DMs Hospitals nodal officer review 11 th Jan to 10 th JUNE 2016amp17 TNHSP Review Date 20062017 Venue DMS Chennai District Wise DMS Hospital Performance 11 th JAN 2012 TO 10 ID: 932403
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Slide1
Chief Minister’s Comprehensive Health Insurance Scheme
DMs Hospitals nodal officer review
11
th
Jan to 10
th
JUNE 2016&17
TNHSP - Review
Date: 20.06.2017
Venue: DMS -Chennai
Slide2District Wise DMS Hospital Performance
11th JAN 2012 TO 10
th JUN 2017 Preauth
Appr. In Crore
Slide3DMS - Top
30 Hospitals 11th JAN 2012 TO 10
th JUN 2017 Preauth
Appr. In Crore
Slide4DMS -
Middle Upper 30 Hospitals 11th JAN 2012 TO 10
th JUN 2017 Preauth
Appr. In Crore
Slide5DMS -
Middle Lower 30 Hosp 11
th JAN 2012 TO 10th
JUN 2017 Preauth Appr. In Crore
Slide6DMS - Low
Performance Hospitals 11TH JAN 2012 TO 10
TH JUN 2017 Preauth
Appr.
Slide7DIRECTORATE PREAUTH PERFORMANCE
S.No
Directorate
11-01-2016 to 10-06-201611-01-2017 to 10-06-2017ReceivedAppr. NosAmt in CroresReceivedAppr. NosAmt in Crores1DMS
145351182614.93204081764921.353DME573324823487.9872159
62769
111.402PRIVATE111092104625
229.67
125532
118135
256.72
Grand Total
182959
164685
332.58
218099
198553
389.47
Slide8ARIYALUR
Slide9Govt. Head Quarters
Hospital,Ariyalur TN.
Month Wise Performance
YearPreauth Status on 11.06.2016 & 17RECEIVEDAPPROVEDCANCELLEDDENIEDNMIPROCESSNos.Nos.Amt. in Lakhs
Nos.Nos.Nos.Nos.5H32028938.221317106H
298
27639.53411
7
0
Year
Claims Status on
11.06.2016
& 17
RECEIVED
CLAIMS
APPROVED
DENIED
NMI
PROCESS
Nos.
Nos.
Amt. in Lakhs
Nos.
Nos.
Nos.
5H
25223026.5213186H18116322.192142
Bed Strength - 132
Slide10Govt. Head Quarters
Hospital,Ariyalur TN.
S.No
Top 10 Package - 5HNosTop 10 Package - 6HNos1TN0565: Hearing Aid105CM0513 : MAINTANENCE HEMODIALYSIS FOR CRF (8 DIALYSIS) INCLUDING SEROPOSITIVE312TN0637: Abdominal Hystrectomy for Benign Conditions
38TN0385 : Term Baby /Culture Positive Sepsis/ Non-Ventilated/ Hyperbilirubinemia193TN0386: Preterm Baby/ Clinical Sepsis/ Hyperbilirubinemia (Non-Ventilated)27TN0870 : Lap. Appendicectomy144TN0385: Term Baby /Culture Positive Sepsis/ Non-Ventilated/ Hyperbilirubinemia22CM0623-I : ABDOMINAL HYSTERECTOMY FOR BENIGN / MALIGNANT CONDITIONS14
5
TN0314-b: Fracture Shaft of Other Long Bones (Humerus, Both Bones of Forarm, Both Bones of Leg)12CM0221 A : PRETERM BABY WITH CULTURE POSITIVE SEPSIS / CLINICAL SEPSIS WITHOUT MECHANICAL VENTILATION / CPAP13
6
TN0621: Vaginal Hysterectomy with Pelvic Floor Repair
12
TN0386 : Preterm Baby/ Clinical Sepsis/ Hyperbilirubinemia (Non-Ventilated)
12
7
TN0871: Appendicular Perforation
8
TN0702 : Maintenance Haemodialysis For CRF
11
8
TN0388: Term Baby With Severe Perinatal Asphyxia - Non-Ventilated clinical Sepsis with or without Hyperbilirubinemia
7
CM0924 : APPENDICULAR PERFORATION
11
9
TN0869: Ventral and Scar Hernia with Mesh
6
CM0218 C : TERM BABY WITH CULTURE POSITIVE SEPSIS / CLINICAL SEPSIS WITH MECHANICAL VENTILATION
1010TN0870: Lap. Appendicectomy6TN0314-b : Fracture Shaft of Other Long Bones (Humerus, Both Bones of Forarm, Both Bones of Leg)10
Slide11Govt.
Jayakondam Hospital, Ariyalur TN.
Month Wise Performance
YearPreauth Status on 11.06.2016 & 17RECEIVEDAPPROVEDCANCELLEDDENIEDNMIPROCESSNos.Nos.Amt. in Lakhs
Nos.Nos.Nos.Nos.5H41383.8703006H
39
373.7402
0
0
Year
Claims Status on
11.06.2016
& 17
RECEIVED
CLAIMS
APPROVED
DENIED
NMI
PROCESS
Nos.
Nos.
Amt. in Lakhs
Nos.
Nos.
Nos.
5H
28282.850006H31292.60002
Bed Strength - 144
Slide12Govt.
Jayakondam Hospital, Ariyalur TN.
S.No
Top 10 Package - 5HNosTop 10 Package - 6HNos1TN0565: Hearing Aid23CM0399 : HEARING AID - RESERVED TO GOVT142TN0637: Abdominal Hystrectomy for Benign Conditions
10TN0565 : Hearing Aid133TN0621: Vaginal Hysterectomy with Pelvic Floor Repair4TN0637 : Abdominal Hystrectomy for Benign Conditions34TN0636: Vaginal Hysterectomy for BENIGN CONDITIONS1TN0621 : Vaginal Hysterectomy with Pelvic Floor Repair2
5
CM0623-II : ABDOMINAL HYSTERECTOMY FOR BENIGN / MALIGNANT CONDITIONS26
CM0623-I : ABDOMINAL HYSTERECTOMY FOR BENIGN / MALIGNANT CONDITIONS
1
7
CM0758 : INCISIONAL HERNIA REPAIR WITH MESH
1
8
CM0475A : VAGINAL HYSTERECTOMY WITH PELVIC FLOOR REPAIR
1
9
10
Slide13ERODE
Slide14Govt
Hospital Bhavani, Erode TN.
Month Wise Performance
Bed Strength - 124YEARPreauth Status on 11.06.2016 & 17PREAUTH RECEIVEDAPPROVEDCANCELLEDDENIEDNMIPROCESSNo's.App Amt. (lac.)No's.
No's.No's.No's.5H78746.3222006H115
109
9.260510
YEAR
Claims Status on 11.06.2016 & 17
CLAIMS RECEIVED
APPROVED
DENIED
NMI
PROCESS
No's.
App Amt. (lac.)
No's.
No's.
No's.
5H
63
63
5.37
0
0
0
6H90897.07100
Slide15Govt
Hospital Bhavani, Erode TN.
S.No
Top 10 Package - 5HNosTop 10 Package - 6HNos1TN0385: Term Baby /Culture Positive Sepsis/ Non-Ventilated/ Hyperbilirubinemia57TN0385 : Term Baby /Culture Positive Sepsis/ Non-Ventilated/ Hyperbilirubinemia362TN0871: Appendicular Perforation5
CM0218 A : TERM BABY WITH CULTURE POSITIVE SEPSIS / CLINICAL SEPSIS WITHOUT MECHANICAL VENTILATION / CPAP223TN0317: Soft Tissue Injury4TN0565 : Hearing Aid64TN0867: Umbilical Hernia with Mesh3CM0219 D : TERM BABY HYPERBILIRUBINEMIA - Phototherapy65
TN0869: Ventral and Scar Hernia with Mesh
2CM0399 : HEARING AID - RESERVED TO GOVT56
TN0862: Epigastric Hernia with Mesh
2
TN0871 : Appendicular Perforation
5
7
TN0637: Abdominal
Hystrectomy
for Benign Conditions
1
CM0222 A : PRETERM BABY HYPERBILIRBINEMIA / EXCHANGE TRANSFUSION / WITH OR WITHOUT MECHANICAL VENTILATION / CPAP
3
8
-
-
TN0317 : Soft Tissue Injury
3
9
-
-
CM0219 A : TERM BABY HYPERBILIRUBINEMIA - EXCHANGE TRANSFUSION WITHOUT MECHANICAL VENTILATION / CPAP310--CM0223 A : TERM BABY - PNEUMONIA/BRONCHIOLITIS /TRANSIENT TACHYPNEA OF NEW BORN WITH CPAP2
Slide16Govt. Hospital
Gobichettipalayam, Erode TN.
Month Wise Performance
Bed Strength - 143YEARPreauth Status on 11.06.2016 & 17PREAUTH RECEIVEDAPPROVEDCANCELLEDDENIEDNMIPROCESSNo's.App Amt. (lac.)No's.
No's.No's.No's.5H11810916.6736006H251
224
32.1671019
YEAR
Claims Status on 11.06.2016 & 17
CLAIMS RECEIVED
APPROVED
DENIED
NMI
PROCESS
No's.
App Amt. (lac.)
No's.
No's.
No's.
5H
102
101
14.66
0
1
0
6H20319325.730100
Slide17Govt. Hospital
Gobichettipalayam, Erode TN.
S.No
Top 10 Package - 5HNosTop 10 Package - 6HNos1TN0688: Acute MI (Conservative Management without Angiogram)23TN0385 : Term Baby /Culture Positive Sepsis/ Non-Ventilated/ Hyperbilirubinemia302TN0870: Lap. Appendicectomy19
TN0688 : Acute MI (Conservative Management without Angiogram)243TN0386: Preterm Baby/ Clinical Sepsis/ Hyperbilirubinemia (Non-Ventilated)13CM0487 : ACUTE MI (CONSERVATIVE MANAGEMENT WITHOUT ANGIOGRAM)184TN0711: Ischemic Strokes12TN0870 : Lap. Appendicectomy12
5
TN0317: Soft Tissue Injury7TN0314 : Surgical Correction of Longbone Fracture116
TN0279: Upto-40% Mixed Burns (With Surgeries)
4
TN0711 : Ischemic Strokes
10
7
TN0974: Lap.Cholecystectomy
3
CM0516B : ISCHEMIC STROKE
8
8
TN0621: Vaginal Hysterectomy with Pelvic Floor Repair
3
CM0183 : SURGICAL CORRECTION OF LONGBONE FRACTURE-FRACTURE NECK/ SHAFT OF FEMUR/FRACTURE SHAFT OF OTHER LONG BONES (HUMERUS,BOTH BONES OF FOREARM, BOTH BONES OF LEG)
6
9
TN0388: Term Baby With Severe Perinatal Asphyxia - Non-Ventilated clinical Sepsis with or without Hyperbilirubinemia
3
CM0923 : LAP. APPENDICECTOMY
5
10TN0314-b: Fracture Shaft of Other Long Bones (Humerus, Both Bones of Forarm, Both Bones of Leg)3CM0186B : IMPLANT EXIT- PLATES (SPINE IMPLANTS/OTHER MAJOR IMPLANT)5
Slide18Govt.Head
Quarters Hospital,Erode TN.
Month Wise Performance
Bed Strength - 608YEARPreauth Status on 11.06.2016 & 17PREAUTH RECEIVEDAPPROVEDCANCELLEDDENIEDNMIPROCESSNo's.App Amt. (lac.)No's.
No's.No's.No's.5H29628129.9767206H320
309
36.452351
YEAR
Claims Status on 11.06.2016 & 17
CLAIMS RECEIVED
APPROVED
DENIED
NMI
PROCESS
No's.
App Amt. (lac.)
No's.
No's.
No's.
5H
208
200
19.87
0
2
6
6H22521421.31056
Slide19Govt.Head
Quarters Hospital,Erode TN.
S.No
Top 10 Package - 5HNosTop 10 Package - 6HNos1TN0702: Maintenance Haemodialysis For CRF188TN0702 : Maintenance Haemodialysis For CRF1002TN0870: Lap. Appendicectomy15
CM0513 : MAINTANENCE HEMODIALYSIS FOR CRF (8 DIALYSIS) INCLUDING SEROPOSITIVE963TN0386: Preterm Baby/ Clinical Sepsis/ Hyperbilirubinemia (Non-Ventilated)14TN0711 : Ischemic Strokes144TN0637: Abdominal Hystrectomy for Benign Conditions8TN0565 : Hearing Aid105
TN0385: Term Baby /Culture Positive Sepsis/ Non-Ventilated/ Hyperbilirubinemia
5TN0870 : Lap. Appendicectomy106
TN0867: Umbilical Hernia with Mesh
4
TN0688 : Acute MI (Conservative Management without Angiogram)
6
7
TN0389: Term Baby With Persistent Pulmonary Hypertension/Meconium Aspiration Syndrome/Mechanical Ventilation/with or Without- Clinical Sepsis/with or without-
Hyperbilirubinemia
/ with or without Perinatal Asphyxia
4
CM0399 : HEARING AID - RESERVED TO GOVT
6
8
TN0388: Term Baby With Severe Perinatal Asphyxia - Non-Ventilated clinical Sepsis with or without Hyperbilirubinemia
4
CM0487 : ACUTE MI (CONSERVATIVE MANAGEMENT WITHOUT ANGIOGRAM)
5
9
TN0688: Acute MI (Conservative Management without Angiogram)
4
CM0778-A-I : WIDE EXICISION/ LUMPECTOMY - TUMORS OF BREAST -BENIGN410TN0621: Vaginal Hysterectomy with Pelvic Floor Repair3CM0516B : ISCHEMIC STROKE4
Slide20Govt.
Hospital,Anthiyur, Erode TN.
Bed Strength - 60
YEARPreauth Status on 11.06.2016 & 17PREAUTH RECEIVEDAPPROVEDCANCELLEDDENIEDNMIPROCESSNo's.App Amt. (lac.)No's.No's.
No's.No's.6H000.000000YEAR
Claims Status on 11.06.2016 & 17
CLAIMS RECEIVEDAPPROVEDDENIEDNMI
PROCESS
No's.
App Amt. (lac.)
No's.
No's.
No's.
6H
0
0
0.00
0
0
0
Emp
Date- 20-04-2017
Slide21Govt.
Hospital,Perundurai, Erode TN.
Emp Date- 20-04-2017
Bed Strength - 60YEARPreauth Status on 11.06.2016 & 17PREAUTH RECEIVEDAPPROVEDCANCELLEDDENIEDNMIPROCESSNo's.App Amt. (lac.)No's.
No's.No's.No's.6H000.000000
YEAR
Claims Status on 11.06.2016 & 17CLAIMS RECEIVEDAPPROVEDDENIED
NMI
PROCESS
No's.
App Amt. (lac.)
No's.
No's.
No's.
6H
0
0
0.00
0
0
0
Slide22Govt.
Hospital,Sathyamangalam, Erode TN.
Bed Strength - 120
YEARPreauth Status on 11.06.2016 & 17PREAUTH RECEIVEDAPPROVEDCANCELLEDDENIEDNMIPROCESSNo's.App Amt. (lac.)No's.No's.
No's.No's.6H000.000000YEAR
Claims Status on 11.06.2016 & 17
CLAIMS RECEIVEDAPPROVEDDENIEDNMI
PROCESS
No's.
App Amt. (lac.)
No's.
No's.
No's.
6H
0
0
0.00
0
0
0
Emp
Date- 20-04-2017
Slide23KANYAKUMARI
Slide24Govt Hospital
Bhoothapandi,Kanyakumari
TN.
Month Wise PerformanceYearPreauth Status on 11.06.2016 & 17RECEIVEDAPPROVEDCANCELLEDDENIEDNMIPROCESSNos.Nos.Amt. In Lakhs
Nos.Nos.Nos.Nos.5H 22182.5410216H
67
647.34300
0
Year
Claims Status on 11.06.2016 & 17
RECEIVED
CLAIMS APPROVED
DENIED
NMI
PROCESS
Nos.
Nos.
Amt. In Lakhs
Nos.
Nos.
Nos.
5H
15
15
1.68
0
006H 55545.41010Bed Strength- 73
Slide25Govt Hospital
Bhoothapandi,Kanyakumari
TN.
S.No Top 10 Package - 5H NosTop 10 Package - 6H Nos1TN0621: Vaginal Hysterectomy with Pelvic Floor Repair3TN0643 : Acute Bronchitis and Pneumonia with Respiratory Failure252TN0711: Ischemic Strokes3
CM0501 : ACUTE BRONCHITIS AND PNEUMONIA WITH RESPIRATORY FAILURE143TN0688: Acute MI (Conservative Management without Angiogram)3TN0637 : Abdominal Hystrectomy for Benign Conditions44TN0637: Abdominal Hystrectomy for Benign Conditions2TN0711 : Ischemic Strokes35
TN0701: Chronic Renal Failure 1 (CRF )
2TN0701 : Chronic Renal Failure 1 (CRF )26
TN0673: Cirrhosis with Hepatic Encephalopathy
2
TN0698 : Acute Renal Failure-(ARF)
2
7
TN0661: Bronchiectasis with Repeated Hospitalisation > 6 Per Year
1
CM0921D : EPIGASTRIC HERNIA/UMBILICAL HERNIA - WITH MESH - OPEN
2
8
TN0893: Cirrhosis of Liver
1
CM0778-A-I : WIDE EXICISION/ LUMPECTOMY - TUMORS OF BREAST -BENIGN
2
9
TN0692: Refractory Cardiac Failure
1
TN0278 : Upto-40% With Scalds (Conservative)
1
10TN0688 : Acute MI (Conservative Management without Angiogram)1
Slide26Govt
hospital,kulithurai,Kanyakumari,TN
.
Month Wise PerformanceYearPreauth Status on 11.06.2016 & 17RECEIVEDAPPROVEDCANCELLEDDENIEDNMIPROCESSNos.Nos.Amt. In Lakhs
Nos.Nos.Nos.Nos.5H 72546.9759316H
67
596.20422
0
Year
Claims Status on 11.06.2016 & 17
RECEIVED
CLAIMS APPROVED
DENIED
NMI
PROCESS
Nos.
Nos.
Amt. In Lakhs
Nos.
Nos.
Nos.
5H
50
47
5.26
0
126H 52413.65155Bed Strength- 132
Slide27Govt
hospital,kulithurai,Kanyakumari,TN
.
