Medical Examination Portal - Area Doctor Login
Contents
1. 7 Infotech Innovation Insight Integrity TM Taking the risk out of insurance Pre Insurance Medical Examination Portal Operational Manual Area Doctor Login EP Infotech Innovation Insight Integrity iring Insurance Copyright Information used in this document is subject to change without notice Companies names and the data used in the examples herein are fictitious unless otherwise noted No part of this document can be reproduced or transmitted in any format by any means electronic or mechanical for any purpose without permission of 3i Infotech Ltd Any documentation or information for external use such as advertising press releases or promotional materials requires prior written approval from 3i Infotech Ltd Copyright 2012 3i Infotech Ltd All rights reserved Disclaimer This documentation has been produced to complement the software developed and marketed by 3i Infotech Ltd a registered Indian company with limited liability The document accompanies the software made available through a license This document has been created with good intention and the company does not take responsibility if it is put to for any malicious use The document is original in content and presentation and is protected by international copyright law Hence the company places restriction on any part of the written material being disclosed or reproduced Though the document ha2. Corporate Doctors The Area Zonal Corporate Doctors are only authorized to select PED in web portal from list of values which will automatically fetch in to PREMIA Policy Schedule will display the relevant wordings of PED selected by the Doctors EP Infotech y AR nem gt Personal amp Caring Insurance Innovation Insight Integrity The Health Insurance Specialist Operational Flow UNDERWRITER QE D p Call to fix appointment website Test Conducted Diagnostic Center AREA DOCTOR LOGIN When a Medical Doctor of Area Office logs on to the MER portal they are able to check the lab reports available for review The medical doctor is able to LJ View the uploaded proposal MER and the documents Q Enter the Pre Existing Disease if any Q Enter their comment suggestion in the proposal If the report is critical they decided to escalate to Zonal Corporate doctor for approval Analyze and Confirm the Medical Report To analyze and confirm medical reports submitted by lab 1 Logon to MER web portal with the login credentials of Area Doctor 2 Enter the URL provided to you in the address bar of the Internet Explorer screen and then click Go The Medical Doctor Portal login screen is displayed as shown below EP Infotech STAR ie iring Insurance Innovation Insight Integrity The Health Insurance Specialist 3 Infotech Username SH7326 Password 3
3. Enter the valid and unique Username and Password in the spaces provided 4 Click Submit to login 5 Click Reset to reset the password The system displays the message Authentication Failed if a wrong password is entered On successful login the Welcome page is displayed which comprises of the following menus and sub menus LJ Masters main menu o Maintenance sub menu e Change Password sub menu Q Transactions main menu o Medical Confirmation sub menu EP Infotech STAR ream iring Insurance Innovation Insight Integrity Th e h Insurance Specialist MASTERS Change Password The Change Password sub menu enables you to change the login password as shown below Old Password Hew Password Confirm Password Fields marked with are mandatory TRANSACTIONS Medical Confirmation The Medical Confirmation menu is applicable for Area Medical Doctor to take a decision on the medical test report uploaded for the insured person The decision can be Q Approve with or without PED details Q Deny Q Pass to Zonal Corporate Doctor approval LI Suggest for retest additional test To search for the medical confirmation records 1 Click Transactions Medical Confirmation The system displays the Medical Confirmation List screen as shown below 3j Infotech Proposal No Request Type 2 Select the Request Type as Lab
