"I-SPRINT-electronic health care data exchange platform" for hassle free and seamless real-time health care data exchange b/n payers and providers for faster cashless hospitalizations. currently used by around 700 hospitals and 10 payers across india.

1. Presentation
Healthcare Payer Provider
Network
This document is confidential and is intended solely for the use and
information of the client to whom it is addressed.
HealthSprint Networks Pvt. Ltd.
i Sprint: Connecting Healthcare Ecosystem

2. Outline
 iSprint Goals
 Healthcare Insurance Payer Provider Ecosystem
 Key Challenges
 Current Processes
 Web Enabled & Improved Processes by iSprint
 Integrated Solution Architecture
 Summary: Value Proposition to Key Stakeholders
i Sprint: Connecting Healthcare Ecosystem

3. i Sprint Goals
i Sprint aims to be the pioneer in enabling efficiency in the healthcare
ecosystem by providing innovative Internet enabled services and
technology solutions to the healthcare industry.
The key objectives:
Enabling efficiencies among Providers, Payers and Patients by
providing solutions that streamline the information exchange
processes. Bridging the digital divide between payer and providers.
Enabling new cost effective business models for healthcare
insurance processes.
Enabling more effective processes to deliver better value
proposition in terms of customer satisfaction and money.
i Sprint: Connecting Healthcare Ecosystem

4. HealthCare Ecosystem
 Key Stake Holders
Doctors Medical colleges
(General/Specialist)
Hospitals/Healthcare Transaction
People/Patient
Institutes Banks
Verification Pharmaceutical
Entity/TPAs Companies
Insurers
Government Regulatory Authority
i Sprint: Connecting Healthcare Ecosystem

5. Annexure: Initiative of IT Department & IRDA;
HealthSprint’s Role
iSprint
i Sprint: Connecting Healthcare Ecosystem

6. Healthcare Internet:
Payer-Provider Network
 Need Seamless & timely exchange of information between TPAs &
Hospitals for providing best services to patients. This necessitates
following processes to be more efficient:
 Pre-Authorization
 Discharge Summary & Billing
 Validation of Submitted Info e-Preauth e-Claims
 Payment of Claims
Task
2 e-Payment e-Validation
 Internet Enabled Payer Provider Network
 To provide more effective process and work-flow for information
and money flow between Hospitals and TPAs.
 To manage payment risks for hospitals, TPAs and insurers.
i Sprint: Connecting Healthcare Ecosystem

7. Current Pre-Auth Process:
Paper Based Workflow
TPA/
Provider Faxed Insurance
Company
Batched
Sent by fax
Data Entry
Clerk:
Key in Data
Authorised
Examined
Need for more
by Auditor:
Information
Rejected/
Sent by fax
Accepted
i Sprint: Connecting Healthcare Ecosystem

8. Current Process Pain Points
Current Issues – Pre-authorization
 Incomplete information
 Fax transmission errors and fax transmission losses
 High Turnaround time
 No mapped flow of information
 Traceability & Accountability is absent
i Sprint: Connecting Healthcare Ecosystem

9. ePre-auth work flow
TPA/
HS Insurance
Provider
Company
HS HS
Authorised
Examined
Need for more
by Auditor:
Information
Rejected/
Accepted
i Sprint: Connecting Healthcare Ecosystem

10. i Sprint Pre-Auth Module
 All required information mandatory – complete Pre-Auth
sent electronically.
 No transmission losses.
 Integrated with TPA software drastic reduction in
Turnaround time for Pre-Authorization.
• Real time information to patients through SMS and e-mail alerts
i Sprint: Connecting Healthcare Ecosystem

11. Intelligent Monitoring and Analytics
iSprint – Connecting the Healthcare Ecosystem

12. Intelligent Monitoring and
Analytics(Graphical MIS)

13. i Sprint Network Architecture
Provider WWW Payer
Browser (IE)
Accounts Receivable
iSprint TPA
Sy
nc
Pre-Auth
Provider Host Application
TPA Host Application
Claims
Discharge DB
Sy Summary /
TPA Server
Medical Records
nc Case History
Secure
iSprint
Internet
Billing Browser
(IE)
Pre-Auth
Billing
Case History
Claims
Request Discharge
Summary
Response
Bank Application
i Sprint: Connecting Healthcare Ecosystem

14. i Sprint Improvement over Current paper
Based Process
Current Paper Based i Sprint Process
Process
Pre-Auth turnaround 4-48 hrs 30 min -2 hrs
time
Rejection: Discharge 3-8 % 0.5%
Summary/Billing
Payment Realization 1-3 months 15-30 days
time
This information is based on iSprint network operations in 15 hospitals in Bangalore.
i Sprint: Connecting Healthcare Ecosystem

15. i Sprint Network:
Bringing Benefits to All Key Stakeholders
 Reduced wait time for Pre-authorization
 Early identification of out of pocket payments
Patients
 Eliminates need for reimbursements
 Payment Risk Management
Providers  Ability to collect Balance payment from Patients
 Faster Settlement of Claims-Improved cash flow
 Reduction in erroneous claims- Saving processing cost, & payment
risk management
TPA
 Greater Visibility on cash flow commitments
 IT solutions reducing transaction cost / complexity
i Sprint: Connecting Healthcare Ecosystem

16. Customer Base
More than 150 Healthcare providers
and 8 TPAs and Insurance
companies using the platform in
India
CARE HOSPITAL
St.John's Medical College
iSprint – Connecting the Healthcare Ecosystem

17. i Sprint: Connecting Healthcare Ecosystem