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Software Application

for

Bhamashah Swasthya Bima Yojana

Training Manual (Version 2.0)

RajComp Info Services Limited (RISL)

March 2016

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Contents

S. No. Chapter Page

1. Introduction 3

2. Abbreviations 4

3. Services integrated with BSBY Software 5

4. Logging In 6

5. Beneficiary Identification Form 7-17

6. Emergency Case Conversion Form 18-19

7. Pre-Authorization Request Form 20-26

8. Patient Admission Form 27

9. TID Cancellation Form 28-30

10. Patient Discharge and Claim Submission Form 31-33

11. Query Panel 34-37

12. Case Status Tracker 38-40

13. Report Summary 41-42

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Introduction

Bhamashah Swasthya Bima Yojana (BSBY) was launched in the State of Rajasthan on 13th

December 2015 and a software developed by RISL is in use for providing health insurance

coverage to eligible beneficiary families under the scheme. A Training Manual (Version 1.0)

was prepared as a guide to the users of the software. In the last two months and a half, the

software has undergone major improvements and changes, which necessitated the bringing

out of an updated version of the Training Manual for the benefit of software users.

It is against this background that Training Manual Version 2.0 has been brought out for the

benefit of the users of BSBY software. This Training Manual Version 2.0 is a guide intended

to provide you step-by-step guidance on successful use of BSBY software application.

Training Manual Version 2.0 contains guidance on the following additional / upgraded

features of the upgraded BSBY software application:

1. Merging of Patient Discharge Form and Claim Submission Form into a single Patient

Discharge and Claim Submission Form

2. TID Cancellation Form

3. The Query Panel

4. Report Summary

It is hoped this updated Training Manual Version 2.0 will be a good and user-friendly guide

which will aid in smooth and successful use of BSBY software for providing benefits to

beneficiary families.

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Abbreviations used in this Document

S. No. Abbreviation Full Form

1. Aadhaar EID Aadhaar Enrolment ID (Enrolment Identification No.)

2. BSBY Bhamashah Swasthya Bima Yojana

3. CEO Chief Executive Officer

4. CRN Central Registration Number

5. DoIT&C Department of Information Technology & Communication

6. FCS Dept Department of Food and Civil Supplies

7. LAMA Left Against Medical Advice

8. M&H Dept Department of Medical, Health and Family Welfare

9. MLC Medico-Legal Case

10. MOIC Medical Officer Incharge

11. MRD No. Medical Record Department No.

12. NHM National Health Mission

13. NIA New India Assurance Company Limited

14. NFSA National Food Security Act

15. OTP One Time Password

16. PDS Public Distribution System

17. RISL RajComp Info Services Limited

18. RSBY Rashtriya Swasthya Bima Yojana

19. SHAA State Health Assurance Agency

20. TID Transaction Identity No.

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Services integrated with BSBY Software

The following services have been integrated with BSBY software application:

1. Services with UIDAI – for verification of identity of beneficiary family using Aadhaar

Card

2. Services with Public Distribution System of Department of Food and Civil Supplies

3. Services with Bhamashah Database Hub (BDH)

N.B.: It is to be noted that there is no integration of any kind for capturing photo through web

camera – web camera is a plug-and-play device that does not require any integration. If you

are facing an issue regarding capturing photograph using web camera, you are advised to

contact a computer engineer locally and seek his / her support.

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Logging In

1. Software Application – The software application site is bsbyapp.health.rajasthan.gov.in.

2. On entering this address on the web page, the following Log-In Screen appears:

a. User Name: You need to enter the User ID provided to you by M&H Dept or by NIA.

b. Password: Enter the password provided to you by M&H Dept or by NIA.

c. Captcha: Enter the captcha that appears on the screen. Please note that the captcha is not

case sensitive and you may enter the captcha in lower case in case of alphabets.

d. Forgot Password: A facility has been developed within the software for this issue.

However, this facility has not been activated because mobile numbers of majority users

have not been entered into the database of the software.

N.B.: For any issues related to User IDs or Passwords, please contact New India Assurance

Company Limited at the landline no. 0141-2643814 or 0141-2643815.

3. After you have successfully logged in, the following screen appears on your computer:

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Beneficiary Identification Form

This is the first form that has to be used for providing benefits to an eligible beneficiary under BSBY.

1. After you have successfully logged in, the following screen appears on your computer:

2. Click on the ‘Beneficiary Identification Form’ link under Quick Links on the left side of the

screen. The following screen appears.

3. Choose ‘Admission Type’ for the patient from the drop-down menu as shown below:

4. ‘Normal’ Admission: If you choose ‘Admission Type’ as ‘Normal’, follow the following steps

for identification of beneficiary status of a family based on Family ID Type:

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i. Please select the ‘Identity Type’ by clicking on the appropriate Radio Button; after

clicking on a radio button for ‘Identity Type’, the box on the right becomes enabled and

you can type or paste the family identity number in this box. E.g., if you select

‘Bhamashah Family ID’, you need to enter the seven-alphabet Bhamashah Card ID / No.