4. PED Block Q PED Pre Existing Disease Q ICD Chapter LY ICD Block u ICD Code L Remarks The screen displays Doctor Remarks 1 Enter the doctor s remarks in the space provided 2 Click Save to save the appointment details View Documents On clicking this hyperlink the system enables you to view uploaded reports and documents of various formats 1 Click View Documents The screen displays the window to upload the documents as shown below EP Infotech Innovation Insight Integrity iring Insurance The Health Insurance Specialist F http 192 168 1 237 80872 Upload Documents Windows Internet Explorer p Saks p cu Proposal Form Proposal Form pdf View Report Insured Photo Raj JPG View Seport BLOOD TEST Blood Sugar Report jpg View Report Et ECG IPG View Report GEN DOT General Physician Report jpg View Report View All All uploaded Documents can be viewed in one PDF and individually 2 Click View Report hyperlink to view the uploaded report type The system displays the File Download dialog box to open and view the report as shown below File Download Do you want to open or save this file pa Name Proposal Form pdr dae Type Adobe Acrobat Document 1 47 MB From 192 168 1 257 harm your computer IF you do not trust the source do not open or G While files from the Internet can be useful some files can potentially save this fle What s the
5. Submit and then click Search The system displays the list of medical reports submitted by the Diagnostic Lab and pending for Area Manager approval as shown below EP Infotech Innovation Insight Integrity er sring Insurance The Health Insurance Specialist Welcome Dr Rupali Last Login 5 11 2012 11 37 05 AM Medical Confirmation List Proposal Ho Request Type Lab Submit This will populate the entries which are all submitted by Diagnostic Lab and pending for Area Manager Approval Se Le R 322200 01 2012 001920 RISK 5 Male 19 4PR 1958 9444227402 Hitech Diagnostic Centre T Nagar IS MAY 2012 Analyse R 322200 01 2013 000451 RAJENDAR Male 10 MA 1954 9897984061 Hitech Diagnostic Centre T Nagar 12 MA 2012 Analyse R 322200 01 2013 000451 RANI Female 27 MAR 1957 9897984061 Hitech Diagnostic Centre T Nagar 11 May 2012 Analyse The screen displays the following details as listed below LJ Proposal No Insured Name Gender Date of Birth Phone Number Lab Name DOODO DOO Date of Appointment Q Medical Confirmation 3 Click Analyse hyperlink as shown in the screen above under the medical confirmation heading to view the details of the selected proposal number The screen is as shown below EP Infotech Innovation Insight Integrity The Health Insurance Specialist Policy Details Proposal Ho P S222 0001 2013 000451 System Entry Date TUMAY Product Hame Mecdic
6. risk EP Infotech TAR en Insurance Innovation Insight Integrity The Health Insurance Specialist 3 Click Open The proposal form in PDF format displayed is shown below Proposal Form No Star Health And Allied Insurance Company Limited Regd amp Corporate Office 1 New Tank Street Valluvar Kolttam High Road Nungarmbakkam Chennai 600 034 Phone 044 28288800 Telefax 044 28260062 Website www starhealth n ith wl i ill A Ein al PROPOSAL FORM The company will not be on risk until the proposal has been accepted and full payment of premium has been received C A a Business Urban Rural Policy Issuing Office Please fill up the form in block letters Also submit photograph of each person proposed for insurance for issuance of identity cards Name of the proposer Address 1 Residence ee en o e Please tick the policy opted Mediclassic C Family Health Optima Super Surplus Heakh Gain C Criticare Plus Family Health Optima Plan Please Tick Family Health Optima Sum Insured Opted Please Tick 2A tate tav2c tava 2asic 2A 2c 2A 3C eA Lakh Z2Lakhs Z3Lakhs C4 Lakhs FS Lakhs 10 Lakhs 715 Lakhs C E I A A Re RT Annual Premium 7 Payment Details Details of persons proposed for insurance Ploase fill in the respective column for each of the person proposed to be covered S No Sex Refetionsnip Height Weight
