ORALZY
FAQ

RGHS patient ka ek treatment RGHS rate list me nahi hai — kaunsa rate lagega?

Jis treatment ka RGHS rate blank hai uspe system apne aap general rate laga deta hai (fallback). Non-covered treatment cash me hoga — patient ko pehle clearly bata do ki ye claim me nahi jayega.

Where in ORALZY: Setup → Settings → Treatment Types

SAMJHO RATE LOGIC

Har Treatment Type me scheme-wise rates hote hain. RGHS patient ke bill me system pehle us treatment ka RGHS/scheme rate dhundta hai; wo blank/0 ho to GENERAL rate fallback me lagta hai. Ye design hai — taaki bill kabhi ₹0 na bane.

SITUATION HANDLE karo:

  1. Treatment sach me RGHS package me covered hai par tumne rate nahi bhara → Setup → Treatment Types me us treatment ka RGHS rate bhar do (ek hi treatment me general + RGHS dono rate rehte hain). Aage se sahi lagega.
  2. Treatment RGHS me covered hi NAHI hai (jaise kuch cosmetic procedures) → general rate hi lagega aur patient CASH me pay karega. Sabse important: treatment se PEHLE patient ko batao — 'ye wala RGHS me nahi aata, iska ₹X aapko dena hoga'. Likhit consent/estimate me bhi likho, warna baad me jhagda hota hai.
  3. Ek hi visit me mixed case (kuch covered, kuch nahi) → bill me har line apne rate se aayegi; patient ko breakup samjha do.

CLAIM SIDE

Covered procedures pe claim-photo protocol chalega (mandatory photos, geo-stamped) — non-covered pe nahi. Claim file karte waqt sirf covered items jayenge.

PREVENTION

RGHS empanelment ki package list ke hisaab se ek baar saare RGHS rates bhar lo.

Quick steps

  1. Check karo treatment RGHS package me covered hai ya nahi
  2. Covered ho to Setup → Treatment Types me RGHS rate bhar do
  3. Non-covered ho to patient ko pehle batao — cash me hoga
  4. Estimate/consent me non-covered items alag likho
  5. Mixed bill me patient ko line-wise breakup samjhao

rghsratecoveredpackagefallbackcashclaimschemeestimatemixed

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