Alankit - Healthcare

We like to listen our customers please give your feedback in the form ⇓

While as we are thankful to you and to your organization in giving us the opportunity to provide you with the quality services and it will be our endure to give our best to our customers by continuously improving our TPA services. In this regard we also seek your cooperation therefore shall highly appreciate your giving the feedback on our overall services by completing of the below details in the feedback form..

Personal Information:

Name:		EmailID:
Policy Number:		Mobile No.:

Receipt of AHCL ID Card :

Have you received the AHCL ID Cards :	YesNo
If yes AHCL ID Card No. :

Information For Identity Card and Guide Book :

I/We have received the ID card through Post/SMS & E-Mail :

YesNo

Cashless Hospitalization :

Have you applied the cashless hospitalization facility:	YesNo
Was your pre authorization request approved or rejected:
The Cashless Authorization Sanctions took total period of :	0-1 hrs2-3 hrs4-12 hrsAbove 12 hrs
The Authorization Process took :	30 min01 hrs02 hrs03 hrs or Above
Did you find process of cashless hospitalization :	EasyDifficultUnclear
Was your cashless authorization request rejected or partially declined? If rejected /amount partially declined.
If your cashless authorization request was partially declined? Please mention the amount declined.
Did you seek any clarification about the rejection from Customer Care Dept’.?	YesNo
Did you get satisfied clarification about the rejection or partially rejection?	YesNo
Did you find the reason of rejection as incomplete information given by hospital?	YesNo
Here your suggestions for improvement, can be valuable. Please do write.

Claims Reimbursement services for non cashless or in addition to cashless claims :

Have you received the SMS/E-mail confirmation alert within 5 days of submission of claim document to AHCL :	YesNo
Was the inadequacy in documents informed by the help desk at the time of submission of documents?	YesNo
Was any discrepancy e-mail sent to you within 3 working days?	YesNo
Was the claim approval advice sent / received for reimbursement claims within	< 15 Days15 to 30 Days> 30 Days
Have you received the payment by cheque/RTGS Credit to you account for reimbursement claim received within	< 10 Days11 to 30 Days> 30 Days

Claims Reimbursement : (If Rejected )

Did you get the rejection letter on time?	YesNo
Was your claim rejected?	YesNo
Did you get the copy of inadmissibility claim liability letter?	YesNo
Did you submit any reasonable clarification about the inadmissibility which was not considered?	YesNo
Are you satisfied with the reasons of inadmissibility of claim?	YesNo
Any suggestions you would like to convey for improvement in rejection claims, please mention

Overall Call Centre & Customer Care Services

Did you have opportunity to contact call center or customer care per Phone / E-mail?	YesNo
Were your queries responded adequately and nicely	YesNo
Was satisfied solution provided to you within 48 hours?	YesNo
Is accessibility to our call centre numbers/help desk telephone lines	EasyNormalNot Reachable

We seek your cooperation in pointing out of existence of any following concern areas:
Language issuesQuery was not understood by the executiveThe response was unlearLong response time
Or Any other, concern areas not mention above

Support of our Network Hospital :

Name of the hospital where in policy holder / beneficiary was hospitalized
Did the hospital provide timely and proper services to AHCL card holder and services were	GoodAveragePoor
Do you feel the hospitals are adding extra charges for ID Card holders against the normal cost of hospitalization	YesNoWe do not have any knowledge
Overall experience of the hospital in hospitalization of your patient	Good AveragePoor

Hospital Outlook :

In which hospital was the policy holder / patient hospitalized
Overall experience with the hospital	GoodAveragePoor

Special Response Only For Responding to Help Desk Services At Corporate Sites :

AHCL Desk Representatives are available/Visiting as per SLA	DailyWeeklyMonthly
The cooperation AHCL Desk Representatives available/Visiting at site	AverageGoodVery Good
I/We received response /explanation for the incomplete / inadmissible claims papers at the helpdesk?	YesNo
We are satisfied with the onsite services?	YesNo
If No, In which aspect were you dissatisfied?
Lack of complete information Documents not understood by the executive The response was unlearNon availability of Technical Staff
Or Any other, important reason not mentioned above
We herein submit the above information without prejudice to any quarters.