Vipul MedCorp TPA Private Limited

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Presentation on TPA Services

VIPUL

GROUP

TPA- Third Party Administrator

Vipul MedCorp. TPA Pvt. Ltd. –is one of the leading IRDA Licensed, TPA

servicing over 6 million lives

Software Development

Vipul Informatics Pvt Ltd

Is into software development and caters to both In house and 3rd Party software development.

Leading players in data management and providing customized

Automobile dealerships .Vipul Motors Pvt Ltd

is One of the largest dealers of Maruti SuzukiCars in India with approx. sales

of 15,000 cars per annum and an annual turnover of approx 500 crores $ 112 Million) .

It operates dealerships/service and repair centers in

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and providing customized solutions on turnkey basis.

repair centers inFaridabad, Noida, Gurgaon and Jaipur

Health Tourism & International Operations

Vipul MedCare Pvt Ltd is engaged in offering Health Tourism facilities and has integrated hospitalnetworks all over Gulf, and Asian region for health care facilitation

VIPUL Better Care Management Services LLC, Oman

TPA Services & Medical Tourism

Vipul MedCorp Introduction

Vipul MedCorp TPA Pvt. Ltd., is anISO 9001:2008 certified and an IRDALicensed, Third Party Administrator(Health), engaged in following services

� Cashless Medical Service Facilitation at Network Hospitals upto limit authorized by Hospitalization Insurance.

� Claim processing and

EMPANELLMENT

• New India Assurance Co Ltd.• National Insurance CO Ltd.• United Insurance Co Ltd• Oriental Insurance CO Ltd• Al Ahlia Insurance co SAOC Oman• State Insurance & PF deptt Rajasthan• Reliance General Insurance Co Ltd• Royal Sundaram

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� Claim processing and reimbursement, for non network Hospitals

� Enrollment of data and Health Card issuance to Insured.

� Cost Containment services for Insurance Companies & Insured with inadequate insurance

� Online assistance to Insured during hospitalization .

� MIS/Reports (online/offline) to Insurance co and Insured.

• Royal Sundaram• ICICI Lombard General Insurance Co• Star Health & Allied General Insurance • Apollo DKV Health Insurance• HDFC Ergo Insurance• IFFCO Tokyo General Insurance• Bharti Axa General insurance• Universal Sompo Gen Ins Co

Corporate ClientsIndustry Segment Major Clients

IT / BPO / Telecom Wipro BPO, Convergys, Vertex, Hughes Group, Agilent Technologies,Aricent, Indus Towers, Comviva, Birlasoft, Infogain,Colt technologies,Intersoft Data Labs, Interra-IT Group, Atrenta, Acme Telepower, SpiceTelecom , Nucleus Software , Citi Phone etc.

Education / Press Hindustan Times HT Firefly , Institute of Engineers, IIT Delhi , IIMIndore , BITS Mesra, FIIT JEE, IIT Roorkee, Dehradun Inst ofTechnology

Multinational Group 4, Becton Dickinson, RayBan, Baush & Lomb, Technip KT India,

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Multinational Group 4, Becton Dickinson, RayBan, Baush & Lomb, Technip KT India,Louis Berger Group, Triburg Sportwear, NIS Sparta, JCB India, PernodRecard, Delphi, Carlsberg, Espn Software India Pvt. Samsung Data .

HealthCare / Hotel / Airlines / Embassy

ITC Hotels (22 Locations ) , VLCC, Dr. Lal’s Path Lab, Raddison Hotel,Thai Airways, Embassy of Finland, Embassy of Japan, Embassy ofMexico, Make My Trip etc .

Insurance / Finance / Banks

India Bulls, Union Bank, SBBJ, IOB, UCO Bank, Ameriprise.CanaraHSBC Life Insurance .Bajaj Capital insurance broking, Fidelity (FIS),

Govt. Bodies / Diversified Groups

Hindalco, Grasim , Power Trading Corporation (PTC), Petronet LNG,Timex Watches, Jagatjit Industries, Universal Glass, Omaxe, UnitechGroup, Avery India, Gujarat Ambuja, Mangalam Cements, HindustanLatex, Indica Chemicals, Everest Industries, Modi Industries, Nuchem,Delta Power , MTNL , Central Warehousing Corporation , TriveniEngineering , Indraprastha Gas Limited etc.