S.No Top 10 Package - 5H NosTop 10 Package - 6H Nos1TN0895: Chronic Hepatitis B9TN0711 : Ischemic Strokes62TN0711: Ischemic Strokes6
TN0385 : Term Baby /Culture Positive Sepsis/ Non-Ventilated/ Hyperbilirubinemia63TN0385: Term Baby /Culture Positive Sepsis/ Non-Ventilated/ Hyperbilirubinemia6CM0491 : CONGESTIVE CARDIAC FAILURE44TN0692: Refractory Cardiac Failure4TN0316-e : Amputation of Toes35
TN0392: Severe Bronchiolitis/Severe Broncho Pneumonia/Severe aspiration Pneumonia (Non-Ventilated)
3TN0893 : Cirrhosis of Liver36
TN0637: Abdominal Hystrectomy for Benign Conditions
3
TN0637 : Abdominal Hystrectomy for Benign Conditions
2
7
TN0867: Umbilical Hernia with Mesh
2
CM0218 A : TERM BABY WITH CULTURE POSITIVE SEPSIS / CLINICAL SEPSIS WITHOUT MECHANICAL VENTILATION / CPAP
2
8
TN0863: Femoral Hernia
2
CM0820-III : AMPUTATION OF ANY SITE / ANY CAUSE WITHOUT PROSTHESIS (fingers, toes and small joints)
2
9
TN0869: Ventral and Scar Hernia with Mesh
2
CM0623-I : ABDOMINAL HYSTERECTOMY FOR BENIGN / MALIGNANT CONDITIONS
2
10TN0110: Lumpectomy2CM0225 A : TERM - WITH OR WITHOUT /SEVERE PERINATAL ASPHYXIA /SEPTIC SHOCK /SEIZURES /RENAL FAILURE/ - NON VENTILATED2
Slide28Govt. Head Quarters
Hospital,Kanyakumari
TN.
Month Wise PerformanceYearPreauth Status on 11.06.2016 & 17RECEIVEDAPPROVEDCANCELLEDDENIEDNMIPROCESSNos.Nos.Amt. In Lakhs
Nos.Nos.Nos.Nos.5H 26722522.62434226H
426
38837.5432113
1
Year
Claims Status on 11.06.2016 & 17
RECEIVED
CLAIMS APPROVED
DENIED
NMI
PROCESS
Nos.
Nos.
Amt. In Lakhs
Nos.
Nos.
Nos.
5H
210
180
14.08
4
1976H 34428623.7433322Bed Strength- 154
Slide29Govt. Head Quarters
Hospital,Kanyakumari
TN.
S.No Top 10 Package - 5H NosTop 10 Package - 6H Nos1FP0073 : COPD Respiratory Failure (infective exacerbation) (First Otr)31CM0522 : ACUTE RESPIRATORY FAILURE (WITHOUT VENTILATOR)492TN0692: Refractory Cardiac Failure
28TN0702 : Maintenance Haemodialysis For CRF243TN0711: Ischemic Strokes25TN0664 : Acute Respiratory Failure (Without Ventilator)214TN0642: Copd Respiratory Failure (Infective Exacerbation)22TN0385 : Term Baby /Culture Positive Sepsis/ Non-Ventilated/ Hyperbilirubinemia21
5
TN0702: Maintenance Haemodialysis For CRF20TN0711 : Ischemic Strokes196
FP0073-a : COPD Respiratory Failure (infective exacerbation) (Next 3 Qtrs)
13
CM0500 : COPD RESPIRATORY FAILURE (INFECTIVE EXACERBATION)
18
7
TN0688: Acute MI (Conservative Management without Angiogram)
7
TN0642 : Copd Respiratory Failure (Infective Exacerbation)
17
8
TN0392: Severe Bronchiolitis/Severe Broncho Pneumonia/Severe aspiration Pneumonia (Non-Ventilated)
7
CM0513 : MAINTANENCE HEMODIALYSIS FOR CRF (8 DIALYSIS) INCLUDING SEROPOSITIVE
15
9
TN0661: Bronchiectasis with Repeated Hospitalisation > 6 Per Year
7
CM0218 A : TERM BABY WITH CULTURE POSITIVE SEPSIS / CLINICAL SEPSIS WITHOUT MECHANICAL VENTILATION / CPAP
14
10TN0893: Cirrhosis of Liver6TN0692 : Refractory Cardiac Failure14
Slide30Govt Hospital
Kulasekaram
, Kanyakumari TN.
YearPreauth Status on 11.06.2016 & 17RECEIVEDAPPROVEDCANCELLEDDENIEDNMIPROCESSNos.Nos.Amt. In LakhsNos.
Nos.Nos.Nos.5H 20002006H 0
0
00000
Year
Claims Status on 11.06.2016 & 17
RECEIVED
CLAIMS APPROVED
DENIED
NMI
PROCESS
Nos.
Nos.
Amt. In Lakhs
Nos.
Nos.
Nos.
5H
0
0
0
0
0
06H 000000Bed Strength- 60
Slide31MADURAI
Slide32Govt Hospital Thirumangalam, Madurai TN
.
Month Wise Performance
YearPreauth Status on 11.06.2016 & 17RECEIVEDAPPROVEDCANCELLEDDENIEDNMIPROCESSNos.Nos.Amt. In LakhsNos.
Nos.Nos.Nos.5H 11810113.9186216H 109
94
8.952103
0
Year
Claims Status on 11.06.2016 & 17
RECEIVED
CLAIMS APPROVED
DENIED
NMI
PROCESS
Nos.
Nos.
Amt. In Lakhs
Nos.
Nos.
Nos.
5H
87
79
8.32
3
506H 69655.66220Bed Strength- 145
Slide33Govt Hospital Thirumangalam, Madurai TN
.
S.No
Top 10 Package - 5H NosTop 10 Package - 6H Nos1TN0385: Term Baby /Culture Positive Sepsis/ Non-Ventilated/ Hyperbilirubinemia37TN0385 : Term Baby /Culture Positive Sepsis/ Non-Ventilated/ Hyperbilirubinemia332TN0637: Abdominal Hystrectomy for Benign Conditions
11CM0399 : HEARING AID - RESERVED TO GOVT133TN0617: Rupture Uterus with Tubectomy7CM0219 A : TERM BABY HYPERBILIRUBINEMIA - EXCHANGE TRANSFUSION WITHOUT MECHANICAL VENTILATION / CPAP74TN0688: Acute MI (Conservative Management without Angiogram)6TN0278 : Upto-40% With Scalds (Conservative)6
5
TN0314-a: Fracture Neck/ Shaft Of Femur6TN0637 : Abdominal Hystrectomy for Benign Conditions66
TN0692: Refractory Cardiac Failure
6
TN0642 : Copd Respiratory Failure (Infective Exacerbation)
4
7
TN0650: Thrombocytopenia with Bleeding Diathesis
5
TN0688 : Acute MI (Conservative Management without Angiogram)
3
8
TN0278: Upto-40% With Scalds (Conservative)
4
TN0692 : Refractory Cardiac Failure
3
9
TN0654: Snake Bite Requiring Ventilator Support
3
CM0158 : UPTO-40% WITH SCALDS (CONSERVATIVE)
3
10TN0279: Upto-40% Mixed Burns (With Surgeries)3CM0500 : COPD RESPIRATORY FAILURE (INFECTIVE EXACERBATION)3
Slide34Govt hospital,Melur,Madurai,TN
.
Month Wise Performance
YearPreauth Status on 11.06.2016 & 17RECEIVEDAPPROVEDCANCELLEDDENIEDNMIPROCESSNos.Nos.Amt. In LakhsNos.
Nos.Nos.Nos.5H 1118911.8299136H 99
89
14.00424
0
Year
Claims Status on 11.06.2016 & 17
RECEIVED
CLAIMS APPROVED
DENIED
NMI
PROCESS
Nos.
Nos.
Amt. In Lakhs
Nos.
Nos.
Nos.
5H
81
75
9.27
2
406H 726710.04005Bed Strength- 108
Slide35Govt hospital,Melur,Madurai,TN
.
S.No
Top 10 Package - 5H NosTop 10 Package - 6H Nos1TN0314-b: Fracture Shaft of Other Long Bones (Humerus, Both Bones of Forarm, Both Bones of Leg)19TN0314-b : Fracture Shaft of Other Long Bones (Humerus, Both Bones of Forarm, Both Bones of Leg)102TN0565: Hearing Aid
13CM0183 : SURGICAL CORRECTION OF LONGBONE FRACTURE-FRACTURE NECK/ SHAFT OF FEMUR/FRACTURE SHAFT OF OTHER LONG BONES (HUMERUS,BOTH BONES OF FOREARM, BOTH BONES OF LEG)83TN0392: Severe Bronchiolitis/Severe Broncho Pneumonia/Severe aspiration Pneumonia (Non-Ventilated)8TN0314-a : Fracture Neck/ Shaft Of Femur84TN0650: Thrombocytopenia with Bleeding Diathesis7TN0587 : Endoscopic Sinus Surgery4
5
TN0314-a: Fracture Neck/ Shaft Of Femur7TN0637 : Abdominal Hystrectomy for Benign Conditions4
6
TN0670: Acute Pancreatitis (Mild)
4
CM0419 : ENDOSCOPIC SINUS SURGERY-CHRONIC RHINO SINUSITIS
4
7
TN0385: Term Baby /Culture Positive Sepsis/ Non-Ventilated/ Hyperbilirubinemia
3
TN0650 : Thrombocytopenia with Bleeding Diathesis
4
8
TN0863: Femoral Hernia
3
CM0218 A : TERM BABY WITH CULTURE POSITIVE SEPSIS / CLINICAL SEPSIS WITHOUT MECHANICAL VENTILATION / CPAP
3
9
TN0710: Hemorrhagic Stroke/Strokes
3
TN0711 : Ischemic Strokes
310TN0388: Term Baby With Severe Perinatal Asphyxia - Non-Ventilated clinical Sepsis with or without Hyperbilirubinemia3TN0565 : Hearing Aid2
Slide36Govt. Head Quarters
Hospital,Madurai
TN.
Month Wise PerformanceYearPreauth Status on 11.06.2016 & 17RECEIVEDAPPROVEDCANCELLEDDENIEDNMIPROCESSNos.Nos.Amt. In Lakhs
Nos.Nos.Nos.Nos.5H 17514522.40319716H
369
31830.71162311
1
Year
Claims Status on 11.06.2016 & 17
RECEIVED
CLAIMS APPROVED
DENIED
NMI
PROCESS
Nos.
Nos.
Amt. In Lakhs
Nos.
Nos.
Nos.
5H
130
121
15.19
4
506H 22220219.250200Bed Strength- 185
Slide37Govt. Head Quarters
Hospital,Madurai
TN.
S.No Top 10 Package - 5H NosTop 10 Package - 6H Nos1TN0637: Abdominal Hystrectomy for Benign Conditions30TN0388 : Term Baby With Severe Perinatal Asphyxia - Non-Ventilated clinical Sepsis with or without Hyperbilirubinemia1012TN0388: Term Baby With Severe Perinatal Asphyxia - Non-Ventilated clinical Sepsis with or without Hyperbilirubinemia
27CM0225 A : TERM - WITH OR WITHOUT /SEVERE PERINATAL ASPHYXIA /SEPTIC SHOCK /SEIZURES /RENAL FAILURE/ - NON VENTILATED493TN0386: Preterm Baby/ Clinical Sepsis/ Hyperbilirubinemia (Non-Ventilated)16CM0218 A : TERM BABY WITH CULTURE POSITIVE SEPSIS / CLINICAL SEPSIS WITHOUT MECHANICAL VENTILATION / CPAP224TN0617: Rupture Uterus with Tubectomy10TN0617 : Rupture Uterus with Tubectomy20
5
TN0711: Ischemic Strokes9CM0220 A : TERM BABY PERSISTENT PULMONARY HYPERTENSION / MECONIUM ASPIRATION SYNDROME / PERINATAL ASPHYXIA / WITHOUT MECHANICAL VENTILATION / CPAP17
6
TN0688: Acute MI (Conservative Management without Angiogram)
8
TN0385 : Term Baby /Culture Positive Sepsis/ Non-Ventilated/ Hyperbilirubinemia
13
7
TN0314-b: Fracture Shaft of Other Long Bones (Humerus, Both Bones of Forarm, Both Bones of Leg)
6
CM0227 A : PRETERM BABY RDS WITHOUT SURFACTANT WITH CPAP
11
8
TN0621: Vaginal Hysterectomy with Pelvic Floor Repair
6
TN0386 : Preterm Baby/ Clinical Sepsis/ Hyperbilirubinemia (Non-Ventilated)
7
9
TN0315-b: Non-Union of Other Long Bones (Humerus, Both Bones of Forarm, Both Bones of Leg)
4
TN0314-b : Fracture Shaft of Other Long Bones (Humerus, Both Bones of Forarm, Both Bones of Leg)
610TN0278: Upto-40% With Scalds (Conservative)4CM0219 A : TERM BABY HYPERBILIRUBINEMIA - EXCHANGE TRANSFUSION WITHOUT MECHANICAL VENTILATION / CPAP5
Slide38GOVT HOSPITAL PERAIYUR, Madurai TN.
Month Wise Performance
Year
Preauth Status on 11.06.2016 & 17RECEIVEDAPPROVEDCANCELLEDDENIEDNMIPROCESSNos.Nos.Amt. In LakhsNos.
Nos.Nos.Nos.5H 47408.5342106H 10
9
1.12001
0
Year
Claims Status on 11.06.2016 & 17
RECEIVED
CLAIMS APPROVED
DENIED
NMI
PROCESS
Nos.
Nos.
Amt. In Lakhs
Nos.
Nos.
Nos.
5H
38
34
6.35
0
406H 881.02000Bed Strength- 132
Slide39GOVT HOSPITAL PERAIYUR, Madurai TN.
S.No
Top 10 Package - 5H NosTop 10 Package - 6H Nos1TN0642: Copd Respiratory Failure (Infective Exacerbation)8TN0654 : Snake Bite Requiring Ventilator Support52TN0587: Endoscopic Sinus Surgery7
CM0502 : REQUIRING VENTILATORY SUPPORT -OP POISIONING / METABOLIC COMA/SCORPION STING/ SNAKE BITE / BITES & STINGS (PER DAY)- MAX 7 DAYS23TN0654: Snake Bite Requiring Ventilator Support7CM0502 : REQUIRING VENTILATORY SUPPORT -OP POISIONING / METABOLIC COMA/SCORPION STING/ SNAKE BITE / BITES & STINGS - MAX 7 DAYS14TN0408: Snake Bite Requiring Ventilator Assistance5TN0386 : Preterm Baby/ Clinical Sepsis/ Hyperbilirubinemia (Non-Ventilated)1
5
TN0806: URSL36
TN0661: Bronchiectasis with Repeated Hospitalisation > 6 Per Year
3
7
TN0571: Mastoidectomy
2
8
TN0858: Total Thyroidectomy
2
9
TN0836: Transurethral Resection of Prostate (TURP)
1
10
TN0580: Adenoidectomy - Gromet Insertion
1
Slide40Govt Hospital
Vadipatti,Madurai
TN.
YearPreauth Status on 11.06.2017RECEIVEDAPPROVEDCANCELLEDDENIEDNMIPROCESSNos.Nos.Amt. In LakhsNos.
Nos.Nos.Nos.6H 0000000Year
Claims Status on
11.06.2017RECEIVEDCLAIMS APPROVED DENIED
NMI
PROCESS
Nos.
Nos.
Amt. In Lakhs
Nos.
Nos.
Nos.
6H
0
0
0
0
0
0
Bed Strength- 48
Emp
Date- 15.5.2017
Slide41NAGAPATTINAM
Slide42Govt.
Mayiladuthurai
Hospital, Nagapattinam TN.
Month Wise PerformanceYearPreauth Status on 11.06.2016 & 17RECEIVEDAPPROVEDCANCELLEDDENIEDNMIPROCESSNos.Nos.Amt. In Lakhs
Nos.Nos.Nos.Nos.5H 65568.4133306H
132
11511.22263
6
Year
Claims Status on 11.06.2016 & 17
RECEIVED
CLAIMS APPROVED
DENIED
NMI
PROCESS
Nos.
Nos.
Amt. In Lakhs
Nos.
Nos.
Nos.
5H
40
33
3.63
0
706H 80736.79511Bed Strength- 324
Slide43Govt.
Mayiladuthurai
Hospital, Nagapattinam TN.
S.No Top 10 Package - 5H NosTop 10 Package - 6H Nos1TN0388: Term Baby With Severe Perinatal Asphyxia - Non-Ventilated clinical Sepsis with or without Hyperbilirubinemia14CM0218 A : TERM BABY WITH CULTURE POSITIVE SEPSIS / CLINICAL SEPSIS WITHOUT MECHANICAL VENTILATION / CPAP152TN0386: Preterm Baby/ Clinical Sepsis/ Hyperbilirubinemia (Non-Ventilated)
13TN0385 : Term Baby /Culture Positive Sepsis/ Non-Ventilated/ Hyperbilirubinemia133TN0621: Vaginal Hysterectomy with Pelvic Floor Repair9TN0621 : Vaginal Hysterectomy with Pelvic Floor Repair84TN0314-b: Fracture Shaft of Other Long Bones (Humerus, Both Bones of Forarm, Both Bones of Leg)5TN0388 : Term Baby With Severe Perinatal Asphyxia - Non-Ventilated clinical Sepsis with or without Hyperbilirubinemia
7
5TN0637: Abdominal Hystrectomy for Benign Conditions5TN0386 : Preterm Baby/ Clinical Sepsis/ Hyperbilirubinemia (Non-Ventilated)6
6
TN0869: Ventral and Scar Hernia with Mesh
2
CM0220 A : TERM BABY PERSISTENT PULMONARY HYPERTENSION / MECONIUM ASPIRATION SYNDROME / PERINATAL ASPHYXIA / WITHOUT MECHANICAL VENTILATION / CPAP
6
7
TN0314-a: Fracture Neck/ Shaft Of Femur
2
CM0218 B : TERM BABY WITH CULTURE POSITIVE SEPSIS / CLINICAL SEPSIS WITH CPAP
5
8
TN0387: Preterm Baby/ Hyaline Membrane Disease Clinical/Culture Positive Sepsis/Hyperbilirubinemia Mechanical Ventilation
2
CM0982 : OP /ANY POISIONING - CONSERVATIVE MANAGEMENT OR WITHOUT VENTILATORY SUPPORT (ONLY WITH FIR )
5
9
TN0858: Total Thyroidectomy
1
TN0870 : Lap. Appendicectomy
510TN0867: Umbilical Hernia with Mesh1CM0924 : APPENDICULAR PERFORATION4
Slide44Govt.Head
Quarters
Hospital,Nagapattinam TN.
Month Wise PerformanceYearPreauth Status on 11.06.2016 & 17RECEIVEDAPPROVEDCANCELLEDDENIEDNMIPROCESSNos.Nos.Amt. In Lakhs
Nos.Nos.Nos.Nos.5H 25917527.784927806H
309
25933.7027156
2
Year
Claims Status on 11.06.2016 & 17
RECEIVED
CLAIMS APPROVED
DENIED
NMI
PROCESS
Nos.
Nos.
Amt. In Lakhs
Nos.
Nos.
Nos.
5H
133
88
10.88
5
4006H 171604.0309417Bed Strength- 545
Slide45Govt.Head
Quarters
Hospital,Nagapattinam TN.
