Government Panel Billing Management
CGHS, ECHS, DGEHS, ESIC, PSU, PMJAY and state schemes — billed accurately, settled fully.
Government healthcare schemes account for a significant share of in-patient revenue at many hospitals — but they're also where the highest billing complexity, the strictest audit risk and the longest settlement cycles live. CGHS, ECHS, DGEHS, ESIC, PSU panels, PMJAY (Ayushman Bharat) and state schemes each have their own rate cards, eligibility rules, pre-authorisation processes and audit-recovery clauses. Our Government Panel Billing service runs all of them end-to-end with scheme-specific expertise.
Where Hospitals Lose Revenue
Government scheme billing is where hospitals most often leak revenue without realising it:
Outdated rate cards
Scheme rate cards change but the hospital's billing master doesn't catch up, leaving money on the table.
Eligibility verification gaps
Beneficiary eligibility, dependency status and policy validity not verified at admission — leading to claim rejection.
Pre-authorisation lapses
Each scheme has its own pre-auth process; missing steps cause downstream deductions or rejections.
Documentation under scheme rules
Scheme-specific document formats — referral letters, dependency certificates, ID validations — not collected on time.
Long settlement cycles
Many government schemes settle in 90–180 days; weak follow-up extends this further.
Post-payment audit risk
Many schemes can audit claims years later and recover payment if documentation is weak — silent contingent liability.
Empanelment renewal lapses
Empanelment renewal cycles missed, leading to temporary loss of eligibility to bill the scheme.
Scheme billing done right protects current revenue and removes future audit-recovery risk — both are equally important.
Scheme-Specific Billing Discipline — Across Every Government Panel
We run separate scheme-specific workstreams for each government panel your hospital is empanelled with — CGHS, ECHS, DGEHS, ESIC, PSU panels (BHEL, ONGC, NTPC, IOCL, BSNL, Railways, Defence and others), PMJAY and state-level schemes (RGHS, MJPJAY, YSR Aarogyasri, Karunya, Mukhyamantri Amrutum and others).
Each scheme has its own rate card, package definitions, pre-authorisation process and documentation requirement embedded in our workflow. Eligibility is verified at admission — beneficiary card validity, dependency status, referral validity where required. Pre-authorisation is initiated under the scheme's defined process and tracked.
Bills are constructed against the current scheme rate card with package versus itemised decision per claim. Documentation is assembled to the scheme's specification before submission. Settlement is followed up through the scheme's defined process — and aged scheme AR gets focused recovery effort given the longer normal settlement cycle.
Empanelment renewals are tracked and managed proactively, so no scheme drops out of active status. Post-payment audit risk is mitigated by maintaining audit-ready documentation in scheme-prescribed format, available on demand for years after settlement.
Service Workflow
Scheme-by-scheme discipline, end to end.
- 1Beneficiary Eligibility Check
- 2Scheme-Specific Pre-Auth
- 3Documentation Assembly
- 4Rate Card Application
- 5Claim Submission
- 6Query & Audit Response
- 7Settlement Follow-up
- 8Renewal & Audit Defense
Key Features
Everything included as a single, managed engagement.
CGHS Billing
Central Government Health Scheme billing under current CGHS package and rate card.
ECHS Billing
Ex-Servicemen Contributory Health Scheme billing through ECHS station HQs.
DGEHS Billing
Delhi Government Employees Health Scheme billing per DGEHS protocols.
ESIC Billing
Employees' State Insurance Corporation billing under ESIC empanelment rules.
PSU Panel Billing
Public Sector Undertaking panels — BHEL, ONGC, NTPC, IOCL, BSNL, Railways, Defence, others.
PMJAY (Ayushman Bharat)
PMJAY claims under empanelled hospital scheme, including package codes and surveillance audit support.
Scheme-Specific Rate Cards
Rate cards maintained per scheme; package definitions and rate updates tracked.
Government Tender Compliance
Tender-bid hospitals supported with bid documentation and post-award scheme billing.
Empanelment Renewals
Renewal cycles tracked actively; documentation prepared, submitted and followed up.
Audit-Ready Records
Documentation maintained in scheme-prescribed format for years against post-payment audit.
Benefits
Measurable improvement across the metrics that move hospital finance.
Increase Collections
Recover what's owed faster and reduce the share of write-offs.
Reduce Denials
Catch documentation, coding and authorisation gaps before submission.