Mass Policies

Vipul MedCorp TPA is one of theleading players in servicing masspolicies (RSBY/UHIS) and offersfollowing services• Finalisation of enrollment and

transaction software• IEC/Scheme campaign and

mobilisation.

Project State Families Insured

RSBY

Himachal

Pradesh 162582 515278

RSBY Delhi 8248 27218• IEC/Scheme campaign and mobilisation.

• On site personalisation and issuance of smart cards

• Hospital empanelment and Transaction software installation and training

• Cash less benefits to Insured.• Data Upload/MIS• 24/7 help and maintenance of

Distt. offices/Kiosks

RSBY Delhi 8248 27218

RSBY Haryana 30395 97264

RSBY Bihar 1928753 5979134

Total 2119978 6618894

Business Highlights

2011-12 2010-11 2009-10

Number of Lives Serviced (Mass + Retail +

Corporate ) 8327209 6189240 5421421

Number of Lives Serviced (Retail + Corporate ) 1708314 1608046 1512133

Premium Serviced $ Million (@ INR 50 = 1

USD) 101.12 85.31 70.24(Retail +

Corporate

+mass))

USD) 101.12 85.31 70.24

INR (Crores) 505.59 426.56 351.22

Number of Claims Processed 237713 202407 225865

Claims Volumes

$ Million 81.76 71.25 64.074

INR (Crores) 408.89 356.25 320.37

Gross Revenue

$ Million 4.46 3.95 4.00

INR (Crores) 22.3 19.73 20

Employees

Total 506 460 430

Doctors 86 72 64

Network Service Providers

•• Vipul MedCorp has shortVipul MedCorp has short--listed hospitals listed hospitals and Nursing Homes as per the minimum and Nursing Homes as per the minimum norms prescribed under Health norms prescribed under Health Insurance Schemes. The steps involved Insurance Schemes. The steps involved in our empanelment process are the in our empanelment process are the following: following:

• Screening of Hospital Profile and Application and Obtaining rate list and negotiation.

Zone No.s

Cost

Advantage No.s

North 1829 Discounts 1339

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negotiation.

• Evaluation of Quality of Service rendered &Patient care background & Infrastructure

• Verifying Management background and past track record

• Verifying IT Infrastructure / Computerization .

• Options of Cost Containment/Package rates.

For Online empanelment and to access our

detailed list of hospitals, visit our website -

www.vipulmedcorp.com

West 860 Packages 836

East 251 RSBY 927

South 1045

Total 3102Total 3985

Decentralized Operations

Locat ion Enro llment Cashless C laims

M umbai a a a

V adodara a a a

Chennai a a a

Delhi NCR a a a

In Order to render seem less services, Vipul MedCorp has decentralised its operations at major locations -

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Bangalore a a a

Cochin a a a

Kolkat a a a a

Chand igarh a a a

Jaipur a a a

Indore a a a

Pat na a a a

Hyderabad a a a

Ahmedabad a a a

E cards can be generatedfrom our website

Insured/Insurer can track the enrollment/ID cards issuance and dispatch details from

our website

Retail Policies and underwriter data of members are collected,

further this data is uploaded onto our systems and ID card is generated and

couriered along with guide book

Enrollment

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from our websiteour website

www.vipulmedcorp.com.

In case of corporate clients – Enrollment form and photos are collected. Corporates can also upload data online on our portal. E cards are emailed to all members.

Laminated / personalised cards are physically delivered. Periodic addition and deduction data is collected

along with endorsement for mid term inclusion / exclusion.

Network Hospitals

Cashless Process•Insured to approach network hospital with doctor prescription and ID card•Insured to fill up Part 1 & 3 of pre authorisation form•Hospital will fill part 2 and fax/ email/ upload to Vipul MedCorp

Authorization•VMC Doctor assesses

the pre-authorization request based on sum insured,

clinical eligibility.•Query if any, is faxed to hospital.