S.No Top 10 Package - 5H NosTop 10 Package - 6H Nos1TN0702: Maintenance Haemodialysis For CRF39TN0385 : Term Baby /Culture Positive Sepsis/ Non-Ventilated/ Hyperbilirubinemia362TN0314-b: Fracture Shaft of Other Long Bones (Humerus, Both Bones of Forarm, Both Bones of Leg)
23CM0183 : SURGICAL CORRECTION OF LONGBONE FRACTURE-FRACTURE NECK/ SHAFT OF FEMUR/FRACTURE SHAFT OF OTHER LONG BONES (HUMERUS,BOTH BONES OF FOREARM, BOTH BONES OF LEG)253TN0688: Acute MI (Conservative Management without Angiogram)19CM0218 A : TERM BABY WITH CULTURE POSITIVE SEPSIS / CLINICAL SEPSIS WITHOUT MECHANICAL VENTILATION / CPAP254TN0302: Reconstructive Lower Limb Surgery Following Infection, Trauma, Tumors / Malignancy, Developmental Including Diabetic Foot - Moderate14TN0702 : Maintenance Haemodialysis For CRF24
5
TN0871: Appendicular Perforation13TN0688 : Acute MI (Conservative Management without Angiogram)226
TN0637: Abdominal Hystrectomy for Benign Conditions
9
CM0513 : MAINTANENCE HEMODIALYSIS FOR CRF (8 DIALYSIS) INCLUDING SEROPOSITIVE
21
7
TN0385: Term Baby /Culture Positive Sepsis/ Non-Ventilated/ Hyperbilirubinemia
9
TN0314-b : Fracture Shaft of Other Long Bones (Humerus, Both Bones of Forarm, Both Bones of Leg)
14
8
TN0278: Upto-40% With Scalds (Conservative)
4
CM0399 : HEARING AID - RESERVED TO GOVT
10
9
TN0869: Ventral and Scar Hernia with Mesh
4
CM0487 : ACUTE MI (CONSERVATIVE MANAGEMENT WITHOUT ANGIOGRAM)
9
10TN0867: Umbilical Hernia with Mesh4TN0565 : Hearing Aid7
Slide46GOVT. HOSPITAL,VEDARANYAM NAGAPATTINAM TN.
Month Wise Performance
Year
Preauth Status on 11.06.2016 & 17RECEIVEDAPPROVEDCANCELLEDDENIEDNMIPROCESSNos.Nos.Amt. In LakhsNos.
Nos.Nos.Nos.5H 23181.6330206H 64
61
3.42210
0
Year
Claims Status on 11.06.2016 & 17
RECEIVED
CLAIMS APPROVED
DENIED
NMI
PROCESS
Nos.
Nos.
Amt. In Lakhs
Nos.
Nos.
Nos.
5H
17
17
1.48
0
006H 54532.56010Bed Strength- 83
Slide47GOVT. HOSPITAL,VEDARANYAM NAGAPATTINAM TN.
S.No
Top 10 Package - 5H NosTop 10 Package - 6H Nos1TN0392: Severe Bronchiolitis/Severe Broncho Pneumonia/Severe aspiration Pneumonia (Non-Ventilated)12TN0392 : Severe Bronchiolitis/Severe Broncho Pneumonia/Severe aspiration Pneumonia (Non-Ventilated)342TN0388: Term Baby With Severe Perinatal Asphyxia - Non-Ventilated clinical Sepsis with or without Hyperbilirubinemia
4CM0399 : HEARING AID - RESERVED TO GOVT83TN0280: Upto-50% With Scalds (Conservative)2CM0233 : SEVERE BRONCHIOLITIS/SEVERE BRONCHO PNEUMONIA / SEVERE ASPIRATION PNEUMONIA (NON-VENTILATED)64TN0388 : Term Baby With Severe Perinatal Asphyxia - Non-Ventilated clinical Sepsis with or without Hyperbilirubinemia4
5
CM0158 : UPTO-40% WITH SCALDS (CONSERVATIVE)46
TN0375 : Kerosene Ingestion
2
7
TN0278 : Upto-40% With Scalds (Conservative)
2
8
CM0218 A : TERM BABY WITH CULTURE POSITIVE SEPSIS / CLINICAL SEPSIS WITHOUT MECHANICAL VENTILATION / CPAP
1
9
10
Slide48Govt.
Srikazhi
Hospital, Nagapattinam TN.
Month Wise PerformanceYearPreauth Status on 11.06.2016 & 17RECEIVEDAPPROVEDCANCELLEDDENIEDNMIPROCESSNos.Nos.Amt. In Lakhs
Nos.Nos.Nos.Nos.5H 36344.3010106H
82
786.83202
0
Year
Claims Status on 11.06.2016 & 17
RECEIVED
CLAIMS APPROVED
DENIED
NMI
PROCESS
Nos.
Nos.
Amt. In Lakhs
Nos.
Nos.
Nos.
5H
25
17
1.76
0
806H 70553.930105Bed Strength- 212
Slide49Govt.
Srikazhi
Hospital, Nagapattinam TN
.S.No Top 10 Package - 5H NosTop 10 Package - 6H Nos1TN0314-b: Fracture Shaft of Other Long Bones (Humerus, Both Bones of Forarm, Both Bones of Leg)10TN0392 : Severe Bronchiolitis/Severe Broncho Pneumonia/Severe aspiration Pneumonia (Non-Ventilated)222
TN0871: Appendicular Perforation4TN0385 : Term Baby /Culture Positive Sepsis/ Non-Ventilated/ Hyperbilirubinemia83TN0386: Preterm Baby/ Clinical Sepsis/ Hyperbilirubinemia (Non-Ventilated)4CM0183 : SURGICAL CORRECTION OF LONGBONE FRACTURE-FRACTURE NECK/ SHAFT OF FEMUR/FRACTURE SHAFT OF OTHER LONG BONES (HUMERUS,BOTH BONES OF FOREARM, BOTH BONES OF LEG)84TN0867: Umbilical Hernia with Mesh3CM0218 A : TERM BABY WITH CULTURE POSITIVE SEPSIS / CLINICAL SEPSIS WITHOUT MECHANICAL VENTILATION / CPAP
8
5TN0388: Term Baby With Severe Perinatal Asphyxia - Non-Ventilated clinical Sepsis with or without Hyperbilirubinemia3TN0314-b : Fracture Shaft of Other Long Bones (Humerus, Both Bones of Forarm, Both Bones of Leg)6
6
TN0316-e: Amputation of Toes
2
TN0386 : Preterm Baby/ Clinical Sepsis/ Hyperbilirubinemia (Non-Ventilated)
4
7
TN0392: Severe Bronchiolitis/Severe Broncho Pneumonia/Severe aspiration Pneumonia (Non-Ventilated)
2
CM0233 : SEVERE BRONCHIOLITIS/SEVERE BRONCHO PNEUMONIA / SEVERE ASPIRATION PNEUMONIA (NON-VENTILATED)
3
8
TN0344: Small Bone Fractures-K-Wiring (To Be Covered along with Other Injuries Only and not as Exclusive Procedure)
1
CM0158 : UPTO-40% WITH SCALDS (CONSERVATIVE)
2
9
TN0973: Cholecystectomy
1
CM0225 A : TERM - WITH OR WITHOUT /SEVERE PERINATAL ASPHYXIA /SEPTIC SHOCK /SEIZURES /RENAL FAILURE/ - NON VENTILATED
210TN0314-a: Fracture Neck/ Shaft Of Femur1TN0388 : Term Baby With Severe Perinatal Asphyxia - Non-Ventilated clinical Sepsis with or without Hyperbilirubinemia2
Slide50Govt Hospital
Karuppampulam,Nagapattinam
TN.
YearPreauth Status on 11.06.2017RECEIVEDAPPROVEDCANCELLEDDENIEDNMIPROCESSNos.Nos.Amt. In LakhsNos.
Nos.Nos.Nos.6H 0000000
Year
Claims Status on 11.06.2017RECEIVEDCLAIMS APPROVED DENIED
NMI
PROCESS
Nos.
Nos.
Amt. In Lakhs
Nos.
Nos.
Nos.
6H
0
0
0
0
0
0
Bed Strength- 26
Emp
Date- 15.5.2017
Slide51NILGIRIS
Slide52Govt
Hospital Connoor,
Nilgiris TN.
Month Wise PerformanceBed Strength - 134YEARPreauth Status on 11.06.2016 & 17PREAUTH RECEIVEDAPPROVEDCANCELLEDDENIEDNMIPROCESSNo's.App Amt. (lac.)No's.
No's.No's.No's.5H30225.7443106H42
32
4.97541
0
YEAR
Claims Status on 11.06.2016 & 17
CLAIMS RECEIVED
APPROVED
DENIED
NMI
PROCESS
No's.
App Amt. (lac.)
No's.
No's.
No's.
5H
19
18
4.48
1
0
06H30263.49022
Slide53Govt
Hospital Connoor,
Nilgiris TN.
S.NoTop 10 Package - 5HNosTop 10 Package - 6HNos1TN0871: Appendicular Perforation4TN0392 : Severe Bronchiolitis/Severe Broncho Pneumonia/Severe aspiration Pneumonia (Non-Ventilated)92TN0159: Total Abdominal Hysterectomy(TAH) + Bilateral Salpingo Ophorectomy (BSO) + Bilateral Pelvic Lymph Node Dissection (BPLND) + Omentectomy2
TN0688 : Acute MI (Conservative Management without Angiogram)83TN0398: Meningitis/Encephalitis (Non-Ventilated)1CM0233 : SEVERE BRONCHIOLITIS/SEVERE BRONCHO PNEUMONIA / SEVERE ASPIRATION PNEUMONIA (NON-VENTILATED)24TN0853: Hemithyroidectomy1CM0487 : ACUTE MI (CONSERVATIVE MANAGEMENT WITHOUT ANGIOGRAM)2
5
TN0867: Umbilical Hernia with Mesh1CM0218 A : TERM BABY WITH CULTURE POSITIVE SEPSIS / CLINICAL SEPSIS WITHOUT MECHANICAL VENTILATION / CPAP16
TN0196: Gastro
Jejunostomy
1
CM0206A : TOTAL HIP REPLACEMENT- CEMENTED
1
7
TN0973: Cholecystectomy
1
TN0318 : Arthrodesis of - Major Joints
1
8
TN0282: Upto-60% With Scalds (Conservative)
1
CM0516B : ISCHEMIC STROKE
1
9
TN0840: Branchial Cyst Excision
1
TN0398 : Meningitis/Encephalitis (Non-Ventilated)
110TN0284: Above 60% Mixed Burns (With Surgeries)1TN0413 : Nehrotic Syndrome/Acute Glomerulo Nephritis1
Slide54Govt.Head
Quarters Hospital,Nilgiris TN.
Month Wise Performance
Bed Strength - 421YEARPreauth Status on 11.06.2016 & 17PREAUTH RECEIVEDAPPROVEDCANCELLEDDENIEDNMIPROCESSNo's.App Amt. (lac.)No's.
No's.No's.No's.5H25022833.57138106H201
192
22.932340
YEAR
Claims Status on 11.06.2016 & 17
CLAIMS RECEIVED
APPROVED
DENIED
NMI
PROCESS
No's.
App Amt. (lac.)
No's.
No's.
No's.
5H
167
167
23.22
0
0
0
6H13212714.03032
Slide55Govt.Head
Quarters Hospital,Nilgiris TN.
S.No
Top 10 Package - 5HNosTop 10 Package - 6HNos1TN0385: Term Baby /Culture Positive Sepsis/ Non-Ventilated/ Hyperbilirubinemia74TN0385 : Term Baby /Culture Positive Sepsis/ Non-Ventilated/ Hyperbilirubinemia512TN0870: Lap. Appendicectomy39
CM0218 A : TERM BABY WITH CULTURE POSITIVE SEPSIS / CLINICAL SEPSIS WITHOUT MECHANICAL VENTILATION / CPAP183TN0386: Preterm Baby/ Clinical Sepsis/ Hyperbilirubinemia (Non-Ventilated)21TN0565 : Hearing Aid154TN0565: Hearing Aid17TN0580 : Adenoidectomy - Gromet Insertion145
TN0580: Adenoidectomy - Gromet Insertion
15TN0870 : Lap. Appendicectomy136
TN0314-b: Fracture Shaft of Other Long Bones (Humerus, Both Bones of Forarm, Both Bones of Leg)
10
TN0386 : Preterm Baby/ Clinical Sepsis/ Hyperbilirubinemia (Non-Ventilated)
9
7
TN0372: Total Hip Replacement
6
CM0399 : HEARING AID - RESERVED TO GOVT
9
8
TN0587: Endoscopic Sinus Surgery
6
CM0220 A : TERM BABY PERSISTENT PULMONARY HYPERTENSION / MECONIUM ASPIRATION SYNDROME / PERINATAL ASPHYXIA / WITHOUT MECHANICAL VENTILATION / CPAP
4
9
TN0858: Total Thyroidectomy
4
TN0314-b : Fracture Shaft of Other Long Bones (Humerus, Both Bones of Forarm, Both Bones of Leg)
4
10TN0867: Umbilical Hernia with Mesh4CM0500 : COPD RESPIRATORY FAILURE (INFECTIVE EXACERBATION)4
Slide56Govt
Hospital, Gudalur,
Nilgiris TN.
Month Wise PerformanceBed Strength - 128YEARPreauth Status on 11.06.2016 & 17PREAUTH RECEIVEDAPPROVEDCANCELLEDDENIEDNMIPROCESSNo's.App Amt. (lac.)No's.
No's.No's.No's.6H220.150000YEAR
Claims Status on 11.06.2016 & 17
CLAIMS RECEIVEDAPPROVEDDENIEDNMI
PROCESS
No's.
App Amt. (lac.)
No's.
No's.
No's.
6H
2
1
0.05
0
0
1
Slide57Govt
Hospital, Gudalur,
Nilgiris TN.
S.NoTop 10 Package - 5HNosTop 10 Package - 6HNos1--CM0841 A : ANY COAGULATION DISORDERS12--
CM0500 : COPD RESPIRATORY FAILURE (INFECTIVE EXACERBATION)13----4----5
-
---6
-
-
-
-
7
-
-
-
-
8
-
-
-
-
9
-
-
-
-
10----
Slide58Govt
Hospital, Kothagiri,
Nilgiris TN.
Month Wise PerformanceBed Strength - 86YEARPreauth Status on 11.06.2016 & 17PREAUTH RECEIVEDAPPROVEDCANCELLEDDENIEDNMIPROCESSNo's.App Amt. (lac.)No's.
No's.No's.No's.6H43414.250110YEAR
Claims Status on 11.06.2016 & 17
CLAIMS RECEIVEDAPPROVEDDENIEDNMI
PROCESS
No's.
App Amt. (lac.)
No's.
No's.
No's.
6H
41
40
3.78
0
0
1
Slide59Govt
Hospital, Kothagiri,
Nilgiris TN.
S.NoTop 10 Package - 5HNosTop 10 Package - 6HNos1--TN0642 : Copd Respiratory Failure (Infective Exacerbation)322--
CM0500 : COPD RESPIRATORY FAILURE (INFECTIVE EXACERBATION)53--TN0641 : Acute Severe Asthma with Acute Respiratory Failure24--TN0643 : Acute Bronchitis and Pneumonia with Respiratory Failure15
-
-CM0501 : ACUTE BRONCHITIS AND PNEUMONIA WITH RESPIRATORY FAILURE16
-
-
-
-
7
-
-
-
-
8
-
-
-
-
9
-
-
-
-
10----
Slide60PUDUKOTTAI
Slide61Govt
hospital,Arranthangi,Pudukottai,TN
.
Month Wise PerformanceYearPreauth Status on 11.06.2016 & 17RECEIVEDAPPROVEDCANCELLEDDENIEDNMIPROCESSNos.Nos.Amt. In Lakhs
Nos.Nos.Nos.Nos.5H 24212.6712006H
65
565.23243
0
Year
Claims Status on 11.06.2016 & 17
RECEIVED
CLAIMS APPROVED
DENIED
NMI
PROCESS
Nos.
Nos.
Amt. In Lakhs
Nos.
Nos.
Nos.
5H
18
16
1.78
2
006H 53423.410110Bed Strength- 168
Slide62Govt
hospital,Arranthangi,Pudukottai,TN
.
S.No Top 10 Package - 5H NosTop 10 Package - 6H Nos1TN0110: Lumpectomy5TN0385 : Term Baby /Culture Positive Sepsis/ Non-Ventilated/ Hyperbilirubinemia152TN0871: Appendicular Perforation4
CM0219 A : TERM BABY HYPERBILIRUBINEMIA - EXCHANGE TRANSFUSION WITHOUT MECHANICAL VENTILATION / CPAP103TN0956: Reconstructive surgery follwing facio maxillary trauma, fracture mandible, maxilla4TN0388 : Term Baby With Severe Perinatal Asphyxia - Non-Ventilated clinical Sepsis with or without Hyperbilirubinemia34TN0386: Preterm Baby/ Clinical Sepsis/ Hyperbilirubinemia (Non-Ventilated)4CM0924 : APPENDICULAR PERFORATION3
5
TN0314-b: Fracture Shaft of Other Long Bones (Humerus, Both Bones of Forarm, Both Bones of Leg)3TN0314-b : Fracture Shaft of Other Long Bones (Humerus, Both Bones of Forarm, Both Bones of Leg)36
TN0862: Epigastric Hernia with Mesh
1
CM0758 : INCISIONAL HERNIA REPAIR WITH MESH
3
7
CM0778-A-I : WIDE EXICISION/ LUMPECTOMY - TUMORS OF BREAST -BENIGN
3
8
TN0110 : Lumpectomy
3
9
TN0871 : Appendicular Perforation
2
10
TN0867 : Umbilical Hernia with Mesh
1
Slide63Govt
Hospital,Thirumayam,Pudukottai,TN
.
Month Wise PerformanceYearPreauth Status on 11.06.2016 & 17RECEIVEDAPPROVEDCANCELLEDDENIEDNMIPROCESSNos.Nos.Amt. In Lakhs
Nos.Nos.Nos.Nos.5H 210.2001006H
24
161.79080
0
Year
Claims Status on 11.06.2016 & 17
RECEIVED
CLAIMS APPROVED
DENIED
NMI
PROCESS
Nos.
Nos.
Amt. In Lakhs
Nos.
Nos.
Nos.
5H
1
1
0.12
0
006H 14110.92003Bed Strength- 66
Slide64Govt
Hospital,Thirumayam,Pudukottai,TN
.
S.No Top 10 Package - 5H NosTop 10 Package - 6H Nos1TN0711: Ischemic Strokes1TN0643 : Acute Bronchitis and Pneumonia with Respiratory Failure32
CM0500 : COPD RESPIRATORY FAILURE (INFECTIVE EXACERBATION)33CM0516B : ISCHEMIC STROKE34TN0642 : Copd Respiratory Failure (Infective Exacerbation)35
TN0711 : Ischemic Strokes
16
TN0710 : Hemorrhagic Stroke/Strokes
1
7
CM0501 : ACUTE BRONCHITIS AND PNEUMONIA WITH RESPIRATORY FAILURE
1
8
TN0664 : Acute Respiratory Failure (Without Ventilator)
1
9
10
Slide65Govt Hospital
Gandarvakottai,Pudukottai
TN.
YearPreauth Status on 11.06.2017RECEIVEDAPPROVEDCANCELLEDDENIEDNMIPROCESSNos.Nos.Amt. In LakhsNos.
Nos.Nos.Nos.6H 0000000Year
Claims Status on
11.06.2017RECEIVEDCLAIMS APPROVED DENIED
NMI
PROCESS
Nos.
Nos.
Amt. In Lakhs
Nos.
Nos.
Nos.
6H
0
0
0
0
0
0
Bed Strength- 32
Emp
Date- 15.5.2017
Slide66Govt Hospital
Annavasal,Pudukottai
TN.
