Connect & Heal - CNH Care
OPD Program
Overview Presentation
2025
Introducing CNH
One Stop Health Platform : Care + Health Plans + Benefit Administration
Family Care Solutions with emphasis on Preventive Care
Telemedicine Health Check / Diagnostics
Worksite Clinics Vaccinations
Mental Health - EAP Emergency Assistance
In-clinic appointments Gyms and Fitness
Dental & Vision Care Condition Care Programs
Pharmacy Pre/Post Natal Care
And many more….
Longitudinal Health Records for the Family
Introducing CNH
Acquisition of Proprietary Claims Adjudication Technology
i3systems is processing 5,000 IPD & OPD claims/day
● 8 years focussed on solutioning for Health and Life CNH i3 Systems
Insurance AI Claim Engine for Insurers
About CNH i3 - 5M claims processed Document
deficiency
FWA
Automated Financial & AI Led Financial &
TAT
Clinical Adjudication Medical Underwriting
Automated Document
Hospital Tariff
Classification &
Comparison, FWA Audits
Standardization of Data
Key Clients
Trusted by India’s leading Employers Serving 7m lives
Lives Served
7m
Years in
Industry
8 550
650+ Team
Clients Strength
95%
Client Retention
*
Configurability
CNH Benefit Management Engine: Ability to configure over 40,000+
combinations
Choose Benefits Conceptualise the Program
Self / Spouse / Children / Parents
Online Consultations
Vaccination Age / Gender / Grade etc.
Lab Tests Cashless / Reimbursement
Medicines Define Limits / Sub Limits
In-Clinic Consults Sponsored / Co pay / Self pay
Gamification Part of Insurance Policy
Cashless Network
Extending 50,000+ Cashless OPD Providers across 450+ cities
Our OPD Network has been building and tested since the last 8+ Years
APIs for Green Doctors - GPs & Consultation Vaccination Pharmacy & Lab Pin Dental
Integration Channels Specialists Network Network Codes
25,483 5,023 3,686 9,120 7,312
Preferred Pre Negotiated
Network Tariffs
Fitness Centres Ambulances # Virtual Doctors # Cities Vision
On Ground
Hyperlocal
Concierge
1,970 11,900 3,104 450 3,423
Access to the Best Healthcare Brands
#CNH is the largest ambulance aggregator in India
Cashless Network
Key aspects of our vendor selection process
Pre-Onboarding Checks Ongoing Checks
● Accreditation e.g. ISO, NABL, NABH etc ● Patient NPS and Feedback
● Path / Non Path / Specialist capabilities under one roof ● Overall Responsiveness
● Physical / Virtual validation - Ambience, cleanliness, ● TAT monitoring e.g. reports and appointments
hygiene and customer service
● Re-refresher Audits
● Assessment of waiting times
● Adherence to SOPs and SLAs
● Referral checks (for unknown laboratories in remote areas)
● Orientation of partner prior to service commencement Ratings
● Online rating reference check ● Lab Specific feedback
● Acceptability towards 3rd Party Appointments ● NPS
● On call feedback
Clinical Ownership
Clinical Ownership to improve quality of experience
CNH Owned Network
● 235+ own phlebo across 8 cities, with 18 hrs/day Virtual Doctors
coverage
OPD Clinics
● 210+ Concierge with 24x7 coverage reports with 24hrs
(happens in home collection wherever possible) Diagnostic Centres
● Doctor in 90 secs, 24x7 coverage, 12+ language Pharmacies Hubs
● Avg experience of 12 years among Telemedicine Ambulances
specialist across 30+ specialities
Hospitals
● In house clinical governance team
Phlebotomist
● 24x7 contact center support with 8+ language
On Ground Concierge Team
● Contact less experience
Virtual Concierge Team
● 92% CSAT and 57 NPS recorded last year
Hospitalization Assistance Team
Processing Laboratories
Network Strategy
Network Onboarding Strategy
Network Strategy
Reverse Engineering the network experience key to increase cashless
conversion
● Auto prompts as and when reimbursement
providers converted to cashless
● Ongoing Reimbursement to Cashless
conversion across providers
● Request to add OPD Partner in-app for CNH to
empanel
● Ability to add self appointments within app –
To enable Scan + Pay where pre-negotiated
discounts can be applied
● Incentivizing higher preventive wallets
● Add a Clinic TAT:
○ 72 - 96 Hours - Hyperlocal Clinic
○ 10 Days - Larger Chain
Suggest Doctors / Clinics Add Your Own Scan and Pay activation
to Onboard Cashless Appointment for specific centers
Service Commitment
Experience is paramount : TATs and SLAs
Teleconsultation 90 seconds Instant Bookings volume 35%, 69% 2 hour slot