(in upper case) in the text box as shown below:

ii. Click on the ‘Search Beneficiary’ button immediately below the box and the following

details about NFSA beneficiary status of the family appear:

iii. If you select ‘Ration Card’, you need to enter the 12-digit Ration Card No. in the text

box:

iv. Click on the ‘Search Beneficiary’ button immediately below the box and the following

details about NFSA beneficiary status of the family appear:

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v. If you enter the Aadhaar Card and the Aadhaar Card is available in Bhamashah Database

Hub, entering the Aadhaar Card No. in the textbox and clicking the ‘Search Beneficiary’

button will get the family entitlement status from BDH. If the Aadhaar Card is not

available in BDH, the message ‘No records available’ will appear.

vi. After you have entered the family ID no. and clicked on the ‘Search Beneficiary’ button,

you will get either of the following three situations:

a. The database tells the Entitlement Type of the family as ‘NFSA’ as shown above.

In this case, if you scroll down, you will find the name, age and gender of the

family members on the screen.

b. The database tells the Entitlement Type of the family as N/A as shown below

(this implies that from the database of Food and Civil Supplies Dept the

confirmed NFSA status of the family is Not Available. In such a case, please

refer to guidelines of M&H Dept, confirm the NFSA status of the family by

seeing the Ration Card (for NFSA status) or RSBY Card (for RSBY status), scan

the relevant documents as per directives of M&H Dept and use the MOIC route

(while following the MOIC route, please refer to and follow the guidelines /

directives of M&H Dept).

c. For some Ration Card IDs, you may even get the status as ‘No records found’.

This implies that this Ration Card no. is not available in the database of Food &

Civil Supplies Dept. In this case also, please follow M&H Dept guidelines and

directives and follow the MOIC route as mentioned in point 4(v)(b) above.

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vii. MOIC Route: For situations described under point 4(vi)(b) and 4(vi)(c) where the

confirmed NFSA status is not available through the software, you need to verify by

looking at the Ration Card of the family if the family is an NFSA family (please follow

M&H guidelines / directives regarding this). If you are convinced that this family is an

NFSA family, please scan the relevant pages of the Ration Card and save it on the system.

a. Then click on the ‘MOIC’ radio button under ‘Identity Type’ and the following

screen appears:

b. Enter the name of the patient to be enrolled under BSBY, enter the age of patient,

gender of patient, choose ‘Verified Identity Type’ by using the drop-down menu

and enter the Verified ‘Identity Number’ – seven-alphabet ID for Bhamashah

Family ID, 12-digit number for Ration Card or 16-digit number for RSBY Family

ID.

c. Click on ‘Choose’ button for selecting the document to be uploaded, then click on

the ‘Upload’ button to upload the document and you get the message ‘PDF

Uploaded Successfully’:

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d. Click on the ‘Submit’ button and you succeed in generating the TID number for

this patient as shown below:

e. Not this TID for all future reference of this patient and use this for filling up the

‘Pre-Authorization Request Form’.

N.B.: On using the MOIC route for identifying the beneficiary status of a family, the

MOIC has already verified the family and identified the patient. Please follow the

guidelines and directives of M&H Dept in this regard.

On generating the TID using MOIC Route under ‘Identity Type, you may go

directly to Pre-Authorization Request Form.

viii. After you have ensured the entitlement status of the family as a beneficiary family

(whether through the software using any of the eligibility cards), you need to establish the

genuineness of the family – be verifying the identity of the patient. For verification of

the genuineness of the patient (or any family member, you are advised to refer to the

guidelines / directives issued by M&H Dept and follow them. Here, the alternatives

available for verification of the patient (or any family member) are described.

a. After you have confirmed the NFSA status of the family, you may see the two

radio buttons available under ‘Verify by’ – ‘Aadhaar’ and ‘MOIC’.

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b. First we describe the scenario of Verification by Aadhaar. Until this point, you

may see in the table below the ‘Verify by’ button that the buttons in the column

titled ‘Verify Aadhaar’ are not enabled.

c. On selecting the ‘Aadhaar’ button opposite ‘Verify by’ you can see that the

‘Verify Aadhaar’ buttons in the table are enabled as shown below.

d. Click on the ‘Verify Aadhaar’ button for the person whose Aadhaar credentials

you want to verify from Aadhaar database (in case a person’s Aadhaar number is

not appearing on the screen but the person has brought his / her Aadhaar Card,

you may enter the Aadhaar number in the box opposite that person’s name under

the column ‘Aadhaar number’ and click on ‘Verify Aadhaar’ button). The

following dialogue box opens:

e. Fingerprint Verification: You must already have successfully installed and

functional Finger Print Reading Device integrated with your computer system.

