One of the key services in CallHealth portfolio is Medical Facilitation, which we extend in conjunction with our Associate Hospitals.
Under Medical Facilitation, we provide end-to-end assistance to the customer for hospitalization and visits to imaging centres. Well-qualified and trained CallHealth Medical Facilitation Officers support the entire process.
Since we recommend you to our customers, you can expect a higher inflow of patients and an increased business opportunity with zero additional investment.
We would be recommending our Associate Hospitals to customers in smaller towns and remote areas and even to international patients. This will ensure you serve patients beyond geographical limitations.
To drive business on the fast growth track, CallHealth will undertake joint promotion programmes and marketing campaigns with Associates like you.
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A typical Medical Facilitation cycle begins with a call centre officer recording a service request followed by a Medical Facilitation officer calling to understand the patient's exact requirement, post which appropriate Medical Facilitation is provided in conjunction with our Associate Hospitals.
To determine the most appropriate Hospital for the customer as per specifications and requirements, and also to evenly distribute opportunity, we have developed a technology driven Selection Rule Engine. The first and the most fundamental rule is that the choice of the customer-if he chooses to exercise it- determines the Associate Hospital he consults with. If he asks CallHealth to recommend, then the Selection Rule Engine applies a set of selection criteria for filtration to the universe of our Associate Hospitals in order to arrive at the Most Appropriate Service Associate (MASA).
The technology driven CallHealth Selection Rule Engine (SRE) ultimately determines the Most Appropriate Service Associate (MASA) as per customer requirements and/or on the basis of fair distribution principles. The filtration process involves applying a set of rules to the universe of CallHealth associates in order to arrive at the MASA.
CallHealth deals with various categories of associates including Hospitals, Specialists, Diagnostic Centres, Imaging Centres, Fitness Centres etc. Hence we have defined a general set of rules, which are then customized and applied to each associate category if applicable.
The General Set of Rules used by CallHealth are as below:
RULES APPLICABLE FOR ASSOCIATE CATEGORY - HOSPITALS:
For associate category hospitals, all the rules / selection criteria stated above are applicable. These rules are applied for filtration in descending order.
This filtration process is depicted visually on page 2.
Definition of Rules:
1. SERVICEABILITY: An Associate Hospital should have the service sought by the customer in its portfolio of services. Example: If the customer requires Gynecology Specialization that a particular hospital does not have, that Associate will be regarded not capable of servicing the client. This filter also includes insurance claim requirements of the customer. Is the hospital in the set of cashless transaction hospitals covered by customer's insurance policy? If not, Serviceability filter will filter-out that Associate Hospital in determining an Associate for that customer.
2. COST: A classification of an associate based on the cost of service. Associate Hospitals fall under the following three categories,
ANNUXURE C contains the list of all the Associate hospitals of CallHealth by category. This list is updated as and when additions and deletions happen or when there are any changes in the categorization.
REACH: A classification of an Associate Hospital based on the distance from the locality of client's home.
Customer-reach falls under the following two categories,
ANNUXURE D contains the list of 'localities' in Hyderabad.
First preference is given to Category A, unless there is a short fall in the Fair-Distribution-Set of having at least two members in each category. Any shortfall in having the minimum set of associate hospitals should be covered by expanding the reach distance in three kilometer chunks and borrowing from Category B.
4. AVAILABILITY: This is about a service being available at the required point in time. Example: If a customer is to be admitted in a hospital on a specified day, the rule of a hospital having rooms or an operation theater available for admission should be fulfilled.
5. CUSTOMER RATING: CallHealth encourages customers to rate their service experience with respect to each associate hospital. Weighted averages of those doctors are used while guiding the customers when they seek help in making a choice.
6. FAIR DISTRIBUTION: This criterion is about selecting a single Associate Hospital from the Fair-Distribution-Set (FDS) as per Proportionality Principle (PP).
How the Selection Rule Engine (SRE) works:
A. Customer Choice: The first and the most fundamental rule is that the choice of the customer - if he chooses to exercise it - determines the Associate Hospital he goes to, at anytime in the process.
B. Waterfall Method: The number of 'Potential Associate Hospitals' keeps shrinking as the SRE filtration happens from rule 1 to 4 in that order. For example, if some of the associate hospitals do not have the required service, the 'serviceability criterion' eliminates those hospitals from the list. The next criterion-'cost'-gets applied to the balance hospitals for further short listing. This process continues till rule four.
C. Customer Seeking Guidance (CSG): Rule number five is about the customer seeking guidance and wanting to make an informed choice. Remaining Associate Hospitals after applying rules 1 to 4 are ordered based on General Customer Ratings (GCR).