Insured is also informed on phone/SMS/Email.

•Hospital is given authorization

Discharge•Insured to pay for all non-covered services like, registration fees,

telephone bills etc•Insured to verify and sign hospital

Bill and claim form and leave all original documents at hospital.Xerox of relevant documents

can be taken

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Claim ProcessPlanned

hospitalization

Emergency

Hospitalization

Non Network Hospitals

Network Hospitals

Reimbursement ClaimsInsured will submit claims for non network hospitals and pre

and post hospitalization claims arising out of cashless hospitalization

Cost

Containment

PREVENTIVE MANAGEMENT

• Preventive Health check upprograms• Health newsletter• Health camp/ Wellness camp• Claims analysis –Introduce changes in policyconditions/ Mid tem policy review

CLAIMS CONTROL

• Original Bills are verified & scrutinized against Standard Discounted Tariff • Medical procedure audit &bill scrutiny • 2nd Medical opinion takenfor complicated cases and

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conditions/ Mid tem policy review• Orientation of how to optimise the policy and reduce claim outflow• Endorsement of blacklistedhospitals in the policy

for complicated cases and re-pricing done on caseto case basis• Implementation of package rates for surgical procedures• Spot Investigation of cashless cases and Investigation of Indoor records for doubtful cases

� Vipul MedCorp is having an integrated software solution on VB &SQL Server to record, track and monitor daily operations both onfront-end and backend. This system by itself is placed on a corepackage, which is having multi company, multi branch, multi useroperations, etc. It provides various level of security including menulevel / user level controls. We also give online access to insurer,insured and hospital through our website, www.vipulmedcorp.com.

The Insurer and Insured get access to following online modules:

Software, Web Access & MIS

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The Insurer and Insured get access to following online modules:� Enrollment data and card status & E Cards� Claims intimated, processed and settled

We also give periodic MIS of following� Disease wise, Age wise & Geographical wise claims analysis� Incurred Claims ratio.

Log in screen for MIS

Service Deliverables & Value added services

Services TAT Value Added Services

Cash less 2-4 hrs • SMS Alerts for cash less and claims.

• Web Access for online data transaction.

Ecard Within 72 hrs

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transaction.• Discounts in leading hospitals for

Health Check up and OPD treatments.

• Online Grievance/Query Module and redressal.

• Help desks and orientations• 24/7 mobile , Call center supported

on IVR with online interphase.• Second Medical Opinion (SMO)• Electronic Medical Record

Management (EMRM)

Laminated Cards within 7 days

Query Generation 4-7 days

Claims Settlement 7 days

PaymentWithin 2 days

ECS

Vipul MedCorp Interactive Voice Response (IVR) System

Insured can dial Vipul MedCorp Toll free No (1800-102-7477) or 27x7 call Centre (0124-4833900 (100 lines ),which is on Interactive Voice response (IVR) System & they can Punch their Numeric card number .

29/10/2012Vipul MedCorp TPA Pvt Ltd.

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For Corporate clients , the system will give a welcome message with corporate name & employee can access following details :

1.Claims ( Intimation / Settlement )2.Cashless (Approval)3.Enrollment (Re-print / dispatch)

Retail Insured can directly access the above on IVR

Strategic Advantages

� Cashless facilitation at around 4000 Hospitals/Nursing Homes allover India. Smart card based Delivery at around 1000 hospitals.

� All India Set-up having decentralised Offices at New Delhi,Gurgaon, Faridabad, Noida, Jaipur, Indore, Chandigarh,Mumbai, Bangalore, Kolkata, Chennai & Cochin.

� Web enabled Software for Claims Tracking and On-Line access.

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� Web enabled Software for Claims Tracking and On-Line access.

� Professional manpower presenting our Clients with benefitsderived from our knowledge and experience of the MedicalNetwork, TPA & Insurance fields

� Dedicated Panel of Doctors, enabling us to render SecondMedical Opinion, Case Management and Medical ProcedureAudit.

� Access to International Health Care facilitation through ouroversees affiliates at Oman , UAE and Malaysia.

