Post on 18-Mar-2020
Operational Manual
1
MA-YOJNA
Hospital Transaction
Operational Manual
Version: 2.1
This document contains information of a proprietary nature.
ALL INFORMATION CONTINED HEREIN SHALL BE KEPT IN CONFIDENCE.
Operational Manual
2
Abbreviations ................................................................................................... 3
1. Introduction ........................................................................................... 4
2. Login ....................................................................................................... 5
2.1. Login Page .................................................................................. 5
3. Patient Registration ............................................................................... 6
3.1. Patient Verification ....................................................................... 6
3.2. Patient Registration ....................................................................... 8
4. Patient Diagnosis and In-Out Patient ................................................... 9
5. In patient Case Search ......................................................................... 15
6. Preauthorization .................................................................................. 17
7. Additional Preauthorization................................................................ 24
8. Claim Management .............................................................................. 26
9. Dialysis Process .................................................................................... 44
10. Seating Verification ............................................................................. 48
11. Follow-up .............................................................................................. 53
Operational Manual
3
Abbreviations
MA Mukhyamantri Amrutum
AM Arogya Mitra
HAM Hospital Arogya Mitra
ISA Implementation Support Agency
PRF Preauthorization Request Form
CTF Claim Transmittal Form
MAV Mukhyamantri Amrutum Vatsalya
Operational Manual
4
1. Introduction
Basic features of this application consist of following modules
Patient Registration and Verification
Patient Diagnosis & In-Out Patient
In-Patient Case Search
Pre Authorization
Additional Pre-Authorization
Claim Management
Billing And Claim
Operational Manual
5
2. Login
2.1. Login Page
First of all, visit the login page of MA YOJNA and enter the username and password of AM (Arogya Mitra).
Operational Manual
6
3. Patient Registration
3.1. Patient Verification
Click on the patient Registration and enter the MA URN and card code of beneficiary.
Operational Manual
7
To verify the patient, capture patients/ relative’s photo and verify fingerprint and click on submit.
Operational Manual
8
3.2. Patient Registration
Now AM enters the patients details and select patient source and click on submit.
After submitting the details of patients, patient is registered and patient ID is generated. After that patient registration slip is generated.
Operational Manual
9
4. Patient Diagnosis and In-Out Patient
Enter Username and password of HAM. (Hospital Arogya Mitra)
Go to the cases tab and Click on Registered cases and select particular patient records.
Operational Manual
10
HAM have to select require tests and click on send to Test if Test is required. (To do the in patient process)
Operational Manual
11
Diagnosis Test Report Slip is generated for patient medical test.
Next Go to Cases tab, click on Pending for Test Result and select particular patient record.
Operational Manual
12
Attach test reports and click on Out-Patient if require no more treatment.
Operational Manual
13
If treatment is not required then outpatient slip is generated.
Attach test reports and click on In-Patient if patient require more treatment.
Operational Manual
14
If patient require more treatment then In patient Slip is generated.
Operational Manual
15
5. In patient Case Search Go to Cases tab, click on Case Search
Operational Manual
16
Click on Inward Status, select In Progress and the particular record status named “In Patient Case Registered”
Above page show patient Information.
Click on Investigation tab and upload diagnosis reports.
Operational Manual
17
6. Preauthorization
Enter treating doctors and cluster details and click on save.
Operational Manual
18
Upload pre authorization Documents (Compulsory to Upload).
PRF (Pre Authorization Request Form) is compulsory to upload.
Operational Manual
19
Enter Remarks and submit details for approval.
After entering approval Details pre authorization slip is generated.
Operational Manual
20
Enter username and password of Level 1 Approval.
Go to cases tab and then select case search for searching cases in pre auth.
Operational Manual
21
Select Inward status “Preauth updated” and patient data in pre auth level 1 approval.
Doctor verifies details of patient and will give approval.
Operational Manual
22
Enter remarks and send case to HAM for query.
Enter Username and password of HAM.
Go to Cases tab, select Inward status “Preauth Approved” and select particular patient record.
Operational Manual
23
Enter remarks and Submit details for Approval again.
Doctor verify details and given approval for treatment.
After approving Preauth request by doctor level, preauth amount is blocked and beneficiary balance is deducted.
Operational Manual
24
7. Additional Preauthorization
Go to Cases tab, select “Request for Additional Preauth” and select particular patient record.
Operational Manual
25
Select new clusters details and click on submit.
Operational Manual
26
8. Claim Management
Enter Username and password.