7. this proposal number The screen is as shown below with details Click Add to add multiple PED for a single risk Sid Infotech FAR seam gt s Insurance Innovation Insight Integrity The Health Insurance Specialist PED Block PED Select the check box if no PED is added Otherwise delete the added PEDs and then select the check box ICD Chapter Click the hyperlink to delete the PED IU Ho PED ICD Chapter ICD Block ICD Coide Remarks Add Ats 01 AOO B99 Certain infectious and Intestinal parasitic diseases infectious diseases Add Cholera due to Exclusion for treatment of Vibrio cholerae 1 diseases related to biovar etor CardioVascular System HEART DISEASES 03 D50 D89 Diseases of the blood and BRAIN SPIHAL blood forming organs and certain CORD DISORDES disorders involving the immune mechanism DiO Di4 Aplastic and other anaemias D608 Other acquired Exclusion for All Heurological oo ee Delete pure red cell aplasias and related Complications If there is no PED added for the proposal 3 Select the No PED checkbox To delete a PED 4 Click Delete hyperlink against the respective PED Recording Medical Doctor s Remarks Enter medical doctor s remark in Doctor Remarks text box provided as shown below Doctor Remarks Doctor Remarks Pre existing diseses are mentioned 5 Click Save to save the entered information in the PED Blo
8. CD Block ICD Code Remarks HYPERTENSION 02 COO D 48 C30 C39 Respiratory and C30 0 Hasal Exclusion for Hypertension and its complications Heoplasms intrathoracic organs cavity including target organ damage Delig Doctor Remarks Doctor Remarks The proposal has to be rejected due to high risk 2 Click Reject The proposal is rejected Escalate Clicking this button signifies assigning the activity of a particular PED to the higher authority for verification Following the verification activity the proposal gets confirmed and approved 1 Enter the remarks for escalation in the Doctor Remark s text box as shown below Doctor Remarks Doctor Remarks Escalated to Zonal DOetor for further verification User ID User Hame Remarks Date Remarks SHf7326 Dr Rupali 4202012 11 55 54 AM Two PEO selected 2 Click Save to save the entered remarks 3 Click Escalate to assign the respective PED to the higher authority The screen is as displayed below EP Infotech SFAR rem Innovation Insight Integrity Personal amp Caring Insurance The Health Insurance Specialist A http 4 192 168 1 237 8082 Assign Higher Authority Win E Choose Office 110000 Zonal Office Chennai Ww 110000 Zonal Office Chennai Doctor Remarks SUO0UK Corporate Office se 4 Select from Choose Office drop down list the option Zonal Office to escalate the proposal
9. ck Upon saving the records get saved successfully Ensure that the PED s selected are correct Each remark given by the Doctor is recorded with Doctors Name Date and Time stamp as highlighted and shown below EP Infotech STAR e a iring Insurance Innovation Insight Integrity nsurance Specialist Doctor Remarks Doctor Remarks User ID User Hame Remarks Date Remarks SH7326 Dr Rupali 420 2012 11 55 54 AM Two PED selected Accept Reject Escalate the Proposal The following are the four options to proceed with Medical Confirmation and the available options are Q Accept Q Reject Q Escalate Accept Clicking this button signifies accepting the proposal with or without PED records successfully 1 Enter Doctor Remarks as required for accepting the proposal as shown below PED Block ICD Chapter ICD Block ICD Code Remarks Aad Hino Pen Doctor Remarks Doctor Remarks Wo FED is identified from best result View Documents zl Reject ReTest Escalate Back 2 Click Accept The Proposal is sent to Underwriter for policy conversion Reject On clicking this button the medical doctor is able to reject the proposal due to various reasons 1 Enter Doctor Remarks as required for rejecting the proposal as shown below Sid Infotech FAR ue gt s Insurance Innovation Insight Integrity The Health Insurance Specialist PED ICD Chapter I
10. e main objectives of this document are Q Introduce you to all the features available in the application Q Familiarize you with the various conventions used in the product Q To function as a reference manual and user guide to all the functionalities and features of this application LY Help you perform various setups and transactions by guiding you through the relevant screens methodically DOCUMENT ICON LIBRARY In order to draw your attention to certain important points icons are used as easy indicators Use this Document Library to identify these icons in the user guide ee cs A note or additional information useful to you Important information that you