Mediview Nepal Pvt. Ltd.
We are a Company established to provide exceptional Consultation for medical claims settlement to insurance companies in Nepal. We are here for 100% ethical business and evidence-based practice. Our clients are insurance companies regulated by the Insurance Board.
We believe in, smooth and rational medical claim settlement as per insurance company policy. Thus, we provide investigative/analytical reports with an expert review of Nepal Medical Council registered doctors and Insurance claim experts on medical/health claims.
Our strengths: We are resourced with MDGP, Orthopedician, Physician, Neurosurgeon, Cardiologist, General Surgeon, Radiologist, Dentist, and Medical Officers who are registered in Nepal Medical Council; working full time/ part-time with us. We also have Registered Nurses and Pharmacists along with insurance claim experts and field investigators who are experienced in this industry. We use the latest pharmacy software to check for the maximum retail prices of the drugs and its availability in Nepal. We are equipped with a database of pharmacy and their bills around major Hospitals in Nepal. We have a database regarding the cost of beds, operation, and treatment costs for the diseases and accidents at major Hospitals. We have a database of quotations of major surgical instruments (e.g. implants and prosthesis). We help to recognize genuine claims and eliminate fake claims with the support of our staff and their vigilance. We justify the rationale of treatment for the patient and assess medical liability for insurance companies.
We provide dedicated service to all the medical/health claims while giving expert advice to your Organization. We extend the committed team to your staff and clients to provide one-stop consultation for medical/health claims.
Problems
Insurance companies are facing problems in medical/health claims settlement, may it be due to moral hazards or agents working in between insurance companies and insured. Evidence of fake medical treatment being brought in the desk of Insurers, submission of medical bills irrelevant to treatment, and overcharged bills are day to day problems faced by Insurance companies. Many medical claims are being settled without proper investigations and medical consultation and with limited medical expertise. Above all, we understand the importance of providing quality medical consultation service and Insured satisfaction. We are joining this industry, with a Vision to help insurance companies tackle these burning issues.
Proposed Solutions
Our Company is devoted to supporting Insurance companies to look after the medical/Health insurance as per their policy on medical documents and bills. We ensure that only ethical and evidence-based Medical Insurance Claims are being processed and settled. With our strong database network and expert suggestion, we provide a proper reason for denial of any medical claims, medical insurance issues that arise or require expert attention. We provide final medical assessment and liability within insurance policy.
Our current services
- 1. Receiving claim intimations from the insurance company and client guidance.
- 2. Inform the client about the proper medical documentation, its submission and claim settlement process on behalf of the insurance company.
- 3. 24/7 Hotline number with SMS integration for claim intimation and client guidance.
- 4. Analyzing client's medical bills and explanations of benefits, reasoning on the client's medical bill errors/denied claim bills.
- 5. Verify whether medical fees are overcharged / injury-related or not/fake.
- 6. Follow up to the concerned party on every phase of treatment on your behalf; saving your time, effort, and cost for medical claims.
- 7. Investigating, tracking and monitoring complicated medical/health claims.
- 8. Ensure if an ethical and rational medical practice is being done or not.
- 9. Proper medical liability assessment on the claim as per policy eliminating fake claim documents.
- 10. As experts in medical insurance claims management, we audit and analyze medical costs on motor/health insurance claims.
- 11. Improving productivity in your organization by keeping your staff focused on your core business and boosting your company’s growth.
Future Services
1. To work as Third Party Administrator of insurance companies
2. To provide cashless services with all tertiary care hospitals in Nepal
What do you get?
1. NMC certified doctors review on the case and treatment rationality based on documents.
2. Insurance expert review on the policy and terms of its coverage.
3. Report on the medical claim to be payable or not payable with reason.
4. Reason of bills not being accepted on each rejected bill amount.
5. Total Medical Liability assessment to be paid on medical/health claims as per insurance policy.
6. Consult/Support on a complicated case where medical claims are filed at Insurance Board.
What value are we bringing?
Providing medical/health claims assessment with insurance liability. We provide hassle-free medical claim settlement to insured and insurer. This will enhance the efficiency and goodwill of the company. We provide 24x7 hotline assistance with SMS integration to insured regarding medical claims. Simply provide us with your client’s claim intimation and we’ll do the rest.
Ethics and Confidentiality
MPNL holds & practices a high level of ethics & integrity values while dealing with customers, partners, employees, statutes & others. We assure hundred percent confidentiality of the documents we receive. We only do ethical and evidence-based practice nothing else.
Operations:
- Forward us insurance policy and client's contact detail; once client intimidate the event at Headoffice/branch office
- Client will get call back from MPNL for medical claim information and guidance for medical documentation process with infographics on viber/whatsApp/Messenger/Email (as per clients convence) along with SMS integration system
- Client will Fill the claim form and Submit all original documents as per the checklist at nearest branch. Without concealing or withholding any information with respect to medical/heath claim.
- Provide us all medical documents.
- Wait for 3 working days for final medical documents/bill assesment report once we receive complete documents
- Review our medical report
- Settle the claim as per company rule and insurance policy with reference to our report to insurer
Management team
Dr. Rojin Thapa
Chief Executive Officer
Email:drthaparojin@gmail.com
Contact no:+977-9851174204
Dr. Umesh Bartaula
Managing Director
Email:brtumesh@gmail.com
Contact no: +977-9849181463
Mrs. Sarita Giri
Registered Nurse
Email:rnsaritagiri@gmail.com
Contact no: +977-9803762208
Mrs. Rashmita Thapaliya
Pharmacist
Email:rashmitathapaliya@gmail.com
Contact no: +977-9863020878
Ms. Shristi Thapa
Chief Marketing Officer
Email:thapashristi2000@gmail.com
Contact no: +977-9861345876
Ms. Alina Baniya
Front Line In charge
Mr. Sushant Shakya
Insurance Executive
Mr. Mohan Khadka
Insurance Investigator Officer
Dr. Binit Acharya
Orthopedic Surgeon
Dr. Bidhan Sigdel
General Surgeon
Dr. Sushil Dulal
Radiologist
Dr. Tulsi Ram Shrestha
Anesthesiologist
Dr. Madan Thapaliya
Medical Officer
Dr. Kristina Shrestha
Medical Officer
Contact us
Phone:
+977-01-5581257
Mobile:
+977- 9851174208
Gmail:
mediviewnepal@gmail.com
Address:
Chandragiri Municipality-15, Kathmandu