Click on the ‘FMR’ button and light glows up on your finger print scanning

device. Ask the person (whose identity you want to verify from Aadhaar

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database) to provide lay his / her finger or thumb on the glass of the fingerprint

scanning device where the light is glowing. And the thumb print of the person

appears in the box adjacent to ‘Read Finger Print’.

Click on ‘Send Request’ button and the request is sent to UIDAI database to

match the fingerprints associated with this Aadhaar Card in UIDAI database. On

confirmation of matching of fingerprint, a message ‘Verified’ appears in the

column ‘Verification Status’ in the row containing the name of the person whose

identify has been verified by using Aadhaar Card. Once ‘Verified’ status appears

in the ‘Verification Status’ column, the radio buttons in the ‘Select Patient’

column are enabled and you can now select the patient by clicking upon the

relevant radio button in the row containing the patient’s name.

If the message appearing in the ‘Verification Status’ column is ‘Not Verified’,

this indicates that the finger print uploaded for this person does not match the

finger prints available in UIDAI database for this Aadhaar Card. You may try

again by repeating the process with the same or another finger / thumb. In the

possibility that despite repeating the process the message ‘Verified’ does not

appear, you have the OTP option as described below.

f. OTP: By clicking on the ‘OTP’ option in the window as described in point

4(vi)(e), an OTP is sent from UIDAI database to the Registered Mobile No.

available in UIDAI database for that Aadhaar Card. An SMS containing OTP is

received on the patient’s Registered Mobile No. – please enter this OTP in the

box and click on ‘Confirm OTP’. Once this goes back to UIDAI database which

matches the submitted OTP with the OTP that was sent from UIDAI database. If

the two match, the message ‘Verified’ appears in the column ‘Verification Status’

in the row containing the name of the person whose identify has been verified by

using Aadhaar Card. Once ‘Verified’ status appears in the ‘Verification Status’

column, the radio buttons in the ‘Select Patient’ column are enabled and you can

now select the patient by clicking upon the relevant radio button in the row

containing the patient’s name.

In case the OTP does not match, the message appearing in the ‘Verification

Status’ column will be ‘Not Verified’ and the radio buttons for selection of the

patient will not be enabled and you will not be able to select patient. You may

like to repeat the process.

g. MOIC route for verification of identity of patient: If the patient has an

Aadhaar Card or any other photoidentity card (please follow guidelines /

directives of M&H Dept on this issue), his / her fingerprints do not match, the

person informs that the Registered Mobile No. that is entered in UIDAI database

is no longer with him / her and your hospital (through any authorized person as

per M&H guidelines) has verified the identity of the patient through some

photoidentity card, you have the option of using MOIC route for verification – in

which you upload scanned copy of verification document of the patient as

described below:

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Scan the photoidentity card of the patient that you want to upload for

verification of identity of the patient and save it in your computer from

where you can select and upload it.

Opposite ‘Verify by’ option, click on the radio button ‘MOIC’ and the

following screen appears:

Click on ‘Choose’ button opposite ‘Upload MOIC Verified Document’

and select the PDF document to be uploaded.

Click on ‘Upload’ button to upload the document and on successful

uploading of document, the ‘Uploaded Successfully’ message appears as

shown below.

Once the document has been uploaded successfully, the radio buttons

under the column ‘Select Patient’ are now enabled and you can select the

patient by clicking on the appropriate radio button opposite the name of

that patient. In this case, ‘mayank’ has been identified as the patient and

the details appear as shown below. Please note that in this case, you used

the MOIC route for verification and for this reason, there is no

information under ‘Aadhaar Verified by Person Name’ and ‘Aadhaar

Verified by Person ID’. In cases where verification has been done

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through UIDAI database using Aadhaar Card of a person, the name of the

person and his / her Aadhaar ID appear in these boxes.

Please enter the mobile number of the patient or person on which they

would like to receive SMS alerts related to this hospitalization episode.

In case the person does not have but has applied for Aadhaar Card and

has Aadhaar EID, please enter this EID in the appropriate box.

Press on the ‘Submit’ button and a TID will be generated as shown

below. You may like to not this TID for future reference.

N.B. After having successfully generated the TID for the patient, you can now book packages for this

patient by filling the Pre-Authorization Request Form.

This TID will not be visible in Case Status Tracker until and unless packages are booked for this TID

using Pre-Authorization Request Form. Once you have filled and successfully submitted the Pre-

Authorization Request Form, you will be able to see this TID in Case Status Tracker.