YearPreauth Status on 11.06.2017RECEIVEDAPPROVEDCANCELLEDDENIEDNMIPROCESSNos.Nos.Amt. In LakhsNos.
Nos.Nos.Nos.6H 0000000Year
Claims Status on
11.06.2017RECEIVEDCLAIMS APPROVED
DENIED
NMI
PROCESS
Nos.
Nos.
Amt. In Lakhs
Nos.
Nos.
Nos.
6H
0
0
0
0
0
0
0
Bed Strength- 52
Emp
Date- 15.5.2017YearClaims Status on 11.06.2017RECEIVEDCLAIMS APPROVED DENIEDNMIPROCESSNos.Nos.Amt. In Lakhs
Nos.
Nos.
Nos.
6H
0
0
0
0
0
0
Slide67RAMANATHAPURAM
Slide68Govt Hospital
Kamudhi,Ramanathapuram
TN.
Month Wise PerformanceYearPreauth Status on 11.06.2016 & 17RECEIVEDAPPROVEDCANCELLEDDENIEDNMIPROCESSNos.Nos.Amt. In Lakhs
Nos.Nos.Nos.Nos.5H 77427.273201206H
131
12316.90341
0
Year
Claims Status on 11.06.2016 & 17
RECEIVED
CLAIMS APPROVED
DENIED
NMI
PROCESS
Nos.
Nos.
Amt. In Lakhs
Nos.
Nos.
Nos.
5H
39
39
5.77
0
006H 11710813.42081Bed Strength- 62
Slide69Govt Hospital
Kamudhi,Ramanathapuram
TN.
S.No Top 10 Package - 5H NosTop 10 Package - 6H Nos1TN0385: Term Baby /Culture Positive Sepsis/ Non-Ventilated/ Hyperbilirubinemia10TN0385 : Term Baby /Culture Positive Sepsis/ Non-Ventilated/ Hyperbilirubinemia422TN0642: Copd Respiratory Failure (Infective Exacerbation)
7TN0637 : Abdominal Hystrectomy for Benign Conditions113TN0622: Vaginal Hysterectomy with Mesh Repair6CM0219 A : TERM BABY HYPERBILIRUBINEMIA - EXCHANGE TRANSFUSION WITHOUT MECHANICAL VENTILATION / CPAP114TN0314-b: Fracture Shaft of Other Long Bones (Humerus, Both Bones of Forarm, Both Bones of Leg)4CM0475B : VAGINAL HYSTERECTOMY WITH MESH REPAIR9
5
TN0637: Abdominal Hystrectomy for Benign Conditions3CM0623-II : ABDOMINAL HYSTERECTOMY FOR BENIGN / MALIGNANT CONDITIONS86
TN0565: Hearing Aid
2
CM0500 : COPD RESPIRATORY FAILURE (INFECTIVE EXACERBATION)
7
7
TN0311: Flap Surgeries A) Cutaneous Flap
2
TN0642 : Copd Respiratory Failure (Infective Exacerbation)
4
8
TN0314-a: Fracture Neck/ Shaft Of Femur
2
TN0622 : Vaginal Hysterectomy with Mesh Repair
4
9
TN0869: Ventral and Scar Hernia with Mesh
2
TN0371 : Toal Knee Replacement
3
10TN0278: Upto-40% With Scalds (Conservative)1TN0565 : Hearing Aid3
Slide70Govt Hospital
Keelakkarai,RamanathapuramTN
.
Month Wise PerformanceYearPreauth Status on 11.06.2016 & 17RECEIVEDAPPROVEDCANCELLEDDENIEDNMIPROCESSNos.Nos.Amt. In Lakhs
Nos.Nos.Nos.Nos.5H 50445.5805106H
172
16312.20711
0
Year
Claims Status on 11.06.2016 & 17
RECEIVED
CLAIMS APPROVED
DENIED
NMI
PROCESS
Nos.
Nos.
Amt. In Lakhs
Nos.
Nos.
Nos.
5H
40
39
3.63
0
106H 1561479.47018Bed Strength- 60
Slide71Govt Hospital
Keelakkarai,RamanathapuramTN
.
S.No Top 10 Package - 5H NosTop 10 Package - 6H Nos1TN0388: Term Baby With Severe Perinatal Asphyxia - Non-Ventilated clinical Sepsis with or without Hyperbilirubinemia13TN0642 : Copd Respiratory Failure (Infective Exacerbation)322TN0392: Severe Bronchiolitis/Severe Broncho Pneumonia/Severe aspiration Pneumonia (Non-Ventilated)
12TN0392 : Severe Bronchiolitis/Severe Broncho Pneumonia/Severe aspiration Pneumonia (Non-Ventilated)283TN0871: Appendicular Perforation5CM0233 : SEVERE BRONCHIOLITIS/SEVERE BRONCHO PNEUMONIA / SEVERE ASPIRATION PNEUMONIA (NON-VENTILATED)234TN0385: Term Baby /Culture Positive Sepsis/ Non-Ventilated/ Hyperbilirubinemia4CM0519 : THROMBOCYTOPENIA WITH BLEEDING DIATHESIS19
5
TN0711: Ischemic Strokes2CM0500 : COPD RESPIRATORY FAILURE (INFECTIVE EXACERBATION)17
6
TN0889: Operation for Acute Intestinal Obstrucion
2
CM0218 A : TERM BABY WITH CULTURE POSITIVE SEPSIS / CLINICAL SEPSIS WITHOUT MECHANICAL VENTILATION / CPAP
15
7
TN0989: Soft tissue tumors wide excision
2
TN0388 : Term Baby With Severe Perinatal Asphyxia - Non-Ventilated clinical Sepsis with or without Hyperbilirubinemia
10
8
TN0302: Reconstructive Lower Limb Surgery Following Infection, Trauma, Tumors / Malignancy, Developmental Including Diabetic Foot - Moderate
2
TN0641 : Acute Severe Asthma with Acute Respiratory Failure
6
9
TN0154: Radical Hysterectomy + Bilateral Pelvic Lymph Node Dissection (BPLND) + Bilateral Salpingo Ophorectomy (BSO) / Ovarian Transposition
1
CM0501 : ACUTE BRONCHITIS AND PNEUMONIA WITH RESPIRATORY FAILURE
410TN0278: Upto-40% With Scalds (Conservative)1TN0664 : Acute Respiratory Failure (Without Ventilator)2
Slide72Govt
Hospital,Mudukalathur,Ramanthapuram
TN.
Month Wise PerformanceYearPreauth Status on 11.06.2016 & 17RECEIVEDAPPROVEDCANCELLEDDENIEDNMIPROCESSNos.Nos.Amt. In Lakhs
Nos.Nos.Nos.Nos.5H 47291.82014316H
104
854.121513
0
Year
Claims Status on 11.06.2016 & 17
RECEIVED
CLAIMS APPROVED
DENIED
NMI
PROCESS
Nos.
Nos.
Amt. In Lakhs
Nos.
Nos.
Nos.
5H
29
29
1.45
0
006H 81712.900010Bed Strength- 62
Slide73Govt
Hospital,Mudukalathur,Ramanthapuram
TN.
S.No Top 10 Package - 5H NosTop 10 Package - 6H Nos1TN0385: Term Baby /Culture Positive Sepsis/ Non-Ventilated/ Hyperbilirubinemia13TN0392 : Severe Bronchiolitis/Severe Broncho Pneumonia/Severe aspiration Pneumonia (Non-Ventilated)602TN0392: Severe Bronchiolitis/Severe Broncho Pneumonia/Severe aspiration Pneumonia (Non-Ventilated)
12CM0233 : SEVERE BRONCHIOLITIS/SEVERE BRONCHO PNEUMONIA / SEVERE ASPIRATION PNEUMONIA (NON-VENTILATED)133TN0375: Kerosene Ingestion2CM0218 A : TERM BABY WITH CULTURE POSITIVE SEPSIS / CLINICAL SEPSIS WITHOUT MECHANICAL VENTILATION / CPAP44TN0388: Term Baby With Severe Perinatal Asphyxia - Non-Ventilated clinical Sepsis with or without Hyperbilirubinemia2TN0278 : Upto-40% With Scalds (Conservative)3
5
CM0982 : OP /ANY POISIONING - CONSERVATIVE MANAGEMENT OR WITHOUT VENTILATORY SUPPORT (ONLY WITH FIR )2
6
CM0158 : UPTO-40% WITH SCALDS (CONSERVATIVE)
1
7
CM0213 : NECROTISING ENTEROCOLITIS - CLINICAL SEPSIS /HYPERBILIRUBINEMIA /NON VENTILATED
1
8
TN0375 : Kerosene Ingestion
1
9
10
Slide74Govt
Hospital,Parthibanur,Ramanathapuram,TN
.
Month Wise PerformanceYearPreauth Status on 11.06.2016 & 17RECEIVEDAPPROVEDCANCELLEDDENIEDNMIPROCESSNos.Nos.Amt. In Lakhs
Nos.Nos.Nos.Nos.5H 37262.2637106H
130
11712.25247
0
Year
Claims Status on 11.06.2016 & 17
RECEIVED
CLAIMS APPROVED
DENIED
NMI
PROCESS
Nos.
Nos.
Amt. In Lakhs
Nos.
Nos.
Nos.
5H
24
22
1.40
0
206H 59422.850512Bed Strength- 30
Slide75Govt
Hospital,Parthibanur,Ramanathapuram,TN
.
S.No Top 10 Package - 5H NosTop 10 Package - 6H Nos1TN0388: Term Baby With Severe Perinatal Asphyxia - Non-Ventilated clinical Sepsis with or without Hyperbilirubinemia13TN0642 : Copd Respiratory Failure (Infective Exacerbation)312TN0385: Term Baby /Culture Positive Sepsis/ Non-Ventilated/ Hyperbilirubinemia
13CM0500 : COPD RESPIRATORY FAILURE (INFECTIVE EXACERBATION)253TN0392 : Severe Bronchiolitis/Severe Broncho Pneumonia/Severe aspiration Pneumonia (Non-Ventilated)184TN0385 : Term Baby /Culture Positive Sepsis/ Non-Ventilated/ Hyperbilirubinemia12
5
TN0388 : Term Baby With Severe Perinatal Asphyxia - Non-Ventilated clinical Sepsis with or without Hyperbilirubinemia8
6
CM0219 A : TERM BABY HYPERBILIRUBINEMIA - EXCHANGE TRANSFUSION WITHOUT MECHANICAL VENTILATION / CPAP
7
7
TN0641 : Acute Severe Asthma with Acute Respiratory Failure
4
8
CM0233 : SEVERE BRONCHIOLITIS/SEVERE BRONCHO PNEUMONIA / SEVERE ASPIRATION PNEUMONIA (NON-VENTILATED)
3
9
TN0643 : Acute Bronchitis and Pneumonia with Respiratory Failure
2
10
TN0371 : Toal Knee Replacement
2
Slide76Govt
Hospital,Rameshwaram,Ramanathapuram
TN.
Month Wise PerformanceYearPreauth Status on 11.06.2016 & 17RECEIVEDAPPROVEDCANCELLEDDENIEDNMIPROCESSNos.Nos.Amt. In Lakhs
Nos.Nos.Nos.Nos.5H 1540.54011006H
61
584.29003
0
Year
Claims Status on 11.06.2016 & 17
RECEIVED
CLAIMS APPROVED
DENIED
NMI
PROCESS
Nos.
Nos.
Amt. In Lakhs
Nos.
Nos.
Nos.
5H
4
2
0.14
0
116H 57533.47040Bed Strength- 62
Slide77Govt
Hospital,Rameshwaram,Ramanathapuram
TN.
S.No Top 10 Package - 5H NosTop 10 Package - 6H Nos1TN0902: Stay in General Ward @Rs.500/Day1TN0643 : Acute Bronchitis and Pneumonia with Respiratory Failure302TN0670: Acute Pancreatitis (Mild)1
TN0392 : Severe Bronchiolitis/Severe Broncho Pneumonia/Severe aspiration Pneumonia (Non-Ventilated)73TN0278: Upto-40% With Scalds (Conservative)1CM0501 : ACUTE BRONCHITIS AND PNEUMONIA WITH RESPIRATORY FAILURE74TN0392: Severe Bronchiolitis/Severe Broncho Pneumonia/Severe aspiration Pneumonia (Non-Ventilated)1TN0641 : Acute Severe Asthma with Acute Respiratory Failure4
5
TN0388 : Term Baby With Severe Perinatal Asphyxia - Non-Ventilated clinical Sepsis with or without Hyperbilirubinemia46
CM0233 : SEVERE BRONCHIOLITIS/SEVERE BRONCHO PNEUMONIA / SEVERE ASPIRATION PNEUMONIA (NON-VENTILATED)
3
7
TN0642 : Copd Respiratory Failure (Infective Exacerbation)
2
8
CM0500 : COPD RESPIRATORY FAILURE (INFECTIVE EXACERBATION)
1
9
10
Slide78Govt
Hospital,Thiruvadanai,Ramanthapuram
TN.
Month Wise PerformanceYearPreauth Status on 11.06.2016 & 17RECEIVEDAPPROVEDCANCELLEDDENIEDNMIPROCESSNos.Nos.Amt. In Lakhs
Nos.Nos.Nos.Nos.5H 1791.2204406H
28
262.58200
0
Year
Claims Status on 11.06.2016 & 17
RECEIVED
CLAIMS APPROVED
DENIED
NMI
PROCESS
Nos.
Nos.
Amt. In Lakhs
Nos.
Nos.
Nos.
5H
9
6
0.52
1
116H 25251.77000Bed Strength- 62
Slide79Govt
Hospital,Thiruvadanai,Ramanthapuram TN
.
S.No Top 10 Package - 5H NosTop 10 Package - 6H Nos1TN0711: Ischemic Strokes3CM0519 : THROMBOCYTOPENIA WITH BLEEDING DIATHESIS102TN0285: Mild2
TN0650 : Thrombocytopenia with Bleeding Diathesis93TN0402: Acute Pancreatitis/Acute Hepatitis1TN0711 : Ischemic Strokes34TN0692: Refractory Cardiac Failure1TN0688 : Acute MI (Conservative Management without Angiogram)35
TN0669: Massive Hemoptysis
1TN0278 : Upto-40% With Scalds (Conservative)16
TN0650: Thrombocytopenia with Bleeding Diathesis
1
7
8
9
10
Slide80Govt
Hospital,Uchipuli
, Ramanathapuram TN.
Month Wise PerformanceYearPreauth Status on 11.06.2016 & 17RECEIVEDAPPROVEDCANCELLEDDENIEDNMIPROCESSNos.Nos.Amt. In Lakhs
Nos.Nos.Nos.Nos.5H 49221.65019716H
102
904.62057
0
Year
Claims Status on 11.06.2016 & 17
RECEIVED
CLAIMS APPROVED
DENIED
NMI
PROCESS
Nos.
Nos.
Amt. In Lakhs
Nos.
Nos.
Nos.
5H
21
21
1.37
0
006H 73723.61010Bed Strength- 30
Slide81Govt
Hospital,Uchipuli
, Ramanathapuram TN.
S.No Top 10 Package - 5H NosTop 10 Package - 6H Nos1TN0388: Term Baby With Severe Perinatal Asphyxia - Non-Ventilated clinical Sepsis with or without Hyperbilirubinemia17TN0388 : Term Baby With Severe Perinatal Asphyxia - Non-Ventilated clinical Sepsis with or without Hyperbilirubinemia252TN0385: Term Baby /Culture Positive Sepsis/ Non-Ventilated/ Hyperbilirubinemia
5CM0220 A : TERM BABY PERSISTENT PULMONARY HYPERTENSION / MECONIUM ASPIRATION SYNDROME / PERINATAL ASPHYXIA / WITHOUT MECHANICAL VENTILATION / CPAP253TN0385 : Term Baby /Culture Positive Sepsis/ Non-Ventilated/ Hyperbilirubinemia244CM0218 A : TERM BABY WITH CULTURE POSITIVE SEPSIS / CLINICAL SEPSIS WITHOUT MECHANICAL VENTILATION / CPAP
16
5
6
7
8
9
10
Slide82Govt.Head
Qrtrs Hosp Paramakudi,Ramanathpuram
TN.Month Wise PerformanceYearPreauth Status on 11.06.2016 & 17RECEIVEDAPPROVEDCANCELLEDDENIEDNMIPROCESSNos.Nos.Amt. In Lakhs
Nos.Nos.Nos.Nos.5H 42737944.631034136H
458
40041.261429
11
4
Year
Claims Status on 11.06.2016 & 17
RECEIVED
CLAIMS APPROVED
DENIED
NMI
PROCESS
Nos.
Nos.
Amt. In Lakhs
Nos.
Nos.
Nos.
5H
281
239
21.94
14106H 2331589.971740Bed Strength- 208
Slide83Govt.Head
Qrtrs Hosp Paramakudi,Ramanathpuram
TN.S.No Top 10 Package - 5H NosTop 10 Package - 6H Nos1TN0385: Term Baby /Culture Positive Sepsis/ Non-Ventilated/ Hyperbilirubinemia86TN0392 : Severe Bronchiolitis/Severe Broncho Pneumonia/Severe aspiration Pneumonia (Non-Ventilated)492TN0392: Severe Bronchiolitis/Severe Broncho Pneumonia/Severe aspiration Pneumonia (Non-Ventilated)
62TN0385 : Term Baby /Culture Positive Sepsis/ Non-Ventilated/ Hyperbilirubinemia473TN0388: Term Baby With Severe Perinatal Asphyxia - Non-Ventilated clinical Sepsis with or without Hyperbilirubinemia24CM0218 A : TERM BABY WITH CULTURE POSITIVE SEPSIS / CLINICAL SEPSIS WITHOUT MECHANICAL VENTILATION / CPAP424TN0637: Abdominal Hystrectomy for Benign Conditions22CM0982 : OP /ANY POISIONING - CONSERVATIVE MANAGEMENT OR WITHOUT VENTILATORY SUPPORT (ONLY WITH FIR )
37
5TN0278: Upto-40% With Scalds (Conservative)18TN0637 : Abdominal Hystrectomy for Benign Conditions17
6
TN0407: Dengue Shock Syndrome
17
CM0233 : SEVERE BRONCHIOLITIS/SEVERE BRONCHO PNEUMONIA / SEVERE ASPIRATION PNEUMONIA (NON-VENTILATED)
15
7
TN0386: Preterm Baby/ Clinical Sepsis/ Hyperbilirubinemia (Non-Ventilated)
16
TN0388 : Term Baby With Severe Perinatal Asphyxia - Non-Ventilated clinical Sepsis with or without Hyperbilirubinemia
11
8
TN0711: Ischemic Strokes
15
CM0626 A : DENGUE SHOCK SYNDROME -(ADULT/PAEDIATRICS)
11
9
TN0571: Mastoidectomy
15
TN0711 : Ischemic Strokes
1110TN0110: Lumpectomy14TN0587 : Endoscopic Sinus Surgery10
Slide84Govt.Head
Quarters
Hospital,Ramanathapuram TN.
