vidal health on whatsappvidalhealthtpa.com/home/forms/tab0/textblock_files/file7...whatsapp number...

Vidal Health on WhatsApp

Vidal Health Insurance TPA Pvt. Ltd has been a frontrunner in providing hurdle-free third party administration for health insurance. Vidal Health Insurance TPA Pvt. Ltd is among the nation's leading providers of Third Party Administration (TPA) Service. We continuously strive to set benchmarks in 3 main focus areas of our functionality-Customer, Innovation andOperational

Catering to more than 100 million lives , we are therefore delighted to announce our integration with WhatsApp for Business. In a very short time since inception, WhatsApp has emerged as one of most widely used communication channels across the world.

Through WhatsApp, we will connect with the customers with their consent and directly share all their pre-auth and claim related details. From approval letter to E-card, all will be at your finger-tips now.

SMS/Email

Here is how this works!Consent from CustomersA. Missed call - give us a missed call from your registered mobile number to share your consentB. Portal - login in to the portal and share your consent with usC. SMS/EMAIL- share your consent with us by clicking on the link sent via sms or email

Missed call US!022-4892-6099

Messages to this chat and calls are now secured withend-to-end encryption. Tap for more info

Hello,

Vidal health insurance TPA PVT LTD welcomes you to a new way of staying in touch with us. Save this WhatsApp number to reach us anytime, as per your convenience. You may choose to reply with any of the following options -

To get your Ecard:Type <ECARD>

To know your PreAuth status:Type <PREAUTH>

To know your claim status:Type <CLAIM>

For any queries:Type <QUERY>

Thanks

Greeting Message

Upon sharing your consent, a greeting message will be sent.A warm welcome is always nice.

Consent Accepted by Claimants

When the insured/ claimant gives the consent, whatsapp message is getting triggered on users whatsapp number.So here when insured / claimant types any of the keywords as stated below, following new screen to appear as shown In here. • Options i.e. STATUS, APPROVAL, REJECTION, SHORT OR • Any other keywords (such as Hi, bye etc) other than 1 to 10

You may choose to reply with any of the following options:


To know your Preauth Status:Type <PREAUTH>


For any Queries / Grievances:Type <QUERY>



ecard

E-card

When users type <ECARD>, following screen to appear as shown here.• All available E-cards for active policies to be generated related to the specific contact number with the PDF format by file name ‘ECARD – Enrolment number’ seperately

If the customers have not shared their consent for WhatsApp messages, they will continue receiving their details through SMS/Emails


Pre-auth

When users type <PREAUTH>, following screen to appear.


To know your PreAuth status:

Type ‘1’ - for <PreAuth Status>

Type ‘2’ - for <PreAuth Approval>

Type ‘3’ - for <PreAuth Rejection>

Type ‘4’ - for <PreAuth Shortfall>

Please find the below details of Preauth Number and its statuses.

Preauth Number :BLR-1219-PA-0000115Claimant Name :ANIL KUMARStatus : SHORTFALLDate Processed :18/12/2019

Preauth Number :BLR-1219-PA-0000150Claimant Name :MANUStatus : APPROVEDDate Processed : 19/12/2019

Regards,Vidal Health TPA.


When users type 1, whatsapp message to get triggered on users whatsapp number listing down all the cases happened in last 15 days with no attachments.

Availability of no cases



When users type 2, whatsapp message to get triggered on users whatsapp number along with preauth approval letter attachment/s, listing down all the approved cases happened in last 15 days.

When users type 3, whatsapp message to get triggered on users whatsapp number along with preauth rejection letter attachment/s, listing down all the rejected cases happened in last 15 days.


HOS-REJECTED-BLR...

When users type 4, whatsapp message to get triggered on users whatsapp number along with preauth shortfall letter attachment/s, listing down all the shortfall cases happened in last 15 days.


HOS-SHORTFALL-BL...

When wrong kwywords are pressed apart from the predefined num-bers, the system to trigger message as shown here.


You may choose to reply with any of the following options:


To know your Preauth Status:Type <PREAUTH>


For any Queries / Grievances:Type <QUERY>

When no cases are available upon typing keywords from 1 to 4, message to get displayed as shown here.


Unable to find the details. To get the further assistance. Please reach us on our call center number1860-425-0251 / 080-46267018.



Dear SUNIL,

We are in receipt of Pre-Authoriza-tion request from A C HOSPITAL for Rs 25000 towards the treatment of SUNIL and are being processed. To get latest <PreAuth Status> please reply ‘1’ to this whatsApp number. In case of any other clarification please reach to us on 1860-425-0251 / 080-46267018.