Reduce Claim Turnaround Time
Shorter cycle from discharge to insurer settlement.
Improve Cash Flow
Predictable, faster realisation of money already earned.
Recover Lost Revenue
Identify and reclaim missed billing, partial deductions and leakage.
Transparent Reporting
Real-time dashboards visible to finance leadership and management.
Dedicated RCM Team
A named team that knows your hospital, TPAs and patient mix.
Scalable Operations
Capacity flexes with claim volume — no in-house hiring overhead.
Industries Served
Healthcare organisations across India trust our RCM expertise.
- Corporate Hospitals
- Multi-Speciality Hospitals
- Single Specialty Hospitals
- Day Care Centres
- Cancer Hospitals
- Eye Hospitals
- Orthopaedic Hospitals
- IVF Centres
- Mother & Child Hospitals
- Dialysis Centres
- Diagnostic Centres
- Healthcare Chains
Performance Metrics
Numbers to be confirmed against the engagement and your hospital's baseline.
Why Choose Us
An enterprise-grade RCM partner, built around hospital realities.
Healthcare Domain Expertise
A team that has spent years inside hospital billing, TPA desks and insurance claim cycles — not a generic BPO retrained on healthcare.
Dedicated Billing & Recovery Team
A named account manager, a coding reviewer and an AR follow-up pod that knows your hospital, your TPA mix and your insurer relationships.
Technology Driven
Workflows orchestrated on a secure billing & recovery platform with audit trails, SLA timers, denial-pattern analytics and automated insurer follow-ups.
Data Security & Privacy
ISO-aligned controls, role-based access, encrypted transmission, secured storage and patient-data handling that maps to DPDP, HIPAA and HL7 best practices.
Transparent Reporting
Live dashboards covering claim status, AR ageing, denial trends, deductions and collection performance — visible to your finance leadership in real time.
Scalable Operations
Capacity scales with your monthly claim volume, peak surgical days and seasonal load — no recruitment burden on your finance team.
Compliance Focus
Coding aligned to ICD-10, CPT and HCPCS where applicable, plus discipline around CGHS, ECHS, ESIC, DGEHS, PSU and PMJAY scheme rules.
Continuous Process Improvement
Monthly root-cause reviews on denials, query patterns and leakage — feeding fixes back into your billing, documentation and EMR workflows.
Frequently Asked Questions
The questions hospital finance and operations leaders ask before they engage.
Government Scheme Billing — Done Right. Audit-Ready For The Long Run.
Scheme-specific expertise for CGHS, ECHS, DGEHS, ESIC, PSU, PMJAY and state schemes.
Or explore the full Hospital Billing & Recovery Services catalogue.
No inflated promises. Documented scope, agreed KPIs and reporting you can audit.
Healthcare regulators rightly distrust guaranteed-outcome marketing — and so do we. Before we start, we put deliverables, KPIs and review cadence in writing; every month, we report against them in accounts you own. That's the kind of accountability healthcare deserves.
Written Scope & KPIs
Deliverables, KPIs, timelines and review cadence signed before kickoff. No vague retainers, no hidden scope, no empty promises.
Transparent Reporting
Monthly reporting you can audit — spend, enquiries, bookings and content shipped, in your own accounts and dashboards.
Healthcare-Only Specialists
20+ years building digital presence for hospitals, clinics & specialist doctors. Every campaign is compliance-reviewed by design.
Your Data, Your IP
Full ownership of website, ads accounts, CRM, creatives and patient data — always. Zero lock-in, full transparency.
What healthcare teams say about working with us
Client statements about our CRM, systems and compliance-first process.
"ClinicBOOST brought every enquiry, follow-up and appointment into one CRM. Our front desk finally works from a single queue, and no patient enquiry slips through the cracks."
"The most healthcare-literate systems team we've worked with. Every creative is compliance-reviewed before it ships, and the CRM reporting shows exactly where every rupee went."
"From website to WhatsApp to CRM — one connected system. Scheduling, reminders and follow-ups run themselves now, and we stopped juggling five separate vendors."
Get a healthcare growth plan built for your speciality.
Share a few details about your hospital, clinic or practice. Our team will audit your current digital presence and send a tailored growth roadmap within 24 hours.
- Speciality-specific patient demand analysis
- Conversion gap audit across web, ads, CRM & WhatsApp
- Compliance-safe creative & campaign blueprint
100% confidential. No spam. Healthcare team replies within 24 hrs.