPITAL KHLIEHRIAT | MEGHALAYA | EAST JAINTIA HILLS | 2020-01-13 | 2020-01-14 | N | M1123079 | PHC or CHC medical | M | GENERAL WARD UNSPECIFIED | Y | 2020-01-13 | 2020-01-14 | 1,050 | 2020-01-14 | null | null | null | null | 5,250 | Procedure Auto Approved,Approved. Kindly, provide all the investigations reports done during admission along with all the mandatory reports at the time of patient discharge. | null | null | null | 2020-01-13 | 1 | 4,200 | NB | 2020-01-16 | null | 2020-01-21 | 2020-01-21 | 5,250 | null | null | null | null | 3,150 | 2020-01-23 | Approved. Case has been considered for settlement basis the merit of the details and documents submitted by hospital. The insurance company and/or SHA reserve the right to audit claims and if found discrepant may reclaim the settled cases. | null | null | null | null | 2020-02-05 | 5,250 | 0 | 0 | 0 | null | 3,150 | 2,100 | 2021-02-09 | null | null | null | 2,202 | No | null | null | 2020-01-14 14:14 |
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