5. ‘Emergency’ Admission: If you choose ‘Admission Type’ as ‘Emergency’, follow the following

steps for generating a TID for the patient admitted in emergency and later normalize such a case

using ‘Emergency Case Conversion’ Form as described in a later chapter.

i. Choose ‘Emergency’ from the drop-down menu of ‘Admission Type’ and the following

screen appears:

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ii. A patient can be admitted in emergency either accompanied or not by a person who can

identify the patient. If the patient in emergency can be identified by another person, click

on the ‘Identified’ radio button and fill in ‘Patient Details’ and in case it is an MLC,

choose the category of MLC from the drop-down menu as shown below.

iii. Thereafter, enter the details of the person identifying the patient and press on ‘Submit’

button and a TID no. will be generated for the patient. Please note this TID for use in

future in ‘Emergency Case Conversion’ Form.

iv. In case a patient has been admitted in emergency and his / her identity cannot be

established whether through himself / herself or by any other person, click on the

‘Unidentified’ radio button and the following screen appears:

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v. Fill up this form and click on ‘Submit’ button and a TID no. will be generated for the

patient. Please note this TID for use in future in ‘Emergency Case Conversion’ Form.

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Emergency Case Conversion

N.B.: This form is to be used only in those cases where a TID was generated for an emergency while

using the ‘Admission Type’ as ‘Emergency’ from the drop-down menu in Beneficiary Identification

Form. This form is not to be filled in case ‘Admission Type’ was selected as ‘Normal’ in

Beneficiary Identification Form.

1. Click on the ‘Emergency Case Conversion”’ link under Quick Links on the left side of the screen.

The following screen appears.

2. A TID no. was generated on submission of ‘Beneficiary Identification Form’ after selecting

‘Admission Type’ as ‘Emergency’. Enter that TID no. in the ‘TID’ box provided on this screen

and click on any part of the screen outside the TID box. The name of the patient gets populate as

shown below:

3. Click on the Radio Button for the ‘Identity Type’ – as you do in ‘Beneficiary Identification Form’

- whether ‘Bhamashah Family ID’ or ‘Ration Card’ or ‘Aadhaar Card’ or ‘MOIC’ as shown

below:

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4. Click on ‘Search Beneficiary’ button after having entered the ID no. in the text box and the

following screen appears:

5. You must be familiar with this screen – that is a common feature when you use ‘Admission Type’

as ‘Normal’ in ‘Beneficiary Identification Form’.

6. Follow further steps as described in ‘Beneficiary Identification’ Form.

N.B.: After having filled the ‘Emergency Case Conversion Form’, you may proceed to fill the ‘Pre-

Authorization’ Request Form’

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Pre-Authorization Request Form

N.B.: Pre-Authorization Request Form can only be filled after a TID has been successfully generated

on successful submission of Beneficiary Identification Form.

In case of ‘Normal’ admissions using Beneficiary Identification Form, once the TID has been

generated, the Pre-Authorization Request Form for that TID can be filled.

In case of ‘Emergency’ admissions using Beneficiary Identification Form, once the TID has been

generated in an emergency, entitlement of the patient under BSBY needs to be established using

Emergency Case Conversion Form and only after this form is filled and successfully submitted can

the Pre-Authorization Request Form be filled for this TID.

1. Click on the ‘Pre-Authorization Request Form’ link under Quick Links on the left side of the

screen. The following screen appears.

1. Type or paste the TID in the box for TID provided on this screen.

2. Click on any part outside the TID box.

2. If the TID has been successfully generated on submission of Beneficiary Identification Form, the

name of the patient gets auto-populated.

3. You can check the balance amount available in the patient’s wallet – separately for Secondary

(including Government) packages and for Tertiary packages.

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4. The package code for the treatment of the patient must already have been specified by the treating

doctor. Click on the radio button ‘Package Code’ and a textbox appears. You can now start

entering the package code in this box and you can see the package codes appear as a drop-down

as you proceed typing the code.

5. Click on the Package Code that you want for this TID.

6. Click on the ‘Add Package’ button to the right of the textbox. You will notice that the package

details appear below – Package Code, Package Name, Package Category and Package Rate.

7. In case you want to book more packages for this TID, you can do so following the steps described

earlier and as shown below:

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8. You can add any number of packages for this TID in this manner. However, please follow

guidelines of M&H Dept regarding booking number of packages for a particular TID.

9. In the picture, you can note that the total of packages appears separately for Secondary packages

and for Tertiary packages.

10. If you realize you have added a wrong package, you have the option of deleting the package by

pressing on the ‘delete / trash’ button under the heading ‘Delete Record’ on the extreme right in

the row of the package.

11. Wallet: Compare the total rates of packages selected by you with the amount available in

patient’s wallet. In case the total amount of packages selected by you exceeds the amount

available in patient’s wallet, you may like to review the situation and delete one or more

packages, otherwise the case will go for fund enhancement.

N.B.: For additional information on Fund Enhancement, please refer to guidelines issued by

M&H Dept.