Month Wise PerformanceYearPreauth Status on 11.06.2016 & 17RECEIVEDAPPROVEDCANCELLEDDENIEDNMIPROCESSNos.Nos.Amt. In Lakhs
Nos.Nos.Nos.Nos.5H 96060275.022618215006H
1,183
82294.4776132152
1
Year
Claims Status on 11.06.2016 & 17
RECEIVED
CLAIMS APPROVED
DENIED
NMI
PROCESS
Nos.
Nos.
Amt. In Lakhs
Nos.
Nos.
Nos.
5H
405
310
31.00
8
76116H 62650249.14277621Bed Strength- 684
Slide85Govt.Head
Quarters
Hospital,Ramanathapuram TN.
S.No Top 10 Package - 5H NosTop 10 Package - 6H Nos1TN0702: Maintenance Haemodialysis For CRF98TN0702 : Maintenance Haemodialysis For CRF1332TN0385: Term Baby /Culture Positive Sepsis/ Non-Ventilated/ Hyperbilirubinemia
94CM0513 : MAINTANENCE HEMODIALYSIS FOR CRF (8 DIALYSIS) INCLUDING SEROPOSITIVE1133TN0711: Ischemic Strokes58TN0385 : Term Baby /Culture Positive Sepsis/ Non-Ventilated/ Hyperbilirubinemia484TN0701: Chronic Renal Failure 1 (CRF )39TN0392 : Severe Bronchiolitis/Severe Broncho Pneumonia/Severe aspiration Pneumonia (Non-Ventilated)46
5
TN0688: Acute MI (Conservative Management without Angiogram)29TN0711 : Ischemic Strokes416
TN0314-b: Fracture Shaft of Other Long Bones (Humerus, Both Bones of Forarm, Both Bones of Leg)
24
TN0688 : Acute MI (Conservative Management without Angiogram)
35
7
TN0388: Term Baby With Severe Perinatal Asphyxia - Non-Ventilated clinical Sepsis with or without Hyperbilirubinemia
24
CM0487 : ACUTE MI (CONSERVATIVE MANAGEMENT WITHOUT ANGIOGRAM)
35
8
TN0565: Hearing Aid
22
CM0516B : ISCHEMIC STROKE
28
9
TN0392: Severe Bronchiolitis/Severe Broncho Pneumonia/Severe aspiration Pneumonia (Non-Ventilated)
21
CM0218 A : TERM BABY WITH CULTURE POSITIVE SEPSIS / CLINICAL SEPSIS WITHOUT MECHANICAL VENTILATION / CPAP
25
10TN0533: A. V Fistula at Elbow19TN0701 : Chronic Renal Failure 1 (CRF )23
Slide86Govt.Upgraded
PHC,Sayalkudi,Paramakudi,Ramnad TN.
Month Wise PerformanceYearPreauth Status on 11.06.2016 & 17RECEIVEDAPPROVEDCANCELLEDDENIEDNMIPROCESSNos.Nos.Amt. In Lakhs
Nos.Nos.Nos.Nos.5H 109715.24333026H
116
1125.95022
0
Year
Claims Status on 11.06.2016 & 17
RECEIVED
CLAIMS APPROVED
DENIED
NMI
PROCESS
Nos.
Nos.
Amt. In Lakhs
Nos.
Nos.
Nos.
5H
69
69
4.47
0
006H 1101065.62004Bed Strength- 30
Slide87Govt.Upgraded
PHC,Sayalkudi,Paramakudi,Ramnad TN.
S.No Top 10 Package - 5H NosTop 10 Package - 6H Nos1TN0388: Term Baby With Severe Perinatal Asphyxia - Non-Ventilated clinical Sepsis with or without Hyperbilirubinemia54CM0218 A : TERM BABY WITH CULTURE POSITIVE SEPSIS / CLINICAL SEPSIS WITHOUT MECHANICAL VENTILATION / CPAP452TN0385: Term Baby /Culture Positive Sepsis/ Non-Ventilated/ Hyperbilirubinemia
15TN0388 : Term Baby With Severe Perinatal Asphyxia - Non-Ventilated clinical Sepsis with or without Hyperbilirubinemia323TN0621: Vaginal Hysterectomy with Pelvic Floor Repair2TN0385 : Term Baby /Culture Positive Sepsis/ Non-Ventilated/ Hyperbilirubinemia254CM0225 A : TERM - WITH OR WITHOUT /SEVERE PERINATAL ASPHYXIA /SEPTIC SHOCK /SEIZURES /RENAL FAILURE/ - NON VENTILATED9
5
CM0219 A : TERM BABY HYPERBILIRUBINEMIA - EXCHANGE TRANSFUSION WITHOUT MECHANICAL VENTILATION / CPAP1
6
7
8
9
10
Slide88SIVAGANGAI
Slide89Govt Hospital
Thirupathur
, Sivagangai TN.
Month Wise PerformanceYearPreauth Status on 11.06.2016 & 17RECEIVEDAPPROVEDCANCELLEDDENIEDNMIPROCESSNos.Nos.Amt. In Lakhs
Nos.Nos.Nos.Nos.5H 43426.1401006H
62
536.78243
0
Year
Claims Status on 11.06.2016 & 17
RECEIVED
CLAIMS APPROVED
DENIED
NMI
PROCESS
Nos.
Nos.
Amt. In Lakhs
Nos.
Nos.
Nos.
5H
39
38
5.56
1
006H 53495.72031Bed Strength- 75
Slide90Govt Hospital
Thirupathur
, Sivagangai TN.
S.No Top 10 Package - 5H NosTop 10 Package - 6H Nos1TN0871: Appendicular Perforation20TN0637 : Abdominal Hystrectomy for Benign Conditions142TN0637: Abdominal Hystrectomy for Benign Conditions
15TN0641 : Acute Severe Asthma with Acute Respiratory Failure113TN0621: Vaginal Hysterectomy with Pelvic Floor Repair2CM0924 : APPENDICULAR PERFORATION44TN0973: Cholecystectomy1TN0688 : Acute MI (Conservative Management without Angiogram)3
5
TN0869: Ventral and Scar Hernia with Mesh1TN0642 : Copd Respiratory Failure (Infective Exacerbation)3
6
TN0110: Lumpectomy
1
CM0623-I : ABDOMINAL HYSTERECTOMY FOR BENIGN / MALIGNANT CONDITIONS
3
7
TN0622: Vaginal Hysterectomy with Mesh Repair
1
TN0871 : Appendicular Perforation
3
8
TN0860: Modified Radical Mastectomy
1
CM0500 : COPD RESPIRATORY FAILURE (INFECTIVE EXACERBATION)
2
9
TN0621 : Vaginal Hysterectomy with Pelvic Floor Repair
2
10
CM0487 : ACUTE MI (CONSERVATIVE MANAGEMENT WITHOUT ANGIOGRAM)2
Slide91Govt
hospital,Devakottai,Sivagangai,TN
.
Month Wise PerformanceYearPreauth Status on 11.06.2016 & 17RECEIVEDAPPROVEDCANCELLEDDENIEDNMIPROCESSNos.Nos.Amt. In Lakhs
Nos.Nos.Nos.Nos.5H 30273.4921006H
55
515.18111
1
Year
Claims Status on 11.06.2016 & 17
RECEIVED
CLAIMS APPROVED
DENIED
NMI
PROCESS
Nos.
Nos.
Amt. In Lakhs
Nos.
Nos.
Nos.
5H
25
24
2.96
0
106H 37272.57082Bed Strength- 86
Slide92Govt
hospital,Devakottai,Sivagangai,TN
.
S.No Top 10 Package - 5H NosTop 10 Package - 6H Nos1TN0870: Lap. Appendicectomy7TN0637 : Abdominal Hystrectomy for Benign Conditions62TN0637: Abdominal Hystrectomy for Benign Conditions
7TN0385 : Term Baby /Culture Positive Sepsis/ Non-Ventilated/ Hyperbilirubinemia53TN0254: Hormonal Therapy4TN0871 : Appendicular Perforation44TN0314-b: Fracture Shaft of Other Long Bones (Humerus, Both Bones of Forarm, Both Bones of Leg)4CM0220 A : TERM BABY PERSISTENT PULMONARY HYPERTENSION / MECONIUM ASPIRATION SYNDROME / PERINATAL ASPHYXIA / WITHOUT MECHANICAL VENTILATION / CPAP4
5
TN0392: Severe Bronchiolitis/Severe Broncho Pneumonia/Severe aspiration Pneumonia (Non-Ventilated)2TN0392 : Severe Bronchiolitis/Severe Broncho Pneumonia/Severe aspiration Pneumonia (Non-Ventilated)46
TN0621: Vaginal Hysterectomy with Pelvic Floor Repair
2
CM0225 A : TERM - WITH OR WITHOUT /SEVERE PERINATAL ASPHYXIA /SEPTIC SHOCK /SEIZURES /RENAL FAILURE/ - NON VENTILATED
3
7
TN0867: Umbilical Hernia with Mesh
1
CM0924 : APPENDICULAR PERFORATION
3
8
TN0870 : Lap. Appendicectomy
2
9
TN0956 : Reconstructive surgery follwing facio maxillary trauma, fracture mandible, maxilla
2
10
TN0386 : Preterm Baby/ Clinical Sepsis/ Hyperbilirubinemia (Non-Ventilated)
2
Slide93Govt. Hospital
Karaikudi,Sivagangai
TN.
Month Wise PerformanceYearPreauth Status on 11.06.2016 & 17RECEIVEDAPPROVEDCANCELLEDDENIEDNMIPROCESSNos.Nos.Amt. In Lakhs
Nos.Nos.Nos.Nos.5H 917910.2548006H
212
18420.599108
1
Year
Claims Status on 11.06.2016 & 17
RECEIVED
CLAIMS APPROVED
DENIED
NMI
PROCESS
Nos.
Nos.
Amt. In Lakhs
Nos.
Nos.
Nos.
5H
66
61
7.41
0
506H 74657.56090Bed Strength- 222
Slide94Govt. Hospital
Karaikudi,Sivagangai
TN.
S.No Top 10 Package - 5H NosTop 10 Package - 6H Nos1TN0637: Abdominal Hystrectomy for Benign Conditions20CM0218 A : TERM BABY WITH CULTURE POSITIVE SEPSIS / CLINICAL SEPSIS WITHOUT MECHANICAL VENTILATION / CPAP242TN0702: Maintenance Haemodialysis For CRF
15TN0385 : Term Baby /Culture Positive Sepsis/ Non-Ventilated/ Hyperbilirubinemia213TN0386: Preterm Baby/ Clinical Sepsis/ Hyperbilirubinemia (Non-Ventilated)7TN0637 : Abdominal Hystrectomy for Benign Conditions194TN0870: Lap. Appendicectomy6CM0923 : LAP. APPENDICECTOMY16
5
TN0209: Adriamycin/Cyclophosphamide (AC)5TN0702 : Maintenance Haemodialysis For CRF146
TN0110: Lumpectomy
5
CM0513 : MAINTANENCE HEMODIALYSIS FOR CRF (8 DIALYSIS) INCLUDING SEROPOSITIVE
11
7
TN0869: Ventral and Scar Hernia with Mesh
4
CM0225 A : TERM - WITH OR WITHOUT /SEVERE PERINATAL ASPHYXIA /SEPTIC SHOCK /SEIZURES /RENAL FAILURE/ - NON VENTILATED
10
8
TN0388: Term Baby With Severe Perinatal Asphyxia - Non-Ventilated clinical Sepsis with or without Hyperbilirubinemia
2
CM0623-I : ABDOMINAL HYSTERECTOMY FOR BENIGN / MALIGNANT CONDITIONS
7
9
TN0867: Umbilical Hernia with Mesh
2
TN0870 : Lap. Appendicectomy
6
10TN0974: Lap.Cholecystectomy2TN0314-b : Fracture Shaft of Other Long Bones (Humerus, Both Bones of Forarm, Both Bones of Leg)6
Slide95THANJAVUR
Slide96GOVT. PATTUKOTTAI HOSPITAL, THANJAVUR TN.
Month Wise Performance
Year
Preauth Status on 11.06.2016 & 17RECEIVEDAPPROVEDCANCELLEDDENIEDNMIPROCESSNos.Nos.Amt. In LakhsNos.
Nos.Nos.Nos.5H 50485.1520006H 144
124
16.60595
1
Year
Claims Status on 11.06.2016 & 17
RECEIVED
CLAIMS APPROVED
DENIED
NMI
PROCESS
Nos.
Nos.
Amt. In Lakhs
Nos.
Nos.
Nos.
5H
41
40
3.85
0
106H 78565.460211Bed Strength- 202
Slide97GOVT. PATTUKOTTAI HOSPITAL, THANJAVUR TN.
S.No
Top 10 Package - 5H NosTop 10 Package - 6H Nos1TN0565: Hearing Aid33TN0565 : Hearing Aid272TN0621: Vaginal Hysterectomy with Pelvic Floor Repair4
CM0399 : HEARING AID - RESERVED TO GOVT163TN0688: Acute MI (Conservative Management without Angiogram)3CM0183 : SURGICAL CORRECTION OF LONGBONE FRACTURE-FRACTURE NECK/ SHAFT OF FEMUR/FRACTURE SHAFT OF OTHER LONG BONES (HUMERUS,BOTH BONES OF FOREARM, BOTH BONES OF LEG)94TN0279: Upto-40% Mixed Burns (With Surgeries)2TN0637 : Abdominal Hystrectomy for Benign Conditions95
TN0388: Term Baby With Severe Perinatal Asphyxia - Non-Ventilated clinical Sepsis with or without Hyperbilirubinemia
1TN0688 : Acute MI (Conservative Management without Angiogram)56
TN0670: Acute Pancreatitis (Mild)
1
CM0475A : VAGINAL HYSTERECTOMY WITH PELVIC FLOOR REPAIR
5
7
TN0699: Nephrotic Syndrome
1
TN0621 : Vaginal Hysterectomy with Pelvic Floor Repair
4
8
TN0871: Appendicular Perforation
1
TN0711 : Ischemic Strokes
4
9
TN0392: Severe Bronchiolitis/Severe Broncho Pneumonia/Severe aspiration Pneumonia (Non-Ventilated)
1
TN0701 : Chronic Renal Failure 1 (CRF )
4
10TN0637: Abdominal Hystrectomy for Benign Conditions1CM0924 : APPENDICULAR PERFORATION4
Slide98Govt.Head
Quarters Hosp
Kumbakonam,Thanjavur TN.
Month Wise PerformanceYearPreauth Status on 11.06.2016 & 17RECEIVEDAPPROVEDCANCELLEDDENIEDNMIPROCESSNos.Nos.Amt. In Lakhs
Nos.Nos.Nos.Nos.5H 13510115.7210101406H
525
44656.4242269
2
Year
Claims Status on 11.06.2016 & 17
RECEIVED
CLAIMS APPROVED
DENIED
NMI
PROCESS
Nos.
Nos.
Amt. In Lakhs
Nos.
Nos.
Nos.
5H
69
64
9.68
3
206H 35033133.283142Bed Strength- 526
Slide99Govt.Head
Quarters Hosp
Kumbakonam,Thanjavur TN.
S.No Top 10 Package - 5H NosTop 10 Package - 6H Nos1TN0637: Abdominal Hystrectomy for Benign Conditions14TN0565 : Hearing Aid432TN0314-b: Fracture Shaft of Other Long Bones (Humerus, Both Bones of Forarm, Both Bones of Leg)
9TN0385 : Term Baby /Culture Positive Sepsis/ Non-Ventilated/ Hyperbilirubinemia373TN0386: Preterm Baby/ Clinical Sepsis/ Hyperbilirubinemia (Non-Ventilated)9TN0392 : Severe Bronchiolitis/Severe Broncho Pneumonia/Severe aspiration Pneumonia (Non-Ventilated)324TN0688: Acute MI (Conservative Management without Angiogram)8CM0399 : HEARING AID - RESERVED TO GOVT31
5
TN0621: Vaginal Hysterectomy with Pelvic Floor Repair7CM0218 A : TERM BABY WITH CULTURE POSITIVE SEPSIS / CLINICAL SEPSIS WITHOUT MECHANICAL VENTILATION / CPAP20
6
TN0388: Term Baby With Severe Perinatal Asphyxia - Non-Ventilated clinical Sepsis with or without Hyperbilirubinemia
5
TN0870 : Lap. Appendicectomy
17
7
TN0314-a: Fracture Neck/ Shaft Of Femur
4
TN0637 : Abdominal Hystrectomy for Benign Conditions
15
8
TN0860: Modified Radical Mastectomy
4
CM0923 : LAP. APPENDICECTOMY
15
9
TN0869: Ventral and Scar Hernia with Mesh
4
CM0158 : UPTO-40% WITH SCALDS (CONSERVATIVE)
1310TN0870: Lap. Appendicectomy3TN0688 : Acute MI (Conservative Management without Angiogram)12
Slide100Govt Hospital
Peravurani,Thanjavur,TN
.
YearPreauth Status on 11.06.2017RECEIVEDAPPROVEDCANCELLEDDENIEDNMIPROCESSNos.Nos.Amt. In LakhsNos.
Nos.Nos.Nos.6H 110.200000Year
Claims Status on 11.06.2017
RECEIVEDCLAIMS APPROVED DENIEDNMI
PROCESS
Nos.
Nos.
Amt. In Lakhs
Nos.
Nos.
Nos.
6H
0
0
0
0
0
0
Bed Strength– 70
Emp
Date- 20.3.2017
Slide101THENI
Slide102Govt. Head
Qrtrs Hosp
Periyakullam,Theni TN.
Month Wise PerformanceYearPreauth Status on 11.06.2016 & 17RECEIVEDAPPROVEDCANCELLEDDENIEDNMIPROCESSNos.Nos.Amt. in Lakhs
Nos.Nos.Nos.Nos.5H110788.2282310
6H
13912312.46103
2
1
Year
Claims Status on
11.06.2016
& 17
RECEIVED
CLAIMS
APPROVED
DENIED
NMI
PROCESS
Nos.
Nos.
Amt. in Lakhs
Nos.
Nos.
Nos.
5H
73666.552236H86797.82007
Bed Strength - 296
Slide103Govt. Head
Qrtrs Hosp
Periyakullam,Theni TN.
S.NoTop 10 Package - 5HNosTop 10 Package - 6HNos1TN0388: Term Baby With Severe Perinatal Asphyxia - Non-Ventilated clinical Sepsis with or without Hyperbilirubinemia42TN0702 : Maintenance Haemodialysis For CRF242TN0565: Hearing Aid
11CM0513 : MAINTANENCE HEMODIALYSIS FOR CRF (8 DIALYSIS) INCLUDING SEROPOSITIVE223TN0385: Term Baby /Culture Positive Sepsis/ Non-Ventilated/ Hyperbilirubinemia8TN0388 : Term Baby With Severe Perinatal Asphyxia - Non-Ventilated clinical Sepsis with or without Hyperbilirubinemia104TN0587: Endoscopic Sinus Surgery4TN0385 : Term Baby /Culture Positive Sepsis/ Non-Ventilated/ Hyperbilirubinemia
10
5TN0159: Total Abdominal Hysterectomy(TAH) + Bilateral Salpingo Ophorectomy (BSO) + Bilateral Pelvic Lymph Node Dissection (BPLND) + Omentectomy2TN0688 : Acute MI (Conservative Management without Angiogram)10
6
TN0580: Adenoidectomy - Gromet Insertion
2
CM0220 A : TERM BABY PERSISTENT PULMONARY HYPERTENSION / MECONIUM ASPIRATION SYNDROME / PERINATAL ASPHYXIA / WITHOUT MECHANICAL VENTILATION / CPAP
9
7
TN0867: Umbilical Hernia with Mesh
2
TN0637 : Abdominal
Hystrectomy
for Benign Conditions
9
8
TN0869: Ventral and Scar Hernia with Mesh
2
CM0218 A : TERM BABY WITH CULTURE POSITIVE SEPSIS / CLINICAL SEPSIS WITHOUT MECHANICAL VENTILATION / CPAP
5
9
TN0865: Rare Hernias (Spigalion, Obuturator, Sciatic)
1TN0565 : Hearing Aid410TN0386: Preterm Baby/ Clinical Sepsis/ Hyperbilirubinemia (Non-Ventilated)1CM0399 : HEARING AID - RESERVED TO GOVT3
Slide104Govt.
kambam Hospital, Theni TN.
