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Letter of Authority - Coggle Diagram
Letter of Authority
Policy Details
Reference No.
*UHID
Emp Name
Policy No.
Relationship
Number of follow up
Patient Name
Emp ID
Policy issue Date
Insurance No.
Relation Code
Age/Gender
Isurance Company
Policy Expiry Date
Basic Pay
Insured Amount
*Grade
*Bed Type
*Limit Type
*Limit Value
Further Level
Tariff Grades
LA
AR
Limit
Patient Type
Outpatient
Inpatient
Valid From
Valid To
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Outputs
Limit Type
Limit Value
Type Name
Approval Required
Further Level
*Letter No.
*Payer
Lt.Date
Approval Type
Authorized By
*specialization
*Doctor
Configuration
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