12. Capturing photograph using web camera: Providing photograph of patient in BSBY software

is mandatory. There are two options available for this – capturing photograph using web camera

or uploading photograph saved in PDF file.

N.B.: Please follow guidelines of M&H Dept regarding capturing or uploading photograph.

For capturing photograph of patient through the web camera, follow the following steps:

i. In the box opposite ‘Patient Photograph’ there is a dialogue box which has two options –

‘Allow’ and ‘Deny’. Click on the ‘Allow’ button to allow the web camera to take the

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photograph. On clicking the ‘Allow’ button, adjust the direction of the web camera in

such a way that you can have a view of the patient as shown below :

ii. Click on the ‘Capture’ button and you will see a frozen frame with captured photograph

of the patient in the box on the right as shown in the picture below:

iii. If you observe that the photograph of the patient that has been captured is blurred or not

proper, please repeat the process as described above.

iv. Uploading photograph in PDF format: An option of uploading photograph of patient as

a PDF file has been provided in this form under the ‘Report Document Type’ heading as

shown below:

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v. Select the option ‘prePatientPhoto’ from the drop-down menu under the heading ‘Report

Document Type’ in this form and for uploading the photo of patient in PDF format,

please follow the steps as described in the next section of this Chapter.

13. Uploading Doctor’s Prescription: Uploading doctor’s prescription is a mandatory field in this

form. For uploading doctor’s prescription, please follow the following steps:

i. In the box opposite ‘Doctor’s Prescription’, click on the ‘Choose’ button to select an

already scanned copy of the prescription in PDF format:

ii. Having selected the file, click on ‘Upload’ button for uploading the document and on

successfully uploading the document, you get the message ‘PDF Uploaded Successfully’.

14. Attaching Documents:

N.B.: Pre-Authorization Request Form is a common form for booking packages for TIDs – be it

Secondary packages or Government Packages or Tertiary Packages.

In case of Tertiary Packages, following successful submission of Pre-Authorization Request

Form, the matter is submitted to the Insurance Agency for authorizing / granting approval for

initiating treatment of the patient.

For this reason mentioned in the box above, you might consider it necessary to attach documents

(like investigation reports or past treatment records of the patient) in ‘Pre-Authorization Request

Form’. You can attach relevant documents using the Report Document Upload menu towards the

bottom of ‘Pre-Authorization Request Form’.

15. For attaching the documents, please follow the following steps:

i. Click on the drop-down menu of ‘Report Document Type’ as shown below:

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ii. Select the document type from the menu – an example has been shown for

‘Electrocardiograph (ECG)’. You must have an already scanned copy of the document

available on your computer ready for uploading. Click on ‘Choose’ button to select the

document and select it.

iii. Then click on ‘Upload’ button to attach the document and note that a message appears

‘Document Attached Successfully’. Till this time, the document is not uploaded into the

software – it has only been attached.

Under ‘Report Document Name’, it still shows ‘No records found’ indicating that the

document has been attached successfully, but has not yet been uploaded.

iv. You have the option of writing ‘brief’ remarks with regard to the report that you are

uploading into the software – though this is not mandatory. Click on the ‘Insert Details’

button on the right and you will see that the document has been uploaded into the

software and appears under the section ‘Attach Documents for Claim Submission’. Under

the Report Type you can see the name of the document and if the document has been

uploaded successfully, you will see ‘SUCCESS’ written under the heading ‘Upload

Status’. If you have typed something in the ‘Enter Remarks’ textbox, it appears under the

heading ‘Remarks’.

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v. This way, you can successfully upload any number of documents in ‘Pre-Authorization

Request Form’ – one document at a time. It may also be noted that the document(s) to

be attached here must be PDF files, not more than 250 KB in size.

vi. Please note that on the extreme right in the picture shown under point 15(iv) is an

‘Action’ button with sign of ‘trash / delete’. In case you realize you have uploaded the

wrong document, you may click on the ‘delete’ icon under the heading ‘Action’ to delete

the document.

16. Press on the submit button and if all requirements have been met and no errors have been

committed, you will get the message ‘Your Pre-Authorization Request submitted successfully’.

After successful generation of a TID, the case does not reflect in the Case Status Tracker until and

unless some package(s) is (are) booked for that TID.

From this point onwards, after you have successfully submitted the Pre-Authorization Request

From, this TID will start showing in the Case Status Tracker.

