Turn provider failures into corrective action
Trace delayed cashless decisions, repeated document requests or poor survey quality to affected cases, contracted service levels and customer outcomes. Provider management agrees remediation with claims and checks whether customers need an immediate remedy.
A notice, complaint, missed commitment or disputed amount opens a case.
People in the process
- PProvider ManagementProcess Owner
- CClaimsParticipating Team
- GGrievance RedressalParticipating Team
- TTPA or SurveyorParticipating Team
Records it works with
Relevant agreement, policy or governing record- Transaction, performance and payment history
- Notices, communications and supporting evidence
The process is a starting point.The standards are yours.
Configure for the insurer, product, distribution model and applicable IRDAI requirements. Claims, underwriting, actuarial and grievance decisions stay with the authorised specialists.
Industries
Industries