Month Wise Performance
YearPreauth Status on 11.06.2016 & 17RECEIVEDAPPROVEDCANCELLEDDENIEDNMIPROCESSNos.Nos.Amt. in Lakhs
Nos.Nos.Nos.Nos.5H978510.51111006H
85
7514.0955
0
0
Year
Claims Status on
11.06.2016
& 17
RECEIVED
CLAIMS
APPROVED
DENIED
NMI
PROCESS
Nos.
Nos.
Amt. in Lakhs
Nos.
Nos.
Nos.
5H
82828.150006H696611.06120
Bed Strength - 146
Slide105Govt.
kambam Hospital, Theni TN.
S.No
Top 10 Package - 5HNosTop 10 Package - 6HNos1TN0385: Term Baby /Culture Positive Sepsis/ Non-Ventilated/ Hyperbilirubinemia33TN0385 : Term Baby /Culture Positive Sepsis/ Non-Ventilated/ Hyperbilirubinemia102TN0688: Acute MI (Conservative Management without Angiogram)
23TN0688 : Acute MI (Conservative Management without Angiogram)93TN0278: Upto-40% With Scalds (Conservative)9TN0637 : Abdominal Hystrectomy for Benign Conditions44TN0637: Abdominal Hystrectomy for Benign Conditions5CM0623-II : ABDOMINAL HYSTERECTOMY FOR BENIGN / MALIGNANT CONDITIONS4
5
TN0392: Severe Bronchiolitis/Severe Broncho Pneumonia/Severe aspiration Pneumonia (Non-Ventilated)5CM0950 : OSTEOMYELITIS REQUIRING IV ANTIBIOTIC3
6
TN0711: Ischemic Strokes
3
TN0314 : Surgical Correction of Longbone Fracture
3
7
TN0974: Lap.Cholecystectomy
2
TN0621 : Vaginal Hysterectomy with Pelvic Floor Repair
2
8
TN0386: Preterm Baby/ Clinical Sepsis/ Hyperbilirubinemia (Non-Ventilated)
2
CM0923 : LAP. APPENDICECTOMY
2
9
TN0371: Toal Knee Replacement
1
CM0183 : SURGICAL CORRECTION OF LONGBONE FRACTURE-FRACTURE NECK/ SHAFT OF FEMUR/FRACTURE SHAFT OF OTHER LONG BONES (HUMERUS,BOTH BONES OF FOREARM, BOTH BONES OF LEG)
210TN0282: Upto-60% With Scalds (Conservative)1CM0186B : IMPLANT EXIT- PLATES (SPINE IMPLANTS/OTHER MAJOR IMPLANT)2
Slide106THOOTHUKUDI
Slide107Govt
Hospital,Thiruchendur,Thoothukudi
TN.
Month Wise PerformanceYearPreauth Status on 11.06.2016 & 17RECEIVEDAPPROVEDCANCELLEDDENIEDNMIPROCESSNos.Nos.Amt. In Lakhs
Nos.Nos.Nos.Nos.5H 88769.46210006H
160
15016.83280
0
Year
Claims Status on 11.06.2016 & 17
RECEIVED
CLAIMS APPROVED
DENIED
NMI
PROCESS
Nos.
Nos.
Amt. In Lakhs
Nos.
Nos.
Nos.
5H
68
58
5.77
0
1006H 11611011.28024Bed Strength- 118
Slide108Govt
Hospital,Thiruchendur,Thoothukudi
TN.
S.No Top 10 Package - 5H NosTop 10 Package - 6H Nos1TN0565: Hearing Aid34CM0399 : HEARING AID - RESERVED TO GOVT322TN0637: Abdominal Hystrectomy for Benign Conditions6
TN0565 : Hearing Aid193TN0388: Term Baby With Severe Perinatal Asphyxia - Non-Ventilated clinical Sepsis with or without Hyperbilirubinemia5TN0688 : Acute MI (Conservative Management without Angiogram)154TN0688: Acute MI (Conservative Management without Angiogram)4TN0388 : Term Baby With Severe Perinatal Asphyxia - Non-Ventilated clinical Sepsis with or without Hyperbilirubinemia13
5
TN0621: Vaginal Hysterectomy with Pelvic Floor Repair4CM0982 : OP /ANY POISIONING - CONSERVATIVE MANAGEMENT OR WITHOUT VENTILATORY SUPPORT (ONLY WITH FIR )106
TN0867: Umbilical Hernia with Mesh
3
CM0513 : MAINTANENCE HEMODIALYSIS FOR CRF (8 DIALYSIS) INCLUDING SEROPOSITIVE
5
7
TN0386: Preterm Baby/ Clinical Sepsis/ Hyperbilirubinemia (Non-Ventilated)
3
TN0392 : Severe Bronchiolitis/Severe Broncho Pneumonia/Severe aspiration Pneumonia (Non-Ventilated)
4
8
TN0110: Lumpectomy
3
TN0621 : Vaginal Hysterectomy with Pelvic Floor Repair
4
9
TN0642: Copd Respiratory Failure (Infective Exacerbation)
3
TN0386 : Preterm Baby/ Clinical Sepsis/ Hyperbilirubinemia (Non-Ventilated)
4
10TN0711: Ischemic Strokes2CM0820-III : AMPUTATION OF ANY SITE / ANY CAUSE WITHOUT PROSTHESIS (fingers, toes and small joints)3
Slide109Govt. Head
Qrtrs
Hosp Kovilpatti,Tuticorin TN.
Month Wise PerformanceYearPreauth Status on 11.06.2016 & 17RECEIVEDAPPROVEDCANCELLEDDENIEDNMIPROCESSNos.Nos.Amt. In Lakhs
Nos.Nos.Nos.Nos.5H 22314422.162844706H
343
28539.50162220
0
Year
Claims Status on 11.06.2016 & 17
RECEIVED
CLAIMS APPROVED
DENIED
NMI
PROCESS
Nos.
Nos.
Amt. In Lakhs
Nos.
Nos.
Nos.
5H
79
45
4.92
1
3306H 17815719.080138Bed Strength- 251
Slide110Govt. Head
Qrtrs
Hosp Kovilpatti,Tuticorin TN.
S.No Top 10 Package - 5H NosTop 10 Package - 6H Nos1TN0388: Term Baby With Severe Perinatal Asphyxia - Non-Ventilated clinical Sepsis with or without Hyperbilirubinemia25CM0513 : MAINTANENCE HEMODIALYSIS FOR CRF (8 DIALYSIS) INCLUDING SEROPOSITIVE492TN0702: Maintenance Haemodialysis For CRF
24TN0702 : Maintenance Haemodialysis For CRF423TN0386: Preterm Baby/ Clinical Sepsis/ Hyperbilirubinemia (Non-Ventilated)11TN0388 : Term Baby With Severe Perinatal Asphyxia - Non-Ventilated clinical Sepsis with or without Hyperbilirubinemia304TN0857: Subtotal Thyroidectomy9CM0183 : SURGICAL CORRECTION OF LONGBONE FRACTURE-FRACTURE NECK/ SHAFT OF FEMUR/FRACTURE SHAFT OF OTHER LONG BONES (HUMERUS,BOTH BONES OF FOREARM, BOTH BONES OF LEG)
13
5TN0621: Vaginal Hysterectomy with Pelvic Floor Repair8TN0314-b : Fracture Shaft of Other Long Bones (Humerus, Both Bones of Forarm, Both Bones of Leg)12
6
TN0688: Acute MI (Conservative Management without Angiogram)
8
CM0218 A : TERM BABY WITH CULTURE POSITIVE SEPSIS / CLINICAL SEPSIS WITHOUT MECHANICAL VENTILATION / CPAP
9
7
TN0637: Abdominal Hystrectomy for Benign Conditions
8
CM0399 : HEARING AID - RESERVED TO GOVT
7
8
TN0565: Hearing Aid
7
TN0857 : Subtotal Thyroidectomy
6
9
TN0871: Appendicular Perforation
5
TN0565 : Hearing Aid
610TN0302: Reconstructive Lower Limb Surgery Following Infection, Trauma, Tumors / Malignancy, Developmental Including Diabetic Foot - Moderate5TN0637 : Abdominal Hystrectomy for Benign Conditions5
Slide111Govt Hospital
Vilathikulam,Tuticorin
TN.
YearPreauth Status on 11.06.2017RECEIVEDAPPROVEDCANCELLEDDENIEDNMIPROCESSNos.Nos.Amt. In LakhsNos.
Nos.Nos.Nos.6H 0000000
Year
Claims Status on 11.06.2017RECEIVEDCLAIMS APPROVED DENIED
NMI
PROCESS
Nos.
Nos.
Amt. In Lakhs
Nos.
Nos.
Nos.
6H
0
0
0
0
0
0
Bed Strength- 56
Emp
Date- 15.5.2017
Slide112Govt Hospital
Kalankudiyirrupu,Tuticorin
TN.
YearPreauth Status on 11.06.2017RECEIVEDAPPROVEDCANCELLEDDENIEDNMIPROCESSNos.Nos.Amt. In LakhsNos.
Nos.Nos.Nos.6H 0000000
Year
Claims Status on 11.06.2017RECEIVEDCLAIMS APPROVED DENIED
NMI
PROCESS
Nos.
Nos.
Amt. In Lakhs
Nos.
Nos.
Nos.
6H
0
0
0
0
0
0
Bed Strength- 24
Emp
Date- 15.5.2017
Slide113Govt Hospital
Sathankulam,Tuticorin
TN.
YearPreauth Status on 11.06.2017RECEIVEDAPPROVEDCANCELLEDDENIEDNMIPROCESSNos.Nos.Amt. In LakhsNos.
Nos.Nos.Nos.6H 0000000
Year
Claims Status on 11.06.2017RECEIVEDCLAIMS APPROVED DENIED
NMI
PROCESS
Nos.
Nos.
Amt. In Lakhs
Nos.
Nos.
Nos.
6H
0
0
0
0
0
0
Bed Strength- 50
Emp
Date- 15.5.2017
Slide114Govt Hospital
Ottapidaram,Tuticorin
TN.
YearPreauth Status on 11.06.2017RECEIVEDAPPROVEDCANCELLEDDENIEDNMIPROCESSNos.Nos.Amt. In LakhsNos.
Nos.Nos.Nos.6H 0000000
Year
Claims Status on 11.06.2017RECEIVEDCLAIMS APPROVED DENIED
NMI
PROCESS
Nos.
Nos.
Amt. In Lakhs
Nos.
Nos.
Nos.
6H
0
0
0
0
0
0
Bed Strength- 44
Emp
Date- 15.5.2017
Slide115Govt Hospital
Kayalpattanam,Tuticorin
TN.
YearPreauth Status on 11.06.2017RECEIVEDAPPROVEDCANCELLEDDENIEDNMIPROCESSNos.Nos.Amt. In LakhsNos.
Nos.Nos.Nos.6H 0000000
Year
Claims Status on 11.06.2017RECEIVEDCLAIMS APPROVED DENIED
NMI
PROCESS
Nos.
Nos.
Amt. In Lakhs
Nos.
Nos.
Nos.
6H
0
0
0
0
0
0
Bed Strength- 85
Emp
Date- 15.5.2017
Slide116TIRUVARUR
Slide117Govt
hospital,Nanillam,Tiruvarur
TN.
Month Wise PerformanceYearPreauth Status on 11.06.2016 & 17RECEIVEDAPPROVEDCANCELLEDDENIEDNMIPROCESSNos.Nos.Amt. In Lakhs
Nos.Nos.Nos.Nos.5H 640.2211006H
10
91.02010
0
Year
Claims Status on 11.06.2016 & 17
RECEIVED
CLAIMS APPROVED
DENIED
NMI
PROCESS
Nos.
Nos.
Amt. In Lakhs
Nos.
Nos.
Nos.
5H
3
3
0.14
0
006H 840.17031Bed Strength- 82
Slide118Govt
hospital,Nanillam,Tiruvarur
TN.
S.No Top 10 Package - 5H NosTop 10 Package - 6H Nos1TN0392: Severe Bronchiolitis/Severe Broncho Pneumonia/Severe aspiration Pneumonia (Non-Ventilated)1TN0392 : Severe Bronchiolitis/Severe Broncho Pneumonia/Severe aspiration Pneumonia (Non-Ventilated)62TN0388: Term Baby With Severe Perinatal Asphyxia - Non-Ventilated clinical Sepsis with or without Hyperbilirubinemia
1TN0278 : Upto-40% With Scalds (Conservative)13TN0278: Upto-40% With Scalds (Conservative)1CM0158 : UPTO-40% WITH SCALDS (CONSERVATIVE)14TN0375: Kerosene Ingestion1CM0160 : UPTO-50% WITH SCALDS (CONSERVATIVE)1
5
6
7
8
9
10
Slide119Govt
hospital,Thiruthuraipoondi,Tiruvarur
TN.
Month Wise PerformanceYearPreauth Status on 11.06.2016 & 17RECEIVEDAPPROVEDCANCELLEDDENIEDNMIPROCESSNos.Nos.Amt. In Lakhs
Nos.Nos.Nos.Nos.5H 20162.0113006H
13
122.09010
0
Year
Claims Status on 11.06.2016 & 17
RECEIVED
CLAIMS APPROVED
DENIED
NMI
PROCESS
Nos.
Nos.
Amt. In Lakhs
Nos.
Nos.
Nos.
5H
13
13
1.57
0
006H 991.51000Bed Strength- 124
Slide120Govt
hospital,Thiruthuraipoondi,Tiruvarur
TN.
S.No Top 10 Package - 5H NosTop 10 Package - 6H Nos1TN0637: Abdominal Hystrectomy for Benign Conditions10TN0871 : Appendicular Perforation32TN0386: Preterm Baby/ Clinical Sepsis/ Hyperbilirubinemia (Non-Ventilated)
2TN0636 : Vaginal Hysterectomy for BENIGN CONDITIONS23TN0711: Ischemic Strokes1TN0637 : Abdominal Hystrectomy for Benign Conditions14TN0871: Appendicular Perforation1CM0475A : VAGINAL HYSTERECTOMY WITH PELVIC FLOOR REPAIR1
5
TN0278: Upto-40% With Scalds (Conservative)1CM0921D : EPIGASTRIC HERNIA/UMBILICAL HERNIA - WITH MESH - OPEN16
TN0636: Vaginal Hysterectomy for BENIGN CONDITIONS
1
CM0758 : INCISIONAL HERNIA REPAIR WITH MESH
1
7
TN0869 : Ventral and Scar Hernia with Mesh
1
8
CM0924 : APPENDICULAR PERFORATION
1
9
TN0285 : Mild
1
10
Slide121Govt.Head
Qrtrs Hosp Mannargudi,Tiruvarur
TN.Month Wise PerformanceYearPreauth Status on 11.06.2016 & 17RECEIVEDAPPROVEDCANCELLEDDENIEDNMIPROCESSNos.Nos.Amt. In Lakhs
Nos.Nos.Nos.Nos.5H 32295.4102106H
70
649.5612
3
0
Year
Claims Status on 11.06.2016 & 17
RECEIVED
CLAIMS APPROVED
DENIED
NMI
PROCESS
Nos.
Nos.
Amt. In Lakhs
Nos.
Nos.
Nos.
5H
14
5
0.63
0906H 11100.53010Bed Strength- 342
Slide122Govt.Head
Qrtrs Hosp Mannargudi,Tiruvarur
TN.S.No Top 10 Package - 5H NosTop 10 Package - 6H Nos1TN0314-b: Fracture Shaft of Other Long Bones (Humerus, Both Bones of Forarm, Both Bones of Leg)9TN0385 : Term Baby /Culture Positive Sepsis/ Non-Ventilated/ Hyperbilirubinemia212
TN0702: Maintenance Haemodialysis For CRF5TN0711 : Ischemic Strokes103TN0621: Vaginal Hysterectomy with Pelvic Floor Repair3CM0183 : SURGICAL CORRECTION OF LONGBONE FRACTURE-FRACTURE NECK/ SHAFT OF FEMUR/FRACTURE SHAFT OF OTHER LONG BONES (HUMERUS,BOTH BONES OF FOREARM, BOTH BONES OF LEG)74TN0869: Ventral and Scar Hernia with Mesh2TN0314-b : Fracture Shaft of Other Long Bones (Humerus, Both Bones of Forarm, Both Bones of Leg)
6
5TN0330: Arthroscopy - ACL Repair2TN0314-a : Fracture Neck/ Shaft Of Femur5
6
TN0316-f: Amputation of Fingers
1
CM0475A : VAGINAL HYSTERECTOMY WITH PELVIC FLOOR REPAIR
4
7
TN0637: Abdominal Hystrectomy for Benign Conditions
1
TN0637 : Abdominal Hystrectomy for Benign Conditions
2
8
TN0692: Refractory Cardiac Failure
1
TN0330 : Arthroscopy - ACL Repair
2
9
TN0372: Total Hip Replacement
1
TN0621 : Vaginal Hysterectomy with Pelvic Floor Repair
110TN0711: Ischemic Strokes1TN0386 : Preterm Baby/ Clinical Sepsis/ Hyperbilirubinemia (Non-Ventilated)1
Slide123TIRUNELVELI
Slide124Dist. Govt. Head
Qrtrs
Hosp Tenkasi,Tiruneveli TN.
Month Wise PerformanceYearPreauth Status on 11.06.2016 & 17RECEIVEDAPPROVEDCANCELLEDDENIEDNMIPROCESSNos.Nos.Amt. In Lakhs
Nos.Nos.Nos.Nos.5H 15413220.12413506H
326
29535.9516104
1
Year
Claims Status on 11.06.2016 & 17
RECEIVED
CLAIMS APPROVED
DENIED
NMI
PROCESS
Nos.
Nos.
Amt. In Lakhs
Nos.
Nos.
Nos.
5H
95
93
10.05
0
206H 19517418.096312Bed Strength- 256
Slide125Dist. Govt. Head
Qrtrs
Hosp Tenkasi,Tiruneveli TN.
