Practo Surgery Concierge · a Practo Assured initiative

A surgery is a medical event for the patient. For the family, it is a full-time job.

Decide
Find the right surgeon
Get a second opinion
Compare hospital costs
Prepare
Verify policy coverage
File pre-authorisation
Follow up with the TPA
Arrange the admission deposit
Chase pre-op test reports
Coordinate pre-OT prep
In hospital
Complete admission paperwork
Book attendant accommodation
Manage visitors and relatives
Exit
Sit through discharge billing
Collect the claim documents
Arrange transport home
Recover
Hire post-op nursing
Track the reimbursement
Book the follow-up review

"I spent my father's surgery day standing in a billing queue, not next to him."

Eighteen tasks in the ten days around a planned surgery. One in twelve insurance claims is rejected or stalled.1 / 6
2 · What we can do

One named Care Manager, from choosing the surgeon to post-operative care.

DECIDEPREPAREIN HOSPITALEXITRECOVER 1 · Consult andsecond opinion 2 · Cost andhospital choice 3 · Insuranceand finance 4 · Pre-oplogistics 5 · Admissionday 6 · Surgeryday 7 · Discharge 8 · Recovery andfollow-up AFTER THE PATIENT IS HOME Family today 18 tasks Care Manager one named person, start to finish Insurance desk pre-auth to claim In the hospital Plan 2 only ATRP, AI agent offer and updates 2 tasks 1 task 4 tasks 2 tasks 2 tasks 1 task 3 tasks 3 tasks until the claim is paid surgeon match,second opinion written estimate,date locked pre-auth filedwithin 4 hours tests, reports,fitness clearance paperwork, room,deposit update within30 min of OT exit bill auditedbefore signing day-7 andday-30 calls claim paid in 30 days policy check,pre-auth filed TPA chased daily claim documentsthe same day reimbursementclosed queues and formspresent on the dayline-item auditat the desk offer made withthe estimate routine updates and document collection
The Care Manager runs through all eight stages and, with the insurance desk, keeps going after the patient is home until the claim is paid. That closed loop is the thing no hospital desk or facilitator offers.
One named person on WhatsApp · a written estimate and service levels before admission · the case stays open until the claim is settled2 / 6
3 · What our human actually does

The same five legs, and the work our Care Manager takes off the family at each one.

Decide

They do not know which surgeon, whether surgery is even needed, or what it should cost.

  • Reads the reports and matches a surgeon in the Assured network by procedure and volume
  • Books the free second opinion and sends the written view
  • Puts two or three hospitals side by side with an all-in written estimate
  • Calls and walks the family through the options in plain language
Remote agent
plus a doctor, ₹800
Prepare

Insurance jargon, a stack of forms, and a TPA that does not call back.

  • Reads the policy and flags exclusions, room-rent caps and co-pay before admission
  • Files the pre-authorisation within four hours of the documents being complete
  • Chases the TPA every day, by name, until a decision is on record
  • Books the pre-op tests, collects reports, gets fitness clearance
  • Tells the family the exact deposit and what to carry
Remote agent
In hospital

Queues and counters on the one day nobody should spend away from the patient.

  • Meets the family at the entrance and completes admission paperwork and the deposit
  • Arranges the attendant bed, meals and transport
  • Stands in the queues so the family can go to the room
  • Tracks theatre status and messages the family within 30 minutes of the patient coming out
Field agent on site
Plan 2 only
Exit

A bill they cannot read, under pressure, at the moment they most want to leave.

  • Audits the final bill line by line against the estimate and the approved pre-authorisation
  • Disputes non-payables and room-rent gaps with the billing desk before the family signs
  • Photographs and files every claim document the same day
  • Arranges transport home
Field agent on site
Plan 2 only
Recover

Recovery at home, and a claim that goes quiet for weeks.