Regards,Vidal Health Insurance TPA Pvt. Ltd.

When PreAuth is raised, following whatsapp message to get trig-gered to users with no attachments.


Dear SUNIL,

A shortfall (query) has been raised for preAuthorization request received from A C HOSPITAL for Rs 25000 towards the treatment of SUNIL. To get the copy of the <PreAuth shortfall letter> please reply ‘4’ to this whatsApp number. In case of any other clarification please reach to us on 1860-425-0251 / 080-46267018.

Regards,Vidal Health Insurance TPA Pvt. Ltd

When PreAuth Shortfall is raised, following whatsapp message to get triggered to users with no attachment.


Dear SUNIL,

Pre-Authorization request received from A C HOSPITAL for Rs 16000 towards the treatment of SUNIL has been approved. To get the copy of the <PreAuth approval letter> please reply ‘2’ to this whatsApp number. In case of any other clarification please reach to us on 1860-425-0251 / 080-46267018.


When PreAuth case is approved, following whatsapp message to get triggered to users with no attachments.

When PreAuth case is rejected, following whatsapp message to get triggered to users with no attachments.


Dear SUNIL,

Pre-Authorization request received from A C HOSPITAL for Rs 20000 towards the treatment of VIJETH has been rejected. To get the copy of the <PreAuth rejection letter> please reply ‘3’ to this whatsApp number. In case of any other clarification please reach to us on 1860-425-0251 / 080-46267018.


Claims

When users type <CLAIM>, following screen to appear.


To know your Claims status:

Type ‘5’ - for <Claim Status>

Type ‘6’ - for <Claim Approval>

Type ‘7’ - for <Claim Shortfall>

Type ‘8’ - for <Claim SettlementAdvice>

Note: Data to be displayed for all the member claims of last 3 months and also if there are any open member claims on and above 3 months.

Claim Status

When users type 5, below whatsapp message to get triggered on users whatsapp number listing down all the reimbursement Claims including pre/post claims of last 3 months and also if there are any open member claims on and above 3 months no attachments.


Dear SUKANYA,Please find the below details of your reimbursement claim of last 3 months.

Claimant Name: SUKANYAClaim Number: BLR-0320-CL-0000183Claim Amount: 200Date of Claim Submission: 18/03/2020Status: UNDER PROCESS

Claimant Name: SUKANYAClaim Number: BLR-0320-CL-0000183Claim Amount: 100Status: APPROVEDNote: Payment to be credited post insurer approval

Claimant Name: SUKANYAClaim Number: BLR-0320-CL-0000183Claim Amount: 100Status: AWAITING INSURER

These details to be displayed onceclaim has been inwarded

These details to be displayed once claim has been approved by claims team. “Note” to be Displayed stating payment to be credited by the respectiveinsurer

Below are the 2 scenarios wherein Awaiting insurer confirmation to be shown as status

For Rejected cases, when status is “Event (Confirmation)" on top right corner of “Claims General” screen, then these details to be displayed inmessage with Status as “Awaiting insurer confirmation”. and

For approved cases if user has sent for insurer concurrence (VINGS > under referred to insurer concurrence)


Claimant Name: SUKANYAClaim Number: BLR-0320-CL-0000183Claim Amount: 100Status: REJECTED

Claimant Name: SUKANYAClaim Number: BLR-0320-CL-0000183Claim Amount: 100Status: SHORTFALL

Claimant Name: SUKANYAClaim Number: BLR-0320-CL-0000183Claim Amount: 100EFT/Cheque Transaction number: 251614Status: CLAIM SETTLED

These details to be displayed once claim has been approved by claims team. “Note” to be Displayed stating payment to be credited by the respectiveinsurer

These details to be displayed onceclaim has been inwarded

For rejected cases, when status is“Event (Complete)" on top rightcorner of “Claims General” screen,then these details to be displayed in message with Status as“Rejected”.

When users type 6, below whatsapp message to get triggered on users whatsapp number listing down all the reimbursement claims Approved cases of last 3 months and also if there are any open member claims on and above 3 months with.

Dear SUKANYA,

Please find the below details of your claimnumber and its status.Claimant Name: SUKANYAClaim Number: BLR-0320-CL-0000183Claimed Amount: 100Approved Amount: 90Status: APPROVED

Note: Payment to be credited post insurer’sapproval

Regards,Vidal Health TPA

BLR-0320-CR-00000...

When users type 7, below whatsapp message to get triggered on users whatsapp number listing down all the member claim shortfall cases which are open with no timelimit and all the open shortfall letters to be attached as below

Dear SUKANYA,

Please find the below details of your claimnumber and its status.Claimant Name: SUKANYAClaim Number: BLR-0320-CL-0000183Claimed Amount: 100Status: SHORTFALL


BLR-0320-CL-000434...