need to keep in mind while using the application Provides you details of error messages encountered in the application EP Infotech TAR nam iring Insurance Innovation Insight Integrity he Health Insurance Specialist Introduction For any issuance of a policy medical checkup is mandatory for insured of age 50 years and above This is done to ascertain the existence of pre existing disease If there is any pre existing disease then the details have to be mentioned in policy contract to express the conditions If there is any such case then the policy is not converted or the coverage is not provided for the particular hospitalization Insurance is a product that is supposed to cover people with similar risk at similar cost While two people are prop
11. eek eee Corre arene 4 D cu ument icon LID ANY cosis Naai 4 About Medical Examination Report MER Porrtal cccccssssssseeeseeeesseeeseeenseeeeseeesneeesseoenes 5 Area DOCO COGI csee R E EA EE sete eos eeweete rennet 6 Analyze and Confirm the Medical Report cccccsssssseeeeeeeeeccesnsneeeeeeseeceenseseeeeeeeeoeenenseeeees 6 Masiero aE EE EEE E EEE E E E aa 8 Change PAS SW ON acces cau sina tease cee ae aaa aaO Ea TORE SEEE EAE 8 ansa Hons oren A E E E 8 Medical COnfirimatlO iiscceiiesevcasacssncesdennstosesreatuirecuutuwaantcinsaieatutnwensxnivad ecentaiuanveswedensiinsineredewudenswiuans 8 Recording Pre Existing Disease PED Block cccssssceesesseeeeenseeseeesseeeoenseeseenseeseeeneeesonas 15 Recording Medical Doctors REMarks ccccccseeesseeeeeeenseeeeeeeesseeeseeesseeeseoesseeeseoeenseeesens 16 Accept Reject Escalate the Proposal cscccceesseesesseeeeenseeeeeenseesenseesoenseeeeeeseessoeaseeses 17 EP Infotech STAR am s iring Insurance Innovation Insight Integrity The Health Insurance Specialist About This Guide This User Guide familiarizes the Medical Doctor at Area Office with various features and functionalities of the MER web portal integrated with PREMIA application to analyze and approve the proposal details medical test reports and pre existing declared in proposal submitted by the Lab in a systematic and step wise manner OBJECTIVES Th
12. esentatve Sianature of the nronoser Version 1 0 Page 13 of 21 ef Infotech Innovation Insight Integrity The Health Insurance Specialist 4 Click View All to view all the uploaded reports against the proposer in a single click mode in one PDF format A sample screen showing few reports is shown below yr AR Star Health And Alhed Insurance Company Lim tod Regt a Seepree Bien tar ue Dun smon none gt a eects s lu sapag OO ta ta moies raf ts popiamg M58 beos cepted oas t pyr FTE ee ns Bees i tesscsat Wane T 4 Wian as te d ene FO p ta tam ed etan Al eame empe n oas penen pmpases te Seems te peamma s memm nern Ree sre e snee es s o eee uam eee u ue PATHOLOGICAL LAS OORT DRT PEDER OCE 4 ARORA HORE ie ME BARA Ne Ww DAT Dee r mia ete Chee TESIT S wate ea tts om OAST be Seer eer m hR aL CL Coe ene te eee Daw i I p Hepta d ATA A CO ee A te ues auus j ta us Arauan mo ax nur SOUR ROOT MEET re tae HEHHEHE 10 mm 1 mV SEREEEEL BADEA RA EHET 0 2 0 4 0 6 0 8 Time sec P wave 0 08 0 10 s ORS 0 06 0 10 s P R interval 0 12 0 20 Q T interval lt 0 44 s QT QT oo Coolant Analysis Ar eee paa we MAN uI e pw Arve e toore wn gt a Cortes Ge Lbehe Iegis he C4 08 R8 Soretved Tete tates te serial m iim i open eit Seserigeioe Coser Piatt bron
13. i Arnal Proof of date of berth Birth Certificate Voter JD Pan card Driving License UID Any other proof Attach copy Affix Afix Allix Allix Affix Photographs Photographs Photographs Photographs Photographs Norninaton Narn Relationship with proposer Family physician s Name Phone No Place Prohibition of rebates Section 41 of the Insurance Act No person shall alow or offer to allow either directly or indirectly as inducement to take out renew or continue an insurance in respect of any kind of risk relating to Ives or property in India ary rebate of the whole or part of the commission payable on the premium shown on the policy nor shal any person taking out renewing of continuing a policy accept any rebate except such rebate as may be allowed in accordance with the pubished prospectus or lables of the Insurer Any person making default in complying with the provision of this section shall be punishable with ine which ma nd to five hundred rupees lam aware that the acceptance of this proposal is subject to the evaluation of the risks based upon the details given by me in Mis proposal and the medical examination repors of proposed persons if applicable from hosptablaboratory referred by the insurer Place Date Signature of the proposer Acknowledgement Received the proposal for__Paficy from Mr Mrs As along wilh paymant of Ze by Cash vide Cheque No dated drawn on The cash cheque given by you is banked for operational conven