In case the customer has used one of the Associate Hospital's services earlier, he would be first asked if he wants to choose the same doctor. Should the customer ask for an alternative, three top rated Associate Hospitals are then presented to the customer for a choice to be made. Customer would be presented with the next three rated Associate Hospitals and more if the first three are not sufficient.
Example: Say, the total number of Associate Hospitals (the number of hospitals CallHealth has relationship with) is 50 in Hyderabad. After applying filtration procedures from rule 1 to rule 4, let us say, that the number comes down to 7. As per CSG rule, these hospitals are ordered from 1 to 7 based on customer ratings. The highest-rated-Associate-Hospital, say the one that is rated 4.5 on a scale of 5.0, gets ranked as number one. The least rated doctor, say the one that is ranked 3.6, gets ranked as number 7.
We are just launching our services and generation of statistically valid customer ratings will take some time, till we have a certain minimum number of customers who have rated an associate. In the interim, the selection and ordering of 3 hospitals after applying rules 1-4 will be done by the system on a random basis.
When the customer is unable to make a choice or when he explicitly asks CallHealth to make a choice, the Most Appropriate Service Associate (MASA) will be selected from the Fair Distribution Set (FDS) following Proportionality Principle (PP).
D. Fair-Distribution-Set (FDS): When the customer leaves the choice to CallHealth, selection is made out of the limited Associate Hospitals left after applying rules 1 to 5, called the Fair-Distribution-Set. Generally speaking, FDS covers only those instances where the customers have not made a choice by themselves.
Example: While the total number of Associate Hospitals of CallHealth may be 50, after applying filtration rules 1 to 5, the FDS Associate Hospitals for a given transaction may be only 7.
E .Proportionality Principle (PP): The computer system automatically records the time of selection of Associate Hospitals for the customers. Therefore, the computer system is aware of last selection times of each of the members of the FDS that resulted in serving a customer. Each eligible member in the FDS is sorted based on its last selection time in a chronological order (earliest to recent with earliest at the top) and PP follows a simple method of selecting the Associate Hospital that is at the top of this chronologically sorted list. Proportionality Principle follows a simple method of selecting an Associate Hospital that served its Last-FDS-Customer- Earliest (LFCE).
Example: If Associate Hospital 'A' served Last-FDS-Customer at 3pm yesterday, 'B' at 10am yesterday and 'C' at 11am today, 'B' gets selected because it served the Last-FDS-Customer-Earliest. It is to be noted that the customers that were served by the Associate Hospitals as chosen by the customers directly are disregarded for the purpose of applying Proportionality Principle.
F. Most Appropriate Service Associate (MASA): The Selection Rule Engine (SRE) always selects a single Associate hospital driven by the rules and principles stated above. As the SRE is mostly driven by technology, there is minimal time and effort on the part of the Call Centre Officer (CCO) in gathering additional information. The average estimated time for determination of MASA is 1 or 2 minutes.
G. Confidentiality: The actual data of Associate Hospitals that determine the ordering of Associate Hospital when the customer seeks guidance (CSG) or selection based on Proportionality Principle (PP) are closely guarded and kept confidential - only accessible to system administrators. Information can be furnished to respective Associate Hospitals on request to indicate their position vis-à-vis the general averages.
H. Transparency: In the spirit of transparency, CallHealth welcomes Associate Hospitals to bring up any deviations from the Selection Rule Engine criteria. A sub-committee that oversees application of Services Rule Engine will provide clarifications in an open manner, without compromising Associate Hospital or Customer confidentiality. The sub-committee also takes corrective action to plug any deficiencies in the SRE or eliminate implementation gaps.
I. Stakeholder Engagement Centre (SEC): SEC hosts all the Selection Rules Engine (SRE) information for the Associate Hospitals to access at all times. This is viewed as an integral part of the associate agreement with Hospitals. Services Rule Engine functioning is reviewed and updated periodically after taking into consideration any valid suggestions made by Associate Hospitals as stated above.
The Stakeholder Engagement Centre SEC is a Cloud computing platform that brings together Associates like you. Customers, Investors and Officers of the company under one virtual Space.
Our team will provide you with all necessary training to efficiently operate the intuitive software. We do understand the busy schedule of your staff and the time constraints they face. However, spending a little time on training will lead to better coordination between the Hospital and CallHealth.
CallHealth will be introducing a mobile app to access the SEC very shortly.
For hospitalisation facilitated by CallHealth, billing and payments are settled directly between the Hospital and the customer (or the insurance company, if applicable).
A copy of the final bill is to be provided at the time of discharge of the customer to the CallHealth Facilitator who will then charge the Hospital a percentage of the gross bill raised on the customer as Medical Facilitation charges.
The Associate Hospital needs to make payment directly into the CallHealth bank account via NEFT / RTGS every fortnight. Complete transparency is maintained and you can log onto the Associate Zone and view the payment history on your dashboard.