COPORATE FEEDBACK FORM
Thank you for your continuous cooperation to improve our TPA services. It is our constant endeavor to upgrade our services levels so that our customers get the best. We highly appreciate receiving your feedback and rank us our overall performance out on the terms given below.
Card Detais :
Vipul Card No :
Identify Card and Guide Book :
I/We have received the ID card through SMS / E-mail alert :
Yes
No
I/We have received the SMS/E-mail alert within 7 days of claim submission :
Yes
No
Hospitalization :
I have used the cashless access facility or hospitalization
Yes
No
The Authorization Process took :
0-3 hrs
3-6 hrs
6-12 hrs
12 hrs
Did you find the process of getting a pre - authorization for cashless :
Simple
Difficult
Unclear
Was your pre authorization request approved/rejected/amount partially declined? If rejected /amount partially declined. Then
Did you seek any clarification about the rejection?
Yes
No
Who did you seek clarification from
VMC Customer care
Hospital
Did you understand why the rejection was made?
Yes
No
Any suggestions for improvement, please specify
Claims Reimbursement : (If Not used cashless facility, please answer the following )
The cheque for reimbursement claim was received within
< 15 Days
15 to 30 Days
> 30 Days
Was the inadequacy in documents informed to you at the helpdesk?
Yes
No
Was your claim rejected?
Yes
No
Claims Reimbursement : (If Rejected )
Did you get the rejection letter on time?
Yes
No
Did you seek any clarification about the rejection?
Yes>
No>
Did you understand why the rejection was made?
Yes
No
Any suggestions for improvement, please specify
Call centre & Customer care
Did you contact VMC regarding any queries through Phone / E-mail?
Yes
No
Were your query answered/reverted back within 48 hours?
Yes
No
Was solution/resolution provided to your queries within 72 hours?
Yes
No
Accessibility to our telephone line
Easy
Difficult
Could not reach
Was your query answered satisfactory?
Yes
No
If No, In which aspect were you dissatisfied?
Language issues
Query was not understood by the executive
The response was unclear
Long response time
Any other, please specify
Help Desk at Corporate
VMC Representative Visits
Daily
Weekly
Monthly
I/We received feedback/explanation for the claim rejected at the helpdesk?
Yes
No
Were you satisfied with your interaction?
Yes
No
If No, In which aspect were you dissatisfied?
Language issues
Query was not understood by the executive
The response was unclear
Long response time
Any other, please specify
Hospital Outlook :
In which hospital was the policy holder / patient hospitalized
Overall experience with the hospital
Good
Average
Poor