Operational Manual
27
Go to Cases tab, select Inward status “Preauth Approved” and select particular patient record.
8.1. Operation Notes
Click on operation notes tab and update doctor details
Select No changes if there is a no change in cluster decided for operation.
If HAM finds that there is a partial change in cluster then HAM have to select Partial change.
If HAM finds that there is complete change in cluster selection (all cluster changes) then HAM has to select Full change.
Operational Manual
28
Upload documents and Post Operation photo of patient.
Update operation notes and click on Submit
Upload post investigation reports and click on Submit.
8.2. Patient Discharge
Operational Manual
29
Click on Discharge Summary tab to do discharge process.
Discharge Summery Documents are compulsory.
Satisfaction letter and Transportation cost Acknowledgement is essential for discharge.
Operational Manual
30
Taking a picture of patient and give him/her as a transportation cost of Rs. 300.
Operational Manual
31
8.3. Patient Discharge Verification
Enter Username and Password of AM
Go to cases tab and select Discharge Verification for discharge verification.
Select particular patient for discharge verification.
Operational Manual
32
Capture Photo, Verify Fingerprint and click on Submit.
Operational Manual
33
Enter Username and Password of HAM.
Operational Manual
34
Go to Cases tab and Select Case search. And select inward status as In Progress.
Now click submit to discharge Patient.
Operational Manual
35
Discharge Summary Slip of Patient.
Click on save billing to generate invoice.
Add MA Invoice and Hospital Invoice in Add/View Attachment and Submit claim.
Operational Manual
36
Invoice of patient.
Operational Manual
37
Go to Claim Status to Submit Physical file.
Physical File pending for Submit by HAM. Select file and Submit.
Operational Manual
38
Enter Username and password of ISA.
Operational Manual
39
Go to Cases tab and click on claim status.
Select claim status “Physical File Pending for Receive” and select particular patient record and Click on Receive Button.
Operational Manual
40
Select claim status “Physical File Received” and select particular patient record by click on inward number.
ISA can select particular case if the case is of Dialysis. Status of rest of the cases will remain as visit done.
Operational Manual
41
Enter approved amount, remarks and process the claim. ISA can send claim to HAM if any query.
Claim Approval Certificate will get generated.
Operational Manual
42
Go to Claim Status and Select “Claims pending for Submit” Select patients records and submit.
Go to Claim Status and Select “Claim Submitted by ISA1” Select patient record to generate CTF Report. ISA1 to ISA2 CTF Report will get generated.
Operational Manual
43
Operational Manual
44
9. Dialysis Process
After getting patient verified from AM, in particular HAM’s Login select cluster 5.142 (Haemodialysis work for this cluster only).
Complete the process flow as similar in normal cases till discharge tab.
Operational Manual
45
Do not go to the billing process after that.
After getting patient verified from AM, Login with HAM and go to the Register Cases tab.
Fill the details and Select Is Dialysis Treatment and Inward number of last Dialysis before submitting in Patient.
Operational Manual
46
After submitting in patient, Complete the process flow as similar as in normal cases till Investigation tab.
Add Post Investigation Reports and submit it .
Preauth Details and Operation Notes tabs will remain filled as it is and Stay disabled i.e. there is no need to fill that tab.
After Investigation tab, Only discharge tab is need to get submitted.
Operational Manual
47
Go to the billing tab only when the whole dialysis process gets completed.
Operational Manual
48
10. Seating Verification
Go to the Cases and Select Seating Verification Search tab.
After selecting that,In Seating Verification status select Pending with HAM and select
specific case.
Operational Manual
49
When the case get selected ,Message of seating verified from HAM will get generated.
After getting Verified from HAM, Login with AM.
Select Cases and in that Select Seating Verification Search in that.
Operational Manual
50
After selecting that,In Seating Verification status select Pending with AM and select
specific case and verify that case.
Add FP verify and Photo and submit the case.
After Submition,Verification Done message will get displayed.
Operational Manual
51
Again Go to the HAM , and in Seating verification , Verified case will get displayed.
Operational Manual
52
Operational Manual
53
11. Follow-up
Login with AM, Go to the Cases and select Follow-up.
In that select specific case.
After that Follow-up Verification Slip will get generated.
Operational Manual
54
Login with HAM, and go to the Followup case search tab.
In that select specific case in Case Registered.
Fill Details, Save details and Submit it.
Operational Manual
55
After Submission, Followup Saisfactory Letter will get generated.
When Followup of specific case will be done, it will be displayed in Visit done.
Operational Manual
56
Operational Manual
57
THANK YOU