14. i Type e Reconwremtston FERTSSR POINT APPCAAS Ela SRROU TON METALIN AXE HIGH BROCCO DRAIN AND FLOUR COOLANT POJEST YOU AUF THE ANTLVESERIE MATEDS VWIETURE TO A 10 50 MIETURE ILOLE YE ALFALINTTY APPEARS Le meih 3 Bewwlt Condition niau atca Version 1 0 Page 14 of 21 EP Infotech STAR ue sring Insurance Innovation Insight Integrity The Health Insurance Specialist You can also click View Report against the Report Type to view the corresponding report 5 Click Submit The entries are posted and queued in Diagnostic Lab s Log in Recording Pre Existing Disease PED Block The PED Block screen is displayed as shown below PEO Bhock ICD Cheaper IED Mock IED Cade 1 Select the appropriate pre existing disease from PED drop down list The screen is as displayed below Based upon the type of PED selected the system automatically displays the remarks about the disease in the Remarks field PED Block PED HEART DISEASES w ICD Chapter 03 050 D89 Diseases of the blood and blood forming organs and certain disorders im eee D50 D53 Nutritional anaemias Haemolytic anaemias Pr Aplastic and other anaemias Coagulation detects purpura and other haemorrhagic conditians Other diseases of blood and blood forming organs Certain disorders involving the immune mechanism Remarks 2 Click Add The PED s are added for
15. ience and banking of the cash cheque does not mean acceptance of risk by us The receipt of the cash cheque wil also be acknowledged by our office vide advance premiurn receipt inrespectof proposer s referred for medical examination If the proposal is accepted the cover wil commences form the date of the advance premium receipt subject io reabzation of the cheque Fihe proposals not accepted ihe amount paid wibe refunded by our cheque Reimbursement af hospital expenses wilde in proportion to the room rent mentioned in the policy Signature of the Insurer Authonsed Representative Signature of the proposer Star Health And Allied Insurance Company Limited Proposal Form No Acknowledgement Received the proposal for Pobcy from MrJMrs Ms along with payment of j by Cash vide Chague No dation drawn on The cash cheque given by you is banked for operational convenience and banking of the cash cheque does nol mean acceptance of risk by us The receipt of the cash cheque will also be acknowledged by our office vide advance premium receipt in respect of proposer s referred for medical examination If the proposal is accepted the caver wii commence form the date of the advance pramiurn receipt subject to realization of the cheque Il the proposallis not accepted the amount paid wil be refunded by our cheque Reimbursement of hospital expanses willbe in proportion to the room rent mentioned in the policy Stonature of the Insurer Authorsed Reor
16. lassic Individual Policy lssuing Office Star Test Office Proposer Hame RANJEET VERMA Proposer Adklress SO SHRI DAUDAYAL VERMA SARAY RAY HEAR PAKKI SARAY ALIGARH Insured Hame RAJENDAR Insured DOB TOMA 1954 Gender Male Sumi Insured 200000 Mobile Humber 2897984061 Proposal PED HYFERTEHSIOH Package Details Diagnostics Package PACKAGE 1 2 Test Details General Physician Examination Fasting Blood Sugar Serum Creatinine ETG Urine Routine Doctor Remarks Lab Remarks Heports attached Hard copy is being sent thru the client PED Block PED Select ICD Chapter Select ICD Block Select ICD Code Select Remarks no PED Doctor Remarks Doctor Remarks The screen displays the following Proposal details Q Proposal No Version 1 0 Page 10 of 21 ff Infotech _ Personal amp Caring Insurance Innovation Insight Integrity he Health Insurance Specialist UY System Entry Date Product name Policy Issuing Office o 0 Q Proposer Name with address 0 Insured Name with DOB and Gender OY Sum Insured LI Proposed PED The screen displays the following Package Details Q Diagnostics Package the Medical Test Package will automatically get displayed based on Age Sum Insured and Product Q Test Details the list of medical tests undergone by the insured person The screen displays Doctor Remarks LI Displays the lab remarks The screen displays