N.B.: On successful submission of Pre-Authorization Request Form, the status will be as follows for

different circumstances:

i. In case of Secondary / Government Packages where there are adequate funds in beneficiary’s

wallet, the status will be Pre-Authorization Approved. You will be able to successfully fill

Patient Admission Form for this TID.

ii. In case of Secondary / Government Packages where there are inadequate funds in

beneficiary’s wallet, the status will be Fund Enhancement Approval Pending. You will not

be able to fill Patient Admission Form for this TID until and unless additional funds are

allocated by CEO, SHAA for this TID from the corpus of Rs. 10.0 crore. Once Fund

Enhancement Approval is granted and additional funds are allocated, the status will change

to Pre-Authorization Approved and you will be able to then successfully fill Patient

Admission Form for this TID.

iii. In case of Tertiary Packages, the matter goes to Insurance Agency for Pre-Authorization and

the status will be Pre-Auth Approval Pending. Once the Insurance Agency approves the pre-

auth request, the status will change to Pre-Authorization Approved and you will be able to

then successfully fill Patient Admission Form for this TID.

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Patient Admission Form

N.B.: You can fill the Patient Admission Form only if that TID is in ‘Pre-Authorization Approved’

status.

If a particular TID is in Pre-Authorization Pending status or Fund Enhancement Approval Pending

status, you will not be able to fill the Patient Admission Form for this TID.

1. Click on the ‘Patient Admission Form’ link under Quick Links on the left side of the screen. The

following screen appears.

2. Type or paste the TID in the box for TID provided on this screen.

3. Click on any part outside the TID box.

4. If the case status for this TID is Pre-Authorization approved, the name of the patient gets auto-

populated.

5. Please enter the date of admission for the patient.

6. Once the date of admission has been filled, please fill the time of admission of this patient.

7. MRD No.: This is a non-mandatory field. This is not relevant for private hospitals and they may

leave it blank. This is also not relevant for those government hospitals that do not have a

functional Aarogya Online system of patient registration. This field is relevant only for those

government hospitals that have a functional Aarogya Online system of patient registration. The

MRD No. generated through Aarogya Online system needs to be entered in this field by only by

those government hospitals that have a functional Aarogya Online system.

8. After having filled the Patient Admission Form, click on the ‘Submit’ button and the data will be

saved.

Once the Patient Admission Form has been successfully submitted, the Date and Time of

Admission of the patient are visible in Case Status Tracker for that TID.

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TID Cancellation / Edit Form

It is important to note that you can Cancel or Edit a TID only if you have selected packages and have

not submitted claims for that TID. Once you have submitted claims for that TID, you won’t be able

to edit the TID.

1. Kindly note the TID no. that you want to edit.

2. In the ‘Quick Links’, click on ‘TID_Cancellation_Form’ and the TID Edit Form opens.

3. Type the TID no. (that you want to edit) in the space for TID on this Form.

Alternatively, you may copy the TID from Case Status Tracker Form or from Report Summary

and paste the TID in the box in TID_Cancellation_Form or TID Edit Form.

4. After you have typed or pasted the TID no., click the cursor on any part of the screen outside the

TID box.

5. Patient’s details appear on the screen – name, Beneficiary Entitlement Type, Hospital Code,

Hospital Name, (Balance) Wallet Details and details of package booked for the patient as shown

below.

6. Scroll down and you will see the ‘Submit’ button. Press this ‘Submit’ button in case you want to

Edit the TID.

7. On pressing the ‘Submit’ button, you get a Confirmation Message asking you ‘Do you want to

edit TID?’ In case you don’t want to edit, press ‘No’.

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8. In case you want to edit the TID, press ‘Yes’.

9. On pressing ‘Yes’ a new TID is generated and message appears on the screen which reads ‘Please

Note Your TID’. Note this TID for all future reference – this is the new TID generated in lieu of

the older TID that you cancelled / edited.

Please note that this is work in progress – at present, the new TID is not available in the message.

We are working on this and the new TID will soon be available by mid-March 2016 at this

place. 10. Please do not click on ‘OK’ button at this moment – since the TID (the new TID generated in

lieu of the older TID) is not visible along with the message. Once the TID starts appearing along

with this message in this box, you may note the new TID and press OK – that can be done only

after the new TID is visible in this box.

Until such time that the new TID no. is available in the box shown in the previous picture, please

do not press on the ‘ok’ button.

11. Using the vertical bar on the right side of the screen, scroll to the top of the screen.

12. You will see the displayed message ‘Your Request Submitted Successfully. Please Note HRNID

“T_____________”.

13. Note down this number – this is the new TID that has been generated in lieu of the older TID

which has been deleted.

Please Note: The new TID has been generated and the data related to older TID has been retained

within the software – you have the option of re-entering (or not) the data that has already been

generated for the older TID. You need not fill again the Beneficiary Identification Form for this TID.

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14. Now that the new TID has been generated, you may like to book changed packages for this

patient within the software. Go to the Pre-Authorization Request Form and paste or type the new

TID in the appropriate box and you get the name of the patient.

15. Go ahead and book new packages for this TID.

N.B.: This additional feature has been incorporated in BSBY (Bhamashah Swasthya Bima Yojana)

software based on request from Medical & Health Department consequent upon requests obtained

from hospitals.

