App har TPA ke default pre-auth pate par bhejta hai (jaise Star Health ke liye [email protected]); apni TPA ka sahi pata alag ho to owner / admin Setup → Integrations → Live TPA Pre-Auth → 'Custom inbox (override)' me daale. Mail clinic ke apne email setting (agar set hai) se, warna ORALZY ke system email se jaata hai — tab TPA ka reply clinic tak nahi pahunchega, isliye TPA ko apna phone / email alag se batao. Mail ke neeche 'Reply to this email with the intimation number to auto-link.' likha hota hai, par abhi aisa auto-link nahi hota. Email fail ho jaye to bhi drawer 'Pre-auth email sent' dikha sakta hai — '🤖 Live Pre-Auth Queue' → '▾ Log' me Status / Note dekh kar confirm karo. Patient ko kuch nahi jaata.
TPA ko pre-auth email me kya jaata hai, X-ray attach hota hai?
'📤 Submit to TPA' TPA ke pre-auth email pate par mail bhejta hai: subject 'PRE-AUTH — <patient> — Policy <no.>', andar patient naam, age / gender, policy no., member, ICD-10, procedure code, Pre-Auth Amount ₹ aur approved narrative (demographics, clinical, diagnosis, necessity). X-ray, consent ya photo apne aap attach nahi hote — web se claim par file lagane ka option nahi, isliye ye TPA ko alag se bhejo.
Where in ORALZY: Billing → Insurance & RGHS → Insurance · Setup → Integrations → Live TPA Pre-Auth
Quick steps
- Claim → '🤖 AI Generate' → narrative theek karke '✓ Mark Approved'
- '📤 Submit to TPA' dabao
- '🤖 Live Pre-Auth Queue' → claim row → '▾ Log' me Status 'ok' dekho
- X-ray / consent / ID TPA ko alag se bhejo