17. osing for a health insurance and one is with a symptom of disease and the second one is healthy Risk of the first person falling ill is much higher compared to the second person In case an insurance company decides to offer them policy then it will not be fair to charge both of them with the same premium as the risks they face are different So the insurance company will charge a higher premium or exclude hospitalization benefit of Pre Existing Diseases or impose additional conditions or reject the proposal There may be various problems in the human body which are unknown to proposer Only when the proposer undergo a medical checkups will come to know about these issues from the medical tests conducted that may have critical impact on health at a later stage ABOUT MEDICAL EXAMINATION REPORT MER PORTAL The Medical Examination Report portal is tightly integrated with PREMIA enabling seamless operation between Operating Offices Diagnostic Labs Area Zonal Corporate Doctors and Claims department It allows you to implement PED Pre existing Disease coding as per IRDA Insurance Regulatory Development Authority guidelines The portal also facilitates LI Automatic selection of Medical test packages based on Age and Sum Insured Q The uniform coding of PED Q Capturing ICD codes in proposal level Q Systematized payment of lab fees The portal provides you with different log in facility like LY Underwriter Q Diagnostic Lab Q Area Zonal
18. s been written with utmost care and concentration there may be a few typographical errors technical or functional inaccuracies and omissions The readers are requested to report these to the content development team at 3i Infotech Ltd However the company may not be held responsible for the damages that have been caused by following what is written in the document 3i Infotech reserves the right to change in part or full the contents of the document without prior intimation to its users The users are also advised to closely relate the document s version to the software in use 3i Infotech welcomes feedback to improvise the written material in of the document However we cannot give more than our appreciation to the effort input by the reader The products other than those developed by 3i Infotech mentioned in the document are mere references They belong to their respective owners and 3i Infotech does not take responsibility to inefficiencies in this software Screen shots provided are representative and may or may not contain all the fields explained in the user manual All data displayed in the screenshots are meant for demonstration purposes and is not intended to refer to any existing person or organization Sid Infotech ai ersonal amp Caring Insurance Innovation Insight Integrity he Health Insurance Specialist Table of Contents 0 ae eee ate ete nr erie ers ae eee erie eee ec eee E eee rere
19. to zonal office 5 Enter Doctor Remarks if any as shown below F http 192 168 1 237 8082 Assign Higher Authority Win O X Choose Office 1410000 Zonal Office Chennai w Doctor Remarks Unable to take a decision in FED Please do the needful 6 Click Save to save the details of the record successfully On saving a pop up message is displayed as shown below EP Infotech STAR nean iring Insurance Innovation Insight Integrity Insurance Specialist Logon to MER portal with login credentials of Zonal Doctor to view the escalated proposals The Zonal Doctor can analyze and submit his opinion and take decision on the proposals Ep Infotech pam Personal amp Caring Insurance PENIEL Insight 7 Integrity The Health Insurance Specialist Acronyms Acronyms Expansions IRDA Insurance Regulatory Development Authority ICD International Classification of Diseases End of Document
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