Claim Settlement Advice

When users type 8, below whatsapp message to get triggered on users whatsapp number listing down all the claim settlement advice cases (i.e. once payment have been credited in claimants account by the insurer) of last 3 months and also if there are any any open member claims on and above 3 months with claim settlement advice (with computation) as an attachment.

Dear SUKANYA,

Please find the below details of your claim number and its status.Claimant Name: SUKANYAClaim Number: BLR-0320-CL-0000183Claimed Amount: 100Settled Amount -900Claim Settled on – DD-MMM-YYYY (E.g.: 03-Apr-2020)EFT No: 251614Status: CLAIM SETTELD


BLR-1219-CR-00001...

When wrong keywords are pressed apart from the predefined numbers, the system to trigger following message as shown in Page 12: Respectively.

When no cases are available upon typing keywords from 5 to 9, message to get displayed as shown in Page 13: Availability of no cases.

When Claim has been inwarded, following whatsapp message to get triggered to users with no attachments:


Dear SUNIL,

Claim has been received at 18/03/2020 for the followingClaim Number: BLR-0320-CL-0000183. To get latest ClaimStatus please reply ‘5’ to this whatsApp number. In case ofany other clarification please reach to us on 1860-425-0251 / 080-46267018.



Dear SUNIL,

The claim for Claim Number: BLR-0320-CL-0000183has completed final process and submitted to <insurance company name> for approval and payment of Rs.100. The amount will be credited to your account by the Insurer shortly. You will receive a separate communication on the same. Toget the copy of the Claim Approval letter please reply ‘6’ to this whatsApp number. In case of anyother clarification please reach to us on 1860-425 0251 / 080-46267018.


When claim has been approved, following whatsapp message to get triggered to users with no attachments:

When claim shortfall has been raised, following whatsapp mes-sage to get triggered to users with no attachments:


Dear SUNIL,

A shortfall (query) has been raised for Claim Number: BLR-0320-CL-0000183 towards the treatment of SUNIL. To get the copy of the Claimshortfall letter please reply ‘8’ to this whatsApp number. In case of any other clarification pleasereach to us on 1860-425-0251 / 080-46267018.



Dear SUNIL,

Your claim having Claim Number: BLR-0320-CL0000183 has been credited with Rs.900. Here is the EFT: 251614. To get the copy of the Claim Settlement Advice letter please reply ‘9’ to this whatsApp number. In case of any other clarifica-tion please reach to us on 1860-425-0251 / 080-46267018.


For Claim Settlement Advice, following whatsapp message to get triggered to users with no attachments:

Query

When users type <QUERY>, following screen to appear as shown here.


For query related issues:

Type ‘9’ – for < Claim formwith Procedures / guidelines>

Type ‘10’ – for <Vidal NetworkHospital lists>

Note: Login to website forfurther queries:http://www.vidalhealthtpa.com

Claim form with Procedures / guidelines

When users type ‘9’, below whatsapp message to get triggered on users whatsapp number with Claim Submission Form and Claim Submission Procedures as an attachment.

If when wrong keywords are pressed apart from the predefined numbers,the system to trigger above message

Hello,

Please go through the attachedClaim Submission Procedures/guidelines and find theattached Claim Submissionform.You can also visit our websitehttp://www.vidalhealthtpa.com

Regards,Vidal Health Insurance TPA Pvt.Ltd.

Claim submission...


When users type ‘10’, below whatsapp message to get triggered on users whatsapp number with Vidal Network hospital lists link to be displayed as below


Hello,

Please find the below link todownload the Vidal NetworkHospital lists by selecting the<insurance company name>and the required networklocation

https://www.vidalhealthtpa.com/home/NetworkServices/Net-work-Hospital-List

You can also visit our websitehttp://www.vidalhealthtpa.comfor any related queries.

Regards,Vidal Health Insurance TPA Pvt.

All the messages you’ll receive from us will be sent from a verified profile (Tick Mark) with corporate username VIDAL HEALTH INSURANCE TPA so that you are assured whilecommunicating with the sender.

At VIDAL HEALTH INSURANCE TPA, we take privacy and security very seriously. So please be assured that the details are secure with us, and only relevant information about your claim will becommunicated to you through WhatsApp – the idea is to reach out to you on a medium of yourchoice.

A new platform. A new experience.Here’s to more convenience and hassle free health insurance processes!

Vidal Health On WhatsApp

vidal health on whatsappvidalhealthtpa.com/home/forms/tab0/textblock_files/file7...whatsapp number...

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