Insurance & Panel Management
Manage Jubilee, EFU, State Life, EOBI and 10+ panels with automated claim tracking
Overview
Configure any insurance or corporate panel with coverage type (Full/Partial/Co-pay/Cashless), coverage percentage, allowed services, max claim per bill, and annual limit per patient. Billing automatically calculates the patient's co-pay and the insurance portion. Claims track from Draft → Submitted → Under Review → Approved → Paid (or Rejected → Appealed).
Standard Operating Workflow
Configure Panel
Add panel name, type, coverage %, allowed services, max claim, annual limit, contact details, and payment terms (Net 30/Net 60).
Enroll Patient
Link patient to panel with policy number and coverage expiry date.
Auto-Calculate Claim
Bill created → insurance portion auto-calculated. Patient pays co-pay at counter. Claim CLM-000042 created (Draft).
Submit Claim
Submit to insurance → status: Submitted → Under Review → Approved/Partially Approved.
Record Payment
Insurance pays cheque → record cheque number and amount → status: Paid → socket alert: '💰 Jubilee payment received: ₨6,500.'
Key Operational Benefits
Real-World Healthcare Scenarios
Jubilee Claim Cycle
Patient bill ₨8,500. Jubilee 80% coverage. System calculates patient co-pay ₨1,700 instantly. Claim CLM-042 submitted. Jubilee approves ₨6,500 (slight reduction). Cheque recorded. Admin receives socket alert.