TPA / Insurance Claims

PMJAY / CGHS / ECHS

Government health scheme management: PMJAY package rates, CGHS/ECHS empanelment, pre-auth, claim submission, and scheme-wise analytics.

Screenshot slot — drop the live ERP capture for "PMJAY / CGHS / ECHS" in /public/shots/tpa-insurance-claims-pmjay-cghs.png

Key fields

PMJAY package master with HBP codes
CGHS rate list mapping
ECHS procedure rate mapping
Scheme eligibility verification

Workflow

01Verify Scheme Eligibility
02Map Treatment to Package
03Submit Pre-Auth
04Treat Patient

Compliance coverage for PMJAY / CGHS / ECHS

Compliance

PMJAY / NHA
CGHS
ECHS

Related reading

TPA / Insurance Claims overview Insurance & TPA Processing NHCX Claims Exchange Patient Registration (ABHA / UHID)Appointment & Queue OPD / Consultation Pricing

External references

PM-JAY official portal — Ayushman Bharat — Pradhan Mantri Jan Arogya Yojana

More in TPA / Insurance Claims

Pre-AuthorisationClaim Submission & SettlementInsurance & TPA Processing NHCX Claims Exchange All of TPA / Insurance Claims →

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