Digitization : 30 mins
60% own phelbo collections - 98% on time
Prescribed Diagnostics Confirmation : 3 Hours
pickup
Reports : 24 - 36 Hours
Confirmation : 91% within 12 hours
Confirmation : 12 Hours
Annual Health Check-up Reports : 84% Home collection within 12, 88%
Reports : 24 - 36 Hours
in lab within 36 hours
Delivery Tier 1 : 6 Hours
Prescribed Pharmacy 70% delivery TATs 3 hours
Delivery Tier 2 & 3 : 8 Hours
OPD In-Clinic Confirmations : 4 hours, same day PM slots 87% within TAT confirmation
Vaccination Confirmations : 24 Hours Choice of vaccine and brand
Reimbursement Adjudication - Same Day Q4 adherence 99% same day
Benefit Activation Same Day 97% within TAT
Benefit Deactivation Same Day 100% within TAT
Claims Processing
CNH Claims Processing Platform with <24 hour adjudication TAT and
processing 120,000 claims monthly
● Increased Efficiency
○ Auto Adjudication <24 Hours TAT
○ AI enabled fraud checks ~40% savings for payors
○ Auto prompts to increase cashless adoption
● Optimised Experience and Tracking
○ Paperless claim submission
○ Track your claims in Real Time
○ HR / Payor claim dashboard to monitor TAT
● Deriving Health Insights
○ Ability to map claims against ICD codes
○ Health data digitization basis reimbursement
documents
● 100% Flexibility
○ Ability to configure capings / sub-limits as per
policy requirements
Customer Support
Knowledge Base and Customer Support
Customer support for end-user
● Using ticketing tool for tracking - Zendesk
● NPS feedback post each transaction First response time in mins 60 mins email, 5 mins chat, 20
seconds call pick up time
● Enhancing the knowledge base based on case history
● Multi support channels
Missed call for call-back : 60 mins
○ Customised FAQ
○ VIdeo Bytes Working days and timings : Calls & chats 24x7 , email 9am - 9pm
○ Dedicated Support
○ Smart Chatbots No of language supported by CS : English, Hindi, Kannada, Telugu,
Tamil, Oriya, Bengali, Urdu, Malayalam (9 languages)
● Customised collateral support
Level 1 Level 2
Level 3 Level 4
Dedicated Key account
OPD KAM Head Co-Founder
Helpline manager
Service Commitment
Our Service Delivery Commitment
Data Analytics
Live OPD view dashboard - Track SLAs, Utilization, Health Risk
Risk stratification by :
● Age group
● Dependent
● Department
● Location
● Time period
● Follow up
● Engagement efficiency
● Benchmarking
Info Security
Information Security & Compliances
Compliance Certifications Vulnerability Assessments
● ISO 27001:2013 (ISMS) for Information ● Network and Cloud Security
Security Management Assessment
● ISO 27701:2019 (PIMS) aligns with GDPR ● Static Application Security
for Privacy Management Testing (SAST)
● SOC 2 Type 2 certifies controls over
security, availability, and privacy
Information Security
Data Security Backup and Recovery
& Compliances
● Encryption for data at rest and in ● Automated backups with
transit encrypted storage
● Time-based Role-Based Access ● Rapid Disaster Recovery (DR)
Control (RBAC) plan for emergencies
Engagement
Engagement Calendar for WHO Theme and Health Risk Based Wellness
● Virtual Thematic Clinic
● Monthly Engagement Session
● Gamification
○ Team Challenges
○ Self Challenges
● Virtual CNH Sessions on App
● Monthly Play Platform Launches
● Key Event Support
Engagement curated to WHO Calendar and Organization
Health Risk | Incentivised with CNH Coins
Key USPs
Summarizing our Key USP’s
In House Clinical Establishment Ability to Service at Scale Tech & Servicing Capabilities
● Medical Governance Board ● 7m lives under coverage Technology Strengths
● Controlling patient touchpoints ● 650+ Organizations Served
● Flexibility - Supporting 40,000 Wallet
Permutations
● AI Claims Engine - Financial and
812 235 450 50K Clinical Adjudication
● Real time HR Dashboards
● Gamification and Engagement
Doctors Phlebotomists Cities Cashless Providers ● Best in class infosec - SOC ii Type 2
● Integrated Journeys
Breadth of Services - One Stop
6 210 75K 120K
● Onsite care (OHCs)
NABL On Ground OPD Monthly Claims ● Virtual Care (Telemedicine + EAP)
Laboratories Concierges Transactions Processed ● OPD Benefits
Monthly (IPD+OPD) ● Health Screenings
● 95% CSAT across Services ● Home Care, Fitness, & Condition
Programs
● Largest Emergency Platform for
Ambulances
Connect & Heal - CNH Care
Thank You