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Patient Discharge and Claim Submission Form

N.B.: You can fill the Patient Discharge and Claim Submission Form only if that TID is in ‘Pre-

Authorization Approved’ status and Patient Admission Form has been filled and successfully

submitted.

1. Click on the ‘Patient Discharge and Claim Submission’ link under Quick Links on the left side of

the screen. The following screen appears.

2. Type or paste the TID in the box for TID provided on this screen.

3. Click on any part outside the TID box.

4. The name of the patient and the date and time of admission get auto-populated on the screen.

5. Please enter the date of discharge for the patient.

6. Once the date of discharge has been filled, please fill the time of discharge of this patient.

7. Click on the drop-down menu for Patient Discharge Status and select the appropriate category of

discharge.

8. Capture patient’s photograph – please follow guidelines of M&H Dept for this. For capturing

photograph of patient through web camera, please follow the steps described in Pre-Authorization

Request Form.

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9. Attaching documents is necessary for successfully submitting the ‘Patient Discharge and Claim

Submission Form’. Attach relevant documents – as per directives of M&H Dept – using the

Report Document Upload menu towards the bottom of ‘Patient Discharge and Claim Submission

Form’.

10. For attaching the documents, please follow the following steps:

a. Click on the drop-down menu of ‘Report Document Type’ as shown below:

b. Select the document type from the menu – an example has been shown for ‘Detailed

Discharge Summary’. You must have an already scanned copy of the document

available on your computer ready for uploading. Click on ‘Choose’ button to select

the document and select it.

c. Then click on ‘Upload’ button to attach the document and note that a message

appears ‘Document Attached Successfully’. Till this time, the document is not

uploaded into the software – it has only been attached.

d. You have the option of writing ‘brief’ remarks with regard to the report that you are

uploading into the software – though this is not mandatory. Click on the ‘Insert

Details’ button on the right and you will see that the document has been uploaded into

the software and appears under the section ‘Attach Documents for Claim

Submission’. Under the Report Type you can see the name of the document and if the

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document has been uploaded successfully, you will see ‘SUCCESS’ written under the

heading ‘Upload Status’. If you have typed something in the ‘Enter Remarks’

textbox, it appears under the heading ‘Remarks’.

e. This way, you can successfully upload any number of documents in ‘Patient

Discharge and Claim Submission Form’ – one document at a time. It may also be

noted that the document(s) to be attached here must be PDF files, not more than

250 KB in size.

f. Please note that on the extreme right in the picture shown under point 10(iv) is an

‘Action’ button with sign of ‘trash / delete’. In case you realize you have uploaded

the wrong document, you may click on the ‘delete’ icon under the heading ‘Action’ to

delete the document.

11. After you have followed the above steps and have uploaded the relevant documents, you may

press the ‘Submit’ button and if it is successfully submitted, you will get a message. In case it has

not been successfully submitted and an error message appears, please take action to address that

error.

N.B.: Once the ‘Patient Discharge and Claim Submission Form’ has been successfully submitted, the

Date and Time of Discharge of the patient are visible in Case Status Tracker and the case status for

that TID changes to Claim Approval Pending.

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Query Panel

1. Queries to hospitals in BSBY Software application may be related to three situations as follows:

1. Related to Claims (Claim Package Queried)

2. Related to Pre-Authorization (PreAuth Package Query)

3. Related to Fund Enhancement (Fund Enhancement Package Query)

2. For finding out the Query related to your hospital, please click on the ‘reportSummary’ quick link

on the left side of your hospital’s screen of BSBY Application. When the ‘reportSummary’ link

opens, click on the ‘claimPackageQuery’ or ‘preAuthPackageQuery’ or

‘fundEnhancementQuery’, as the case might be and you will get the list of TIDs for which queries

under that category have been raised:

3. You will be able to see the list of TIDs for which there is a query under the respective head as

follows:

4. Copy the TID for which you want to see the Query and for which you want to submit reply:

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5. Click on ‘Query Panel’ in Quick Links on left side of the screen of your hospital for BSBY

Software Application. Paste the TID that you had copied from the reportSummary – the TID for

which there is a query (as identified in Step 4). After pasting / typing the TID, click on any part of

the screen and you will see all fields get auto-populated on the screen.

6. Scroll the horizontal bar to the right and you will be able to see the status as

‘claimPackageQuery’:

7. On the extreme right you will be able to see the query that has been posted for your hospital:

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8. Having noted the query in the Query Panel, you may now go ahead with replying to the query by

attaching the documents in a single PDF file or a zip folder of size not more than 1 MB. You may

also like to type remarks in the textbox titled ‘Remarks’ prior to pressing the ‘Submit’ button.

N.B.: Once you have replied to the query through the Query Panel, the query will no longer be visible

in the Query Panel of your hospital and the status available in Case Status Tracker for this TID will

be ‘queryreplybyhospital’.