  • Books nursing or physiotherapy where it is needed
  • Files the reimbursement and chases it through to settlement
  • Calls on day 7 and day 30 to check recovery and answer questions
  • Books the follow-up review with the surgeon
  • Keeps the case open until the money is in the family's account
Remote agent
Every line here is a real unit of work, and it is what the cost per case on the next slides is built from3 / 6
4 · What we can charge

Two plans. The difference is whether we are physically in the hospital.

Plan 1 · remote
₹4,999 per surgery

4.3% of an average ₹1.15 lakh surgery. Everything handled from a desk.

  • Named Care Manager on WhatsApp
  • Free second opinion
  • Policy check, pre-authorisation filed and chased with the TPA
  • Paperwork guided remotely
  • Bill checked from photographs
  • Claim followed until it is settled
  • Day-7 and day-30 calls
Plan 2 · we are there
₹14,999 per surgery

13% of the surgery, about what Practo already earns on it. A person in the building.

  • Everything in Plan 1, plus
  • A Practo executive in the hospital on admission and surgery day
  • Line-item bill audit at the discharge desk before the family signs
  • Pre-op tests coordinated
  • Attendant stay, meals and transport arranged
  • Post-op nursing or physio arranged
One thing to settle before we sell. Attendant stay, meals, transport and nursing are arranged by us but billed to the family by the provider. If those costs sit inside the ₹14,999, Plan 2 loses money. It has to say so on the price card.
Prices are directional and for finance to set. React to the structure. The international plan is parked until domestic works.4 / 6
5 · What it costs to deliver

A remote agent costs ₹107 a touch. A hospital visit costs ₹700. A second opinion costs ₹800.

Cost per casePlan 1 · ₹4,999Plan 2 · ₹14,999
Remote agent
18 and 22 touches at ₹107		₹1,920₹2,347
Hospital visits
3 visits at ₹700		—₹2,100
Doctor, second opinion
one OPD at ₹800		₹800₹800
Telephony, gateway, indemnity, travel₹350₹1,500
Fee waivers and refunds, 5%₹250₹750
Cost to deliver₹3,320₹7,497
Contribution₹1,679₹7,502
Margin34%50%
People are most of it

A remote agent handles 15 cases a day at ₹40,000 a month. A field agent handles 2 a day at ₹35,000. That is 21 Plan 1 or 17 Plan 2 cases per remote agent a month.

The doctor is the swing on Plan 1

At ₹800 on every case the second opinion is 16% of Plan 1's price. If only half of families use it, Plan 1 goes from 34% to 42%.

Plan 2 carries itself

The hospital visit is the expensive part and the reason families would pay three times more. Plan 2 clears 50% where Plan 1 clears 34%.

Before marketing, supervision, technology and tax. Touches per case is the number nobody has measured yet, and it moves everything.5 / 6
6 · Size of the prize

One lakh visitors, converting at five percent, is five thousand paid cases.

1,00,000
people in the surgery journey
5%
take a concierge plan
5,000
paid cases
₹1.3–2.3 cr
contribution, on a realistic plan mix
If the 5,000 cases split like thisRevenueCost to deliverContributionMarginPer case
All Plan 1₹2.50 cr₹1.66 cr₹0.84 cr34%₹1,679
86% Plan 1, 14% Plan 2₹3.20 cr₹1.95 cr₹1.25 cr39%₹2,494
70 / 30₹4.00 cr₹2.29 cr₹1.71 cr43%₹3,426
50 / 50₹5.00 cr₹2.70 cr₹2.30 cr46%₹4,591
All Plan 2₹7.50 cr₹3.75 cr₹3.75 cr50%₹7,502
What it takes to serve. 5,000 cases over a year is about 420 a month, needing 24 people at an 86/14 mix and 35 at 50/50. The plan mix decides both the prize and the payroll.
Read it against the core. Practo already earns about ₹15,000 on each of these surgeries, so 5,000 cases carry ₹7.5 crore of existing take. Concierge adds 17% to 31% on top of that.
Traffic and conversion are the modelling assumption, to be replaced with actual funnel data. Costs exclude marketing, supervision, technology and tax.6 / 6
← → to move · P to print
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