S.No Top 10 Package - 5H NosTop 10 Package - 6H Nos1TN0702: Maintenance Haemodialysis For CRF44CM0513 : MAINTANENCE HEMODIALYSIS FOR CRF (8 DIALYSIS) INCLUDING SEROPOSITIVE592TN0688: Acute MI (Conservative Management without Angiogram)
26TN0702 : Maintenance Haemodialysis For CRF503TN0314-b: Fracture Shaft of Other Long Bones (Humerus, Both Bones of Forarm, Both Bones of Leg)13TN0688 : Acute MI (Conservative Management without Angiogram)254TN0711: Ischemic Strokes12TN0650 : Thrombocytopenia with Bleeding Diathesis24
5
TN0314-a: Fracture Neck/ Shaft Of Femur7CM0487 : ACUTE MI (CONSERVATIVE MANAGEMENT WITHOUT ANGIOGRAM)226
TN0388: Term Baby With Severe Perinatal Asphyxia - Non-Ventilated clinical Sepsis with or without Hyperbilirubinemia
6
CM0183 : SURGICAL CORRECTION OF LONGBONE FRACTURE-FRACTURE NECK/ SHAFT OF FEMUR/FRACTURE SHAFT OF OTHER LONG BONES (HUMERUS,BOTH BONES OF FOREARM, BOTH BONES OF LEG)
18
7
TN0385: Term Baby /Culture Positive Sepsis/ Non-Ventilated/ Hyperbilirubinemia
4
CM0519 : THROMBOCYTOPENIA WITH BLEEDING DIATHESIS
16
8
TN0386: Preterm Baby/ Clinical Sepsis/ Hyperbilirubinemia (Non-Ventilated)
3
TN0314-b : Fracture Shaft of Other Long Bones (Humerus, Both Bones of Forarm, Both Bones of Leg)
11
9
TN0279: Upto-40% Mixed Burns (With Surgeries)
3
TN0870 : Lap. Appendicectomy
8
10TN0294: Nerve and Tendon Repair + Vascular Repair2CM0923 : LAP. APPENDICECTOMY6
Slide126Govt Hospital Sankarankoil, Tirunelveli TN.
Month Wise Performance
Year
Preauth Status on 11.06.2016 & 17RECEIVEDAPPROVEDCANCELLEDDENIEDNMIPROCESSNos.Nos.Amt. In LakhsNos.
Nos.Nos.Nos.5H 23203.3203006H 46
39
4.31043
0
Year
Claims Status on 11.06.2016 & 17
RECEIVED
CLAIMS APPROVED
DENIED
NMI
PROCESS
Nos.
Nos.
Amt. In Lakhs
Nos.
Nos.
Nos.
5H
16
16
1.90
0
006H 27262.34001Bed Strength- 186
Slide127Govt Hospital Sankarankoil, Tirunelveli TN.
S.No
Top 10 Package - 5H NosTop 10 Package - 6H Nos1TN0278: Upto-40% With Scalds (Conservative)7CM0519 : THROMBOCYTOPENIA WITH BLEEDING DIATHESIS122TN0650: Thrombocytopenia with Bleeding Diathesis6
TN0650 : Thrombocytopenia with Bleeding Diathesis63TN0711: Ischemic Strokes4TN0711 : Ischemic Strokes54TN0867: Umbilical Hernia with Mesh1CM0500 : COPD RESPIRATORY FAILURE (INFECTIVE EXACERBATION)35
TN0375: Kerosene Ingestion
1CM0158 : UPTO-40% WITH SCALDS (CONSERVATIVE)36
TN0688: Acute MI (Conservative Management without Angiogram)
1
TN0278 : Upto-40% With Scalds (Conservative)
3
7
TN0388 : Term Baby With Severe Perinatal Asphyxia - Non-Ventilated clinical Sepsis with or without Hyperbilirubinemia
2
8
CM0516B : ISCHEMIC STROKE
2
9
TN0688 : Acute MI (Conservative Management without Angiogram)
1
10
TN0642 : Copd Respiratory Failure (Infective Exacerbation)
1
Slide128Govt hospital,Ambasamudiram,Tirunelveli TN.
Month Wise Performance
Year
Preauth Status on 11.06.2016 & 17RECEIVEDAPPROVEDCANCELLEDDENIEDNMIPROCESSNos.Nos.Amt. In LakhsNos.
Nos.Nos.Nos.5H 740.4003006H 21
18
3.02201
0
Year
Claims Status on 11.06.2016 & 17
RECEIVED
CLAIMS APPROVED
DENIED
NMI
PROCESS
Nos.
Nos.
Amt. In Lakhs
Nos.
Nos.
Nos.
5H
4
3
0.24
1
006H 14131.99001Bed Strength- 88
Slide129Govt hospital,Ambasamudiram,Tirunelveli TN.
S.No
Top 10 Package - 5H NosTop 10 Package - 6H Nos1TN0388: Term Baby With Severe Perinatal Asphyxia - Non-Ventilated clinical Sepsis with or without Hyperbilirubinemia2CM0186B : IMPLANT EXIT- PLATES (SPINE IMPLANTS/OTHER MAJOR IMPLANT)22TN0314-b: Fracture Shaft of Other Long Bones (Humerus, Both Bones of Forarm, Both Bones of Leg)
1TN0278 : Upto-40% With Scalds (Conservative)23TN0375: Kerosene Ingestion1TN0316-e : Amputation of Toes14CM0183 : SURGICAL CORRECTION OF LONGBONE FRACTURE-FRACTURE NECK/ SHAFT OF FEMUR/FRACTURE SHAFT OF OTHER LONG BONES (HUMERUS,BOTH BONES OF FOREARM, BOTH BONES OF LEG)1
5
TN0676 : Corrosive Oesophageal Injury16
TN0869 : Ventral and Scar Hernia with Mesh
1
7
TN0314-a : Fracture Neck/ Shaft Of Femur
1
8
CM0225 A : TERM - WITH OR WITHOUT /SEVERE PERINATAL ASPHYXIA /SEPTIC SHOCK /SEIZURES /RENAL FAILURE/ - NON VENTILATED
1
9
TN0314-b : Fracture Shaft of Other Long Bones (Humerus, Both Bones of Forarm, Both Bones of Leg)
1
10
CM0470 : RUPTURE UTERUS WITH TUBECTOMY
1
Slide130Govt Hospital
Nanguneri,Tirunelveli
TN.
YearPreauth Status on 11.06.2017RECEIVEDAPPROVEDCANCELLEDDENIEDNMIPROCESSNos.Nos.Amt. In LakhsNos.
Nos.Nos.Nos.6H 0000000
Year
Claims Status on 11.06.2017RECEIVEDCLAIMS APPROVED DENIED
NMI
PROCESS
Nos.
Nos.
Amt. In Lakhs
Nos.
Nos.
Nos.
6H
0
0
0
0
0
0
Bed Strength- 52
Emp
Date- 15.5.2017
Slide131Govt Hospital
Vallioor,Tirunelveli
TN.
YearPreauth Status on 11.06.2017RECEIVEDAPPROVEDCANCELLEDDENIEDNMIPROCESSNos.Nos.Amt. In LakhsNos.
Nos.Nos.Nos.6H 0000000
Year
Claims Status on 11.06.2017RECEIVEDCLAIMS APPROVED DENIED
NMI
PROCESS
Nos.
Nos.
Amt. In Lakhs
Nos.
Nos.
Nos.
6H
0
0
0
0
0
0
Bed Strength- 28
Emp
Date- 15.5.2017
Slide132Govt Hospital
Radhapuram,Tirunelveli
TN.
YearPreauth Status on 11.06.2017RECEIVEDAPPROVEDCANCELLEDDENIEDNMIPROCESSNos.Nos.Amt. In LakhsNos.
Nos.Nos.Nos.6H 0000000
Year
Claims Status on 11.06.2017RECEIVEDCLAIMS APPROVED DENIED
NMI
PROCESS
Nos.
Nos.
Amt. In Lakhs
Nos.
Nos.
Nos.
6H
0
0
0
0
0
0
Bed Strength- 53
Emp
Date- 15.5.2017
Slide133Govt Hospital
Auikudi,Tirunelveli
TN.
YearPreauth Status on 11.06.2017RECEIVEDAPPROVEDCANCELLEDDENIEDNMIPROCESSNos.Nos.Amt. In LakhsNos.
Nos.Nos.Nos.6H 0000000
Year
Claims Status on 11.06.2017RECEIVEDCLAIMS APPROVED DENIED
NMI
PROCESS
Nos.
Nos.
Amt. In Lakhs
Nos.
Nos.
Nos.
6H
0
0
0
0
0
0
Bed Strength- 36
Emp
Date- 15.5.2017
Slide134Govt Hospital
Alangulam,Tirunelveli
TN.
YearPreauth Status on 11.06.2017RECEIVEDAPPROVEDCANCELLEDDENIEDNMIPROCESSNos.Nos.Amt. In LakhsNos.
Nos.Nos.Nos.6H 0000000
Year
Claims Status on 11.06.2017RECEIVEDCLAIMS APPROVED DENIED
NMI
PROCESS
Nos.
Nos.
Amt. In Lakhs
Nos.
Nos.
Nos.
6H
0
0
0
0
0
0
Bed Strength- 60
Emp
Date- 15.5.2017
Slide135Govt Hospital
Sengkottai,Tirunelveli
TN.
YearPreauth Status on 11.06.2017RECEIVEDAPPROVEDCANCELLEDDENIEDNMIPROCESSNos.Nos.Amt. In LakhsNos.
Nos.Nos.Nos.6H 0000000
Year
Claims Status on 11.06.2017RECEIVEDCLAIMS APPROVED DENIED
NMI
PROCESS
Nos.
Nos.
Amt. In Lakhs
Nos.
Nos.
Nos.
6H
0
0
0
0
0
0
Bed Strength- 60
Emp
Date- 15.5.2017
Slide136Govt Hospital
Puliangudi,Tirunelveli
TN.
YearPreauth Status on 11.06.2017RECEIVEDAPPROVEDCANCELLEDDENIEDNMIPROCESSNos.Nos.Amt. In LakhsNos.
Nos.Nos.Nos.6H 0000000
Year
Claims Status on 11.06.2017RECEIVEDCLAIMS APPROVED DENIED
NMI
PROCESS
Nos.
Nos.
Amt. In Lakhs
Nos.
Nos.
Nos.
6H
0
0
0
0
0
0
Bed Strength- 60
Emp
Date- 15.5.2017
Slide137Govt Hospital
Koodankulam,Tirunelveli
TN.
YearPreauth Status on 11.06.2017RECEIVEDAPPROVEDCANCELLEDDENIEDNMIPROCESSNos.Nos.Amt. In LakhsNos.
Nos.Nos.Nos.6H 0000000
Year
Claims Status on 11.06.2017RECEIVEDCLAIMS APPROVED DENIED
NMI
PROCESS
Nos.
Nos.
Amt. In Lakhs
Nos.
Nos.
Nos.
6H
0
0
0
0
0
0
Bed Strength- 148
Emp
Date- 15.5.2017
Slide138Govt Hospital
Kalakad,Tirunelveli
TN.
YearPreauth Status on 11.06.2017RECEIVEDAPPROVEDCANCELLEDDENIEDNMIPROCESSNos.Nos.Amt. In LakhsNos.
Nos.Nos.Nos.6H 0000000
Year
Claims Status on 11.06.2017RECEIVEDCLAIMS APPROVED DENIED
NMI
PROCESS
Nos.
Nos.
Amt. In Lakhs
Nos.
Nos.
Nos.
6H
0
0
0
0
0
0
Bed Strength- 30
Emp
Date- 15.5.2017
Slide139Govt Hospital
Cheranmahadevi,Tirunelveli
TN.
YearPreauth Status on 11.06.2017RECEIVEDAPPROVEDCANCELLEDDENIEDNMIPROCESSNos.Nos.Amt. In LakhsNos.
Nos.Nos.Nos.6H 0000000
Year
Claims Status on 11.06.2017RECEIVEDCLAIMS APPROVED DENIED
NMI
PROCESS
Nos.
Nos.
Amt. In Lakhs
Nos.
Nos.
Nos.
6H
0
0
0
0
0
0
Bed Strength- 32
Emp
Date- 15.5.2017
Slide140Govt Hospital
Melapalayam,Tirunelveli
TN.
YearPreauth Status on 11.06.2017RECEIVEDAPPROVEDCANCELLEDDENIEDNMIPROCESSNos.Nos.Amt. In LakhsNos.
Nos.Nos.Nos.6H 0000000
Year
Claims Status on 11.06.2017RECEIVEDCLAIMS APPROVED DENIED
NMI
PROCESS
Nos.
Nos.
Amt. In Lakhs
Nos.
Nos.
Nos.
6H
0
0
0
0
0
0
Bed Strength- 54
Emp
Date- 15.5.2017
Slide141Govt Hospital
Kadayanallur,Tirunelveli
TN.
YearPreauth Status on 11.06.2017RECEIVEDAPPROVEDCANCELLEDDENIEDNMIPROCESSNos.Nos.Amt. In LakhsNos.
Nos.Nos.Nos.6H 0000000
Year
Claims Status on 11.06.2017RECEIVEDCLAIMS APPROVED DENIED
NMI
PROCESS
Nos.
Nos.
Amt. In Lakhs
Nos.
Nos.
Nos.
6H
0
0
0
0
0
0
Bed Strength- 107
Emp
Date- 15.5.2017
Slide142VIRUDHUNAGAR
Slide143Govt
hospital,Arupukottai,Virdhunagar TN
Month Wise Performance
YearPreauth Status on 11.06.2016 & 17RECEIVEDAPPROVEDCANCELLEDDENIEDNMIPROCESSNos.Nos.Amt. in Lakhs
Nos.Nos.Nos.Nos.5H46138353.27466806H
392
33944.86738
5
3
Year
Claims Status on
11.06.2016
& 17
RECEIVED
CLAIMS
APPROVED
DENIED
NMI
PROCESS
Nos.
Nos.
Amt. in Lakhs
Nos.
Nos.
Nos.
5H
35434140.125176H27825530.03959
Bed Strength - 294
Slide144Govt
hospital,Arupukottai,Virdhunagar TN
S.No
Top 10 Package - 5HNosTop 10 Package - 6HNos1TN0711: Ischemic Strokes55TN0388 : Term Baby With Severe Perinatal Asphyxia - Non-Ventilated clinical Sepsis with or without Hyperbilirubinemia492TN0701: Chronic Renal Failure 1 (CRF )
54TN0392 : Severe Bronchiolitis/Severe Broncho Pneumonia/Severe aspiration Pneumonia (Non-Ventilated)223TN0642: Copd Respiratory Failure (Infective Exacerbation)31CM0419 : ENDOSCOPIC SINUS SURGERY-CHRONIC RHINO SINUSITIS184TN0871: Appendicular Perforation31CM0399 : HEARING AID - RESERVED TO GOVT13
5
TN0587: Endoscopic Sinus Surgery29CM0410 : ADENOIDECTOMY - GROMET INSERTION12
6
TN0688: Acute MI (Conservative Management without Angiogram)
23
CM0225 A : TERM - WITH OR WITHOUT /SEVERE PERINATAL ASPHYXIA /SEPTIC SHOCK /SEIZURES /RENAL FAILURE/ - NON VENTILATED
12
7
TN0386: Preterm Baby/ Clinical Sepsis/ Hyperbilirubinemia (Non-Ventilated)
22
TN0580 : Adenoidectomy - Gromet Insertion
10
8
TN0565: Hearing Aid
17
TN0701 : Chronic Renal Failure 1 (CRF )
10
9
TN0314-b: Fracture Shaft of Other Long Bones (Humerus, Both Bones of Forarm, Both Bones of Leg)
12
TN0386 : Preterm Baby/ Clinical Sepsis/ Hyperbilirubinemia (Non-Ventilated)
1010TN0392: Severe Bronchiolitis/Severe Broncho Pneumonia/Severe aspiration Pneumonia (Non-Ventilated)12TN0565 : Hearing Aid8
Slide145Govt
hospital,Kariapatti,Virudhunagar TN.
Month Wise Performance
YearPreauth Status on 11.06.2016 & 17RECEIVEDAPPROVEDCANCELLEDDENIEDNMIPROCESSNos.Nos.Amt. in Lakhs
Nos.Nos.Nos.Nos.5H15214025.2157006H
92
8215.3845
1
0
Year
Claims Status on
11.06.2016
& 17
RECEIVED
CLAIMS
APPROVED
DENIED
NMI
PROCESS
Nos.
Nos.
Amt. in Lakhs
Nos.
Nos.
Nos.
5H
12111620.481136H50428.38008
Bed Strength - 66
Slide146Govt
hospital,Kariapatti,Virudhunagar TN.
S.No
Top 10 Package - 5HNosTop 10 Package - 6HNos1TN0622: Vaginal Hysterectomy with Mesh Repair35TN0622 : Vaginal Hysterectomy with Mesh Repair132TN0620 : Laproscopic Assisted Vaginal Hysterectomy (LAVH)
14TN0806 : URSL63TN0870: Lap. Appendicectomy8TN0587 : Endoscopic Sinus Surgery64TN0278: Upto-40% With Scalds (Conservative)8CM0419 : ENDOSCOPIC SINUS SURGERY-CHRONIC RHINO SINUSITIS6
5
TN0110: Lumpectomy6CM0475B : VAGINAL HYSTERECTOMY WITH MESH REPAIR6
6
TN0213: Cyclophosphamide/ Methotrexate / 5 Fluorouracil (CMF)
6
CM0778-A-I : WIDE EXICISION/ LUMPECTOMY - TUMORS OF BREAST -BENIGN
6
7
TN0462: Undescended Testis
6
CM0774 : LAPROSCOPIC ASSISTED VAGINAL HYSTERECTOMY
4
8
TN0889: Operation for Acute Intestinal Obstrucion
5
TN0620 : Laproscopic Assisted Vaginal Hysterectomy (LAVH)
4
9
TN0587: Endoscopic Sinus Surgery
5
CM0576 : URETERO RENOSCOPIC LITHOTRIPSY
310TN0711: Ischemic Strokes4CM0287 : CONGENITAL HYDROCELE REPAIR2
Slide147Govt
hospital,Sattur,Virudhunagar TN.
Month Wise Performance
YearPreauth Status on 11.06.2016 & 17RECEIVEDAPPROVEDCANCELLEDDENIEDNMIPROCESSNos.Nos.Amt. in Lakhs
Nos.Nos.Nos.Nos.5H12310613.00011606H
132
10814.11218
3
1
Year
Claims Status on
11.06.2016
& 17
RECEIVED
CLAIMS
APPROVED
DENIED
NMI
PROCESS
Nos.
Nos.
Amt. in Lakhs
Nos.
Nos.
Nos.
5H
93849.312346H90849.88150
Bed Strength - 94
Slide148Govt
hospital,Sattur,Virudhunagar TN.