� Value added services like Wellness Programmes , SecondMedical Opinion (SMO) , Electronic Medical Record Management

Head Office 515, Udyog Vihar, Phase 5, Gurgaon, Haryana Pin Code: 122 016Phones : 0124-2438270-75, 0124-4699600 Fax No. : 0124-2438276, 0124-4699611-12Delhi & Registered Office B-416 Ansal Chamber I, Bhikaji Cama Place, New Delhi, Pin Code: 110 066Contact Person : Mr Chandan PrasadPhones : 011-46074578-81, 9311986381Fax No. : 011-41659833Faridabad 27/5, Delhi-Mathura Road, FaridabadContact Person : Mr. Mohit Saxena (9311986374)Phones : 0129-2280244-45, 0129-2267141-45, Fax No. : 0129-2290084JaipurS-10, Shyam Nagar Ajmer Road, Jaipur Rajasthan Pin Code: 302 019Contact Person : Mr Sengupta Phones : 0141-5182035, 2297569-70, 9314186907 Fax No. : 0141-2297335

Coordinates

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Phones : 0141-5182035, 2297569-70, 9314186907 Fax No. : 0141-2297335Mumbai I C/1, 2nd Floor Harganga Mahal, Khodadad Circle Dr. Ambedkar RoadDadar T.T., Dadar (East) Mumbai, Pin Code: 400014Contact Person : Mr. A.K.SachdevaPhones : 022-24157048-9, 022-65951945, 9321235852Fax No. : 022-24160821Mumbai IIB - 14 Wadala Udyog Bhawan, Wadala (W)Mumbai 400031 Phones 022-40764545, Fax NO. 022-40764555,Indore306, 3rd Floor, Shree Vardhan Complex, R.N.T. Marg, Indore - 452001 Contact Person: Mr. Upendra Singh Chauhan (0932973302)

Phones: 0731-4285674 Fax: 0731-4208920Bangalore # 154, 2nd Floor, Mallige Complex, KHB colony, 5th Block, Kormangala, Bangalore - 5600950Contact Person: Malikarjuna 9379620120Phones : 080-40927708-91, Tele Fax : 080-41249694

Kolkata 16/2, 2nd Floor Lord Sinha Road, Kolkata Pin Code: 700 071

Contact Person : Mr. Arup Banerjee (9433629001)Phones : 033-22820224 Fax No. : 033-22820224Chennai Old No 12/2, New No 29, Seshachalam Street, Saidapet, Chennai - 600 015 Contact Person : Mr. K. Rajshekaran (9380037673) Phones : 044-24335717/19, 42010092 Fax No. : 044-24335716/18ChandigarhS.C.I. No. 98, First Floor, Industrial Area, Phase – 2, Chandigarh – 160002Contact Person : Dr. Arvin Bakshi(9316889998)Phones : 0172–2641087,89, 2641304NoidaPlot No. A-7 Sector 3, NoidaContact Person : Ms. PraneetsPhones : 0120-4346187, 9311986371 Fax No. : 0120-2537687Dehradun

Coordinates

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Dehradun119 Raj Plaza, 75 Rajpur Road, Dehradun Contact Person : Mr. Ravi Kumar (09997109901)Phones : 0135-3200004CochinMariam Tower Door No.36/3120-B-3, Kaloor Kadavanthra Road,Kathrikadavu, Cochin-17Contact Person : Mr. Rajesh R (9744497212)Phones : 0484-2102021, 2330079, Fax : 0484-2330080Vadodara449-450, Phoenix Complex, Near Suraj Plaza,Sayajiganj, Vadodara - 390 005Contact Person : Dr. Nehal 9327032154Phones : 0265-2225305, Fax : 0265-2225302Hyderabad

408, 4th floor, Navkethan complex,Opp to Clock Tower.,S D RD, Secunderabad – 500 003 Contact Person: Dr. Srikant (09666757229) Ph : 040 – 27803247 Fax – 39121957Patna2 Floor, House Name-Vasant Kunj, Sweet Dadi LaneBoring Road, Patna -1Contact Person- Mr. Rajeev Agarwal(7488020094)