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Case Status Tracker

You are encouraged to use the Case Status Tracker for finding out the status of a TID. Alternatively,

you may go to the ‘reportSummary’ page and get the list of TIDs under different case statuses – like

Pre-Auth Approved, Claim Approval Pending, Claim Package Approved, Fund Enhancement

Pending, etc.

1. Click on the ‘Case Status Tracker’ link under Quick Links on the left side of the screen. The

following screen appears.

2. You have the option of using the following search criteria for searching a TID in the Case Status

Tracker:

i. TID – searching using a TID

ii. Select Package – searching by type of package – Secondary or Tertiary or All

iii. Case Status – searching by the status of different TIDs

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3. TID – searching using a TID

i. Type a TID in the Textbox provided for it; or paste the TID if you have already copied it

from somewhere else.

ii. Then click on ‘Search Criteria’ button. You will get this TID summary as shown below:

iii. You may then click over the TID no. marked in the Red box under and some details for

this TID appear as shown below:

iv. The details available are – TID No., Name of Patient, Case Type, Hospital Name,

Hospital Type, Identity Type and No., Admission Date, Discharge Date, Package(s)

booked for this TID, Package Rate(s), Wallet Details and Package Status. In addition, you

can also view the query raised related to that TID under ‘Package Remarks’ or the reason

for rejection.

N.B.: The feature of Package Remarks has been added for your convenience – and shows the

latest query or reason for rejection for this TID (as applicable). If there is a remark under the

‘Package Remarks’ box and the status is queryreplybyhospital, etc., you need not worry. Please

give priority to ‘Package Status’ over ‘Package Remarks’ in the Case Status Tracker.

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4. Searching by Type of Package

i. From the drop-down menu as shown below, you can filter the TIDs based on the type of

package as shown below:

ii. In case you want to select TIDs for which Tertiary packages have been selected, please

select ‘Tertiary’ from the drop-down menu and click on Search Criterion. You will get

the list of TIDs for which Tertiary packages have been booked by your hospital:

iii. In case you want to select only TIDs for which Secondary packages have been selected,

please select ‘Secondary from the drop-down menu and click on Search Criterion. You

will get the list of TIDs for which Secondary packages have been booked by your

hospital:

5. Searching by Status of TID – You can refine your search by the status of TID:

i. As an example, if you want to get the list of TIDs for which you have queries to the

claims submitted by your hospital, click on the drop-down menu of Case Status and select

the status ‘Claim Package Queried’ and press the ‘Select Criteria’ button.

ii. You will get the list of TIDs for which Claim Package Query has been raised.

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iii. Alternatively, you may use the ‘reportSummary’ page under Quick Links of your screen

and get the list of TIDs for which Claim Package Query has been raised.

6. By default, the Case Status Tracker screen is designed to show 20 TIDs in one page. In case you

want to see more TIDs in one page, please follow the following steps:

i. On the lower part of this screen, please note ‘20’ in the box along with a drop-down

arrow as shown in the red box in above picture and select the number of TIDs you would

like to see in one page. Click on that number and allow some time for the system to load

the data on the page – you will get those many TIDs on a single page.

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Report Summary

Report Summary provides a snapshot of the packages booked by the hospital and the status of those packages.

This feature has been added in the software to facilitate the work of hospitals for BSBY.

You are encouraged to use the Report Summary for finding out a summary of the performance of the

hospital under BSBY. It provides you the live list of packages (and amounts) under different statuses.

You may use the ‘reportSummary’ page to get the list of TIDs under different case statuses – like Pre-

Auth Approved, Claim Approval Pending, Claim Package Approved, Fund Enhancement Pending,

etc.

1. Click on the ‘Case Status Tracker’ link under Quick Links on the left side of the screen. The

following screen appears:

2. You can see the summary for this hospital in a snapshot. It shows that a total of 92 packages have

been booked by this hospital, amounting to a total of Rs. 2,87,150. Out of these, there is a Claim

Package Query for 21 packages, amounting to a total of Rs. 29,000… and so on.

3. In case you want to get the list of TIDs under different case statuses, click on that status under

‘Pkg Status’ as shown in the red box in the picture above. On clicking on ‘claimPackage Query’,

you get the list of TIDs with this status as shown below:

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4. By default, the Report Summary screen is designed to show 20 TIDs in one page. In case you

want to see more TIDs in one page, please follow the following steps:

i. On the upper part of this screen, please note ‘20’ in the box along with a drop-down

arrow as shown in the red box in the picture under point 3 and select the number of TIDs

you would like to see in one page. Click on that number and allow some time for the

system to load the data on the page – you will get those many TIDs on a single page.

5. You can download a PDF file of this report on your computer by clicking upon the link provided

for download towards the bottom of the screen as shown in the blue box in the picture above.

Alternatively, you can select the portion and copy these TIDs in a file at your end.