METRO ZONE GROUP: Bringing Dynamism into Mediclaim Processing Sector

Rajnish Jaiswal,MD & CEOCashless mediclaim process requires a number of specialized processes, tracked by stringent timelines. In today’s’scenario; several cashless preauthorisation suffer from high level of rejections whereas various approved cases faces high amount of delay in payment disbursements as they are mainly handled by Non experts.

In case of denial by Insurance Company, it becomes difficult for the policy holder to meet such costs on their own without burning a hole in their savings. It is seen in many cases that with escalated medical cost and due to rejections of Insurance claims, many even compromise on quality healthcare. This undoubtedly creates dissatisfaction to the patients and at the same time builds a bad image for hospital and the Insurance Company as well.

Indore based Metro Zone Health Services (India) Pvt. Ltd. observing this has come forward in 2012 with a team of experienced professionals (Doctors and Mediclaim Domain Experts)and created a smooth cashless process for hospitals which is not only helping the Insured patients
for initiating cashless treatments but also helping hospitals in generating their revenues.

Team METRO ZONE by the end of financial year 2017-18 aims to embrace expansion of their business into the states of Jharkhand, Assam, Tamilnadu, Andhra Pradesh,Telangana and Gujarat

A strategic partner to clients in the entire value chain - from situation assessment & audit, process mapping and solutions to ensuring compliance of the same, METRO ZONE began their work initially with the written off cases. The company took up these cases properly with Insurance companies with all mitigants and in two months, Payment for all these cases were disbursed. “During our interaction with Insurance Company, we understood that all those cases which were marked as rejected were because of the lack of proper subject expert. We decided to outsource the mediclaim desk of these hospitals and deputed our employees over there. This has really worked and today we have more than 1000 hospitals,” explicates Rajnish Jaiswal, MD & CEO,METRO ZONE GROUP.

At start, it was difficult for the company to convince the hospitals on the deliverable and the positive payment timelines as most of them were skeptical. Over
the years they gained momentum and created a smooth cashless process which improved hospital revenue exponentially and resulted high percentage of new clients through referrals and turned themselves into a profitable organization.

Complete Healthcare Management Work

The journey which began with five people in September 2012; has added 1000 plus team members today with presence in Uttar Pradesh, Madhya Pradesh, Maharashtra , Haryana , Bihar , West Bengal. The company also owns Premium Health Card. “Our cards are proudly accepted at leading hospitals like Medanta, Max, Apollo, Fortis and Thyrocare, Dr. Lal’s Diagnostic Centres across India. We have approx 20000 active healthcard users in different cities in India.” Rajnish mentions enthusiastically.

METRO ZONE GROUP under its CSR activity are sponsoring several Health & Education Schemes for Unprivileged persons of Kargil & Laddakh in association with Indian Army, Swablamban Health Insurance for Thousands of Special Abled people and other social schemes of ISKCON , ROTARY CLUBS ”.

The Company envisages entering into the business of IT, Super Speciality Medicine, and Medical Devices in Joint Ventures. “We are going to introduce a highly advanced Hospital Management IT system for hospitals with complete paperless work. It will minimize their expenses and maximize the profit ratio exponentially.” Rajnish concludes.