S.No
Top 10 Package - 5HNosTop 10 Package - 6HNos1TN0392: Severe Bronchiolitis/Severe Broncho Pneumonia/Severe aspiration Pneumonia (Non-Ventilated)43TN0392 : Severe Bronchiolitis/Severe Broncho Pneumonia/Severe aspiration Pneumonia (Non-Ventilated)252TN0688: Acute MI (Conservative Management without Angiogram)
28CM0487 : ACUTE MI (CONSERVATIVE MANAGEMENT WITHOUT ANGIOGRAM)93TN0669: Massive Hemoptysis6CM0233 : SEVERE BRONCHIOLITIS/SEVERE BRONCHO PNEUMONIA / SEVERE ASPIRATION PNEUMONIA (NON-VENTILATED)94TN0711: Ischemic Strokes5TN0688 : Acute MI (Conservative Management without Angiogram)7
5
TN0407: Dengue Shock Syndrome4TN0701 : Chronic Renal Failure 1 (CRF )7
6
TN0871: Appendicular Perforation
3
CM0626 A : DENGUE SHOCK SYNDROME -(ADULT/PAEDIATRICS)
5
7
TN0412: Acute Stridor/Foreign Body Obstruction
2
CM0516B : ISCHEMIC STROKE
4
8
TN0701: Chronic Renal Failure 1 (CRF )
2
TN0711 : Ischemic Strokes
4
9
TN0648: Septic Shock (ICU Management)
2
TN0669 : Massive Hemoptysis
310TN0867: Umbilical Hernia with Mesh2TN0407 : Dengue Shock Syndrome3
Slide149Govt
hospital,Sivakasi,Virudhunagar TN
Month Wise Performance
YearPreauth Status on 11.06.2016 & 17RECEIVEDAPPROVEDCANCELLEDDENIEDNMIPROCESSNos.Nos.Amt. in Lakhs
Nos.Nos.Nos.Nos.5H20817226.58424806H
248
20933.30324
10
2
Year
Claims Status on
11.06.2016
& 17
RECEIVED
CLAIMS
APPROVED
DENIED
NMI
PROCESS
Nos.
Nos.
Amt. in Lakhs
Nos.
Nos.
Nos.
5H
15714318.513386H18817725.22416
Bed Strength - 148
Slide150Govt
hospital,Sivakasi,Virudhunagar TN
S.No
Top 10 Package - 5HNosTop 10 Package - 6HNos1TN0388: Term Baby With Severe Perinatal Asphyxia - Non-Ventilated clinical Sepsis with or without Hyperbilirubinemia20TN0701 : Chronic Renal Failure 1 (CRF )182TN0871: Appendicular Perforation
17TN0314-b : Fracture Shaft of Other Long Bones (Humerus, Both Bones of Forarm, Both Bones of Leg)133TN0688: Acute MI (Conservative Management without Angiogram)11TN0870 : Lap. Appendicectomy114TN0701: Chronic Renal Failure 1 (CRF )11CM0183 : SURGICAL CORRECTION OF LONGBONE FRACTURE-FRACTURE NECK/ SHAFT OF FEMUR/FRACTURE SHAFT OF OTHER LONG BONES (HUMERUS,BOTH BONES OF FOREARM, BOTH BONES OF LEG)8
5
TN0407: Dengue Shock Syndrome10TN0392 : Severe Bronchiolitis/Severe Broncho Pneumonia/Severe aspiration Pneumonia (Non-Ventilated)7
6
TN0711: Ischemic Strokes
8
TN0688 : Acute MI (Conservative Management without Angiogram)
7
7
TN0392: Severe Bronchiolitis/Severe Broncho Pneumonia/Severe aspiration Pneumonia (Non-Ventilated)
7
CM0158 : UPTO-40% WITH SCALDS (CONSERVATIVE)
7
8
TN0314-b: Fracture Shaft of Other Long Bones (Humerus, Both Bones of Forarm, Both Bones of Leg)
6
CM0516B : ISCHEMIC STROKE
6
9
TN0642: Copd Respiratory Failure (Infective Exacerbation)
6
TN0711 : Ischemic Strokes
610TN0278: Upto-40% With Scalds (Conservative)5TN0314-a : Fracture Neck/ Shaft Of Femur6
Slide151Govt
hospital,Watrap,Virudhunagar TN.
Month Wise Performance
YearPreauth Status on 11.06.2016 & 17RECEIVEDAPPROVEDCANCELLEDDENIEDNMIPROCESSNos.Nos.Amt. in Lakhs
Nos.Nos.Nos.Nos.5H73606.69111106H
23
141.5606
2
1
Year
Claims Status on
11.06.2016
& 17
RECEIVED
CLAIMS
APPROVED
DENIED
NMI
PROCESS
Nos.
Nos.
Amt. in Lakhs
Nos.
Nos.
Nos.
5H
55546.010016H12101.07200
Bed Strength - 92
Slide152Govt
hospital,Watrap,Virudhunagar TN.
S.No
Top 10 Package - 5HNosTop 10 Package - 6HNos1TN0388: Term Baby With Severe Perinatal Asphyxia - Non-Ventilated clinical Sepsis with or without Hyperbilirubinemia44TN0388 : Term Baby With Severe Perinatal Asphyxia - Non-Ventilated clinical Sepsis with or without Hyperbilirubinemia52TN0621: Vaginal Hysterectomy with Pelvic Floor Repair
10TN0392 : Severe Bronchiolitis/Severe Broncho Pneumonia/Severe aspiration Pneumonia (Non-Ventilated)23TN0392: Severe Bronchiolitis/Severe Broncho Pneumonia/Severe aspiration Pneumonia (Non-Ventilated)4TN0621 : Vaginal Hysterectomy with Pelvic Floor Repair24TN0402: Acute Pancreatitis/Acute Hepatitis2CM0218 A : TERM BABY WITH CULTURE POSITIVE SEPSIS / CLINICAL SEPSIS WITHOUT MECHANICAL VENTILATION / CPAP2
5
CM0815A : RECONSTRUCTIVE UPPER LIMB /HAND/LOWER LIMB/FOOT SURGERY FOLLOWING INFECTION, TRAUMA, BURNS, TUMORS/ MALIGNANCY, DEVELOPMENTAL INCLUDING DIABETIC FOOT - MILD1
6
TN0637 : Abdominal Hystrectomy for Benign Conditions
1
7
CM0475A : VAGINAL HYSTERECTOMY WITH PELVIC FLOOR REPAIR
1
8
9
10
Slide153Govt. Hospital,
Srivilliputhur, Virudhunagar TN.
Month Wise Performance
YearPreauth Status on 11.06.2016 & 17RECEIVEDAPPROVEDCANCELLEDDENIEDNMIPROCESSNos.Nos.Amt. in Lakhs
Nos.Nos.Nos.Nos.5H17413220.40330906H
129
10315.69113
9
3
Year
Claims Status on
11.06.2016
& 17
RECEIVED
CLAIMS
APPROVED
DENIED
NMI
PROCESS
Nos.
Nos.
Amt. in Lakhs
Nos.
Nos.
Nos.
5H
1169110.93112126H84598.623166
Bed Strength - 126
Slide154Govt. Hospital,
Srivilliputhur, Virudhunagar TN.
S.No
Top 10 Package - 5HNosTop 10 Package - 6HNos1TN0388: Term Baby With Severe Perinatal Asphyxia - Non-Ventilated clinical Sepsis with or without Hyperbilirubinemia23TN0621 : Vaginal Hysterectomy with Pelvic Floor Repair222TN0688: Acute MI (Conservative Management without Angiogram)
11CM0475A : VAGINAL HYSTERECTOMY WITH PELVIC FLOOR REPAIR123TN0621: Vaginal Hysterectomy with Pelvic Floor Repair10CM0626 A : DENGUE SHOCK SYNDROME -(ADULT/PAEDIATRICS)94TN0637: Abdominal Hystrectomy for Benign Conditions10TN0637 : Abdominal Hystrectomy for Benign Conditions8
5
TN0889: Operation for Acute Intestinal Obstrucion9TN0711 : Ischemic Strokes7
6
TN0711: Ischemic Strokes
9
CM0220 A : TERM BABY PERSISTENT PULMONARY HYPERTENSION / MECONIUM ASPIRATION SYNDROME / PERINATAL ASPHYXIA / WITHOUT MECHANICAL VENTILATION / CPAP
5
7
TN0402: Acute Pancreatitis/Acute Hepatitis
9
TN0710 : Hemorrhagic Stroke/Strokes
4
8
TN0565: Hearing Aid
8
TN0402 : Acute Pancreatitis/Acute Hepatitis
4
9
TN0871: Appendicular Perforation
7
TN0386 : Preterm Baby/ Clinical Sepsis/ Hyperbilirubinemia (Non-Ventilated)
310TN0407: Dengue Shock Syndrome5CM0516B : ISCHEMIC STROKE3
Slide155Govt. Hospital,
Thiruthangal, Virudhunagar TN.
Year
Preauth Status on 11.06.2017RECEIVEDAPPROVEDCANCELLEDDENIEDNMIPROCESSNos.Nos.Amt. in LakhsNos.
Nos.Nos.Nos.6H320.290100Year
Claims Status on
11.06.2017RECEIVEDCLAIMS APPROVEDDENIED
NMI
PROCESS
Nos.
Nos.
Amt. in Lakhs
Nos.
Nos.
Nos.
6H
1
0
0.00
0
1
0
Bed Strength - 60
Emp
Date – 05-Apr-17
Slide156Govt.Hd.Quarters
Hosp,Rajapalayam,Virudhunagar TN.
Month Wise Performance
YearPreauth Status on 11.06.2016 & 17RECEIVEDAPPROVEDCANCELLEDDENIEDNMIPROCESSNos.Nos.Amt. in Lakhs
Nos.Nos.Nos.Nos.5H1219215.23127106H
151
11117.78130
5
4
Year
Claims Status on
11.06.2016
& 17
RECEIVED
CLAIMS
APPROVED
DENIED
NMI
PROCESS
Nos.
Nos.
Amt. in Lakhs
Nos.
Nos.
Nos.
5H
868411.541106H999213.17502
Bed Strength - 132
Slide157Govt.Hd.Quarters
Hosp,Rajapalayam,Virudhunagar TN.
S.No
Top 10 Package - 5HNosTop 10 Package - 6HNos1TN0711: Ischemic Strokes10TN0637 : Abdominal Hystrectomy for Benign Conditions92TN0692: Refractory Cardiac Failure
10TN0688 : Acute MI (Conservative Management without Angiogram)73TN0688: Acute MI (Conservative Management without Angiogram)10TN0642 : Copd Respiratory Failure (Infective Exacerbation)64TN0637: Abdominal Hystrectomy for Benign Conditions10TN0692 : Refractory Cardiac Failure6
5
TN0392: Severe Bronchiolitis/Severe Broncho Pneumonia/Severe aspiration Pneumonia (Non-Ventilated)7TN0711 : Ischemic Strokes5
6
TN0621: Vaginal Hysterectomy with Pelvic Floor Repair
7
CM0491 : CONGESTIVE CARDIAC FAILURE
5
7
TN0889: Operation for Acute Intestinal Obstrucion
6
TN0670 : Acute Pancreatitis (Mild)
4
8
TN0386: Preterm Baby/ Clinical Sepsis/ Hyperbilirubinemia (Non-Ventilated)
4
TN0650 : Thrombocytopenia with Bleeding Diathesis
4
9
TN0642: Copd Respiratory Failure (Infective Exacerbation)
3
CM0487 : ACUTE MI (CONSERVATIVE MANAGEMENT WITHOUT ANGIOGRAM)
410TN0314-a: Fracture Neck/ Shaft Of Femur3CM0501 : ACUTE BRONCHITIS AND PNEUMONIA WITH RESPIRATORY FAILURE4
Slide158Govt.Head
Quarters Hospital,Virudhunagar TN.
Month Wise Performance
YearPreauth Status on 11.06.2016 & 17RECEIVEDAPPROVEDCANCELLEDDENIEDNMIPROCESSNos.Nos.Amt. in Lakhs
Nos.Nos.Nos.Nos.5H60652469.622947516H
693
61480.033932
0
8
Year
Claims Status on
11.06.2016
& 17
RECEIVED
CLAIMS
APPROVED
DENIED
NMI
PROCESS
Nos.
Nos.
Amt. in Lakhs
Nos.
Nos.
Nos.
5H
50049455.681236H54850960.699237
Bed Strength - 462
Slide159Govt.Head
Quarters Hospital,Virudhunagar TN.
S.No
Top 10 Package - 5HNosTop 10 Package - 6HNos1TN0388: Term Baby With Severe Perinatal Asphyxia - Non-Ventilated clinical Sepsis with or without Hyperbilirubinemia88TN0701 : Chronic Renal Failure 1 (CRF )542TN0701: Chronic Renal Failure 1 (CRF )
68CM0399 : HEARING AID - RESERVED TO GOVT513TN0386: Preterm Baby/ Clinical Sepsis/ Hyperbilirubinemia (Non-Ventilated)59TN0388 : Term Baby With Severe Perinatal Asphyxia - Non-Ventilated clinical Sepsis with or without Hyperbilirubinemia354TN0688: Acute MI (Conservative Management without Angiogram)41CM0513 : MAINTANENCE HEMODIALYSIS FOR CRF (8 DIALYSIS) INCLUDING SEROPOSITIVE32
5
TN0407: Dengue Shock Syndrome34TN0702 : Maintenance Haemodialysis For CRF32
6
TN0702: Maintenance Haemodialysis For CRF
26
TN0688 : Acute MI (Conservative Management without Angiogram)
31
7
TN0565: Hearing Aid
23
TN0386 : Preterm Baby/ Clinical Sepsis/ Hyperbilirubinemia (Non-Ventilated)
27
8
TN0637: Abdominal Hystrectomy for Benign Conditions
22
TN0565 : Hearing Aid
20
9
TN0392: Severe Bronchiolitis/Severe Broncho Pneumonia/Severe aspiration Pneumonia (Non-Ventilated)
20
TN0711 : Ischemic Strokes
1610TN0711: Ischemic Strokes15CM0516B : ISCHEMIC STROKE15
Slide160Govt
Hospital Kallamanayakanpati, Virudhunagar TN.
Year
Preauth Status on 11.06.2017RECEIVEDAPPROVEDCANCELLEDDENIEDNMIPROCESSNos.Nos.Amt. in LakhsNos.
Nos.Nos.Nos.6H0000000
Year
Claims Status on 11.06.2017RECEIVEDCLAIMS APPROVED
DENIED
NMI
PROCESS
Nos.
Nos.
Amt. in Lakhs
Nos.
Nos.
Nos.
6H
0
0
0
0
0
0
Bed Strength - 60
Emp
Date – 05-Apr-17
Slide161Top 20 Procedure Performance
Slide162TOP
20 PROCEDURE 11TH JAN 2012 TO 10
TH JUN 2017
S.NoProcedure NameOver-AllDMS.Per %Nos.Amt. in CroresNos.Amt. in Crores 1
TN0702: Maintenance Haemodialysis For CRF294955234.6085976.842.91%2TN0565: Hearing Aid8995672.282038416.4122.66%
3
TN0806: URSL4690381.89196
0.39
0.42%
4
TN0244: Palliative Chemotherapy
35165
15.87
300
0.12
0.85%
5
TN0002: PTCA with
Baremetal
Stent
34848
235.88
0
0.00
0.00%
6
TN0895: Chronic Hepatitis B3441518.78910.090.26%7TN0385: Term Baby /Culture Positive Sepsis/ Non-Ventilated/ Hyperbilirubinemia2907335.881442116.1449.60%8
TN0711: Ischemic Strokes
28828
51.82
4311
7.98
14.95%
9
TN0371:
Toal
Knee Replacement
28292
184.94
389
2.58
1.37%
10
TN0388: Term Baby With Severe Perinatal Asphyxia - Non-Ventilated clinical Sepsis with or without Hyperbilirubinemia
25718
34.23
17187
21.15
66.83%
11
TN0231: Cervical Cancer Weekly Cisplatin
25023
5.03
9
0.00
0.04%
12
TN0688: Acute MI (Conservative Management without Angiogram)
24279
44.75
7705
14.47
31.74%
13
TN0386: Preterm Baby/ Clinical Sepsis/ Hyperbilirubinemia (Non-Ventilated)
24263
50.49
9380
18.05
38.66%
14
TN0212: Paclitaxel
24162
25.28
31
0.03
0.13%
15
TN0210: 5- Fluorouracil A-C (FAC)
24090
8.98
199
0.07
0.83%
16
TN0314-b: Fracture Shaft of Other Long Bones (
Humerus
, Both Bones of
Forarm
, Both Bones of Leg)
21770
33.35
4938
7.46
22.68%
17
TN0219: Cisplatin- 5Fu
21499
8.77
27
0.01
0.13%
18
TN0259: CML Curable T. Imatinib
21458
11.95
1
0.00
0.00%
19
TN0020: Coronary Bypass Surgery
20052
183.96
0
0.00
0.00%
20
TN0620: Laproscopic Assisted Vaginal Hysterectomy (LAVH)
19177
27.96
0
0.00
0.00%
21
Other Procedures
1088537
2643.36
78522
131.62
7.21%
Grand Total
1,962,463
4,010.04
166,688
243.40
8.49%
Slide163DMS WISE - TOP
20 PROCEDURE 11TH JAN 2012 TO 10
TH JUN 2017
S.NoProcedure NameOver-AllGovt. (DMS Only)Per %Nos.Amt. in Crores Nos.Amt. in Crores 1
TN0565: Hearing Aid8995672.282038416.4122.66%2TN0388: Term Baby With Severe Perinatal Asphyxia - Non-Ventilated clinical Sepsis with or without Hyperbilirubinemia2571834.231718721.1566.83%
3
TN0385: Term Baby /Culture Positive Sepsis/ Non-Ventilated/ Hyperbilirubinemia2907335.881442116.14
49.60%
4
TN0386: Preterm Baby/ Clinical Sepsis/ Hyperbilirubinemia (Non-Ventilated)
24263
50.49
9380
18.05
38.66%
5
TN0702: Maintenance Haemodialysis For CRF
294955
234.60
8597
6.84
2.91%
6
TN0392: Severe Bronchiolitis/Severe Broncho Pneumonia/Severe aspiration Pneumonia (Non-Ventilated)
17692
15.77
81947.0246.31%7TN0688: Acute MI (Conservative Management without Angiogram)2427944.75770514.4731.74%8TN0642: Copd Respiratory Failure (Infective Exacerbation)
15327
42.36
7247
13.36
47.28%
9
TN0637: Abdominal Hystrectomy for Benign Conditions
17156
20.64
6180
7.42
36.02%
10
TN0314-b: Fracture Shaft of Other Long Bones (Humerus, Both Bones of Forarm, Both Bones of Leg)
21770
33.35
4938
7.46
22.68%
11
TN0711: Ischemic Strokes
28828
51.82
4311
7.98
14.95%
12
TN0621: Vaginal Hysterectomy with Pelvic Floor Repair
10690
19.06
3210
5.74
30.03%
13
TN0871: Appendicular Perforation
10176
14.89
3189
4.78
31.34%
14
TN0870: Lap. Appendicectomy
9216
16.53
2330
4.20
25.28%
15
TN0587: Endoscopic Sinus Surgery
11092
16.54
2271
3.36
20.47%
16
TN0278: Upto-40% With Scalds (Conservative)
3949
8.01
1891
3.86
47.89%
17
TN0314-a: Fracture Neck/ Shaft Of Femur
15584
35.32
1810
4.06
11.61%
18
TN0641: Acute Severe Asthma with Acute Respiratory Failure
4452
10.80
1763
2.84
39.60%
19
TN0580: Adenoidectomy - Gromet Insertion
6033
6.03
1698
1.70
28.15%
20
TN0692: Refractory Cardiac Failure
3488
6.80
1540
2.78
44.15%
Slide164Thank
You