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Performance Management System – Apollo Hospitals Enterprise Limited

Appraisal Form – 2015 -2016

All Employees at Executive Grade & Above

Employee Name:- Business Unit:-

Employee Number:- Grade:-

Designation:- Asst. Manager Date of Joining:-

Department:- MRD Appraisal Period:-

Appraiser’s Name & Designation:- Reviewer’s Name & Designation:-

Section A: Performance
Outstanding – 5to 5.99 / Good – 4 to 4.99 / Satisfactory – 3 to 3.99 / Below Average – 2 to 2.99 / Poor – 1 to 1.99

S. KRA Weighta Assessment of Performance Rating Score Weighted

No (Description) ge (%) (Description) (B) Score =
(A) A x B/100
01 30  Wake up Call Audit
Completion of case  Open File Audit
 Close File Audit
sheet in all aspects

02 20 Assigned whatever Files

Mapping of ICD coding received ICD-10 coding and
entered in HIMS.
03 20 Verified Medical bills and
Prepare for Genunity
Issue of Genunity
certificate, take for
Certifies authorization and dispatched
by post for concern persons
and maintained data
04 15 Preparing Morality Data
monthly wise and Department
wise, Consultant Wise, age
Preparing Mortality Wise, Ward Wise
Find out the Death Patient
After Surgery Expired

05 15  Preparing ACE Data

based on the
Monthly Surgeries.
 Find out the
Preparing ACE Data Department wise

06 10 Filling the Insurance Form

based on the Discharge

Insurance Form Filling

Total 100% 33.01 5.59

Section B: Competencies

Competence Self Assessment by Appraisee Rating by Appraiser’s Rating by

Appraisee Comments Appraiser

1. Job knowledge  Medical Terminology 5.96

(Technical/Functional  Medical Records
knowledge, Conceptual Management
skills, Business / Industry  Medical Coding

2. Quality Consciousness  Follow up IP Pending 5.82

(specific action taken to Records Intimation
improve quality of weekly wise.
Service/Process/Activity  Preparing Quality
Indicators and improved
each process.

3. Leadership and Managerial  Co ordinate with ward 5.75

Skills Executive any related
(Taking on cross functional Medical Record Issues
responsibilities carrying the team and Pending IP files
along, crisis management, problem follow-up.
solving)  Assigned Department
work for Assistants.
4. Cost consciousness (Cost  Reduced Un wanted 5.58
control measures forms (like Xerox copy’s)
introduced, monitoring of without QF number didn’t
costs) use in Medical Records
and inform particular
ward nurse

5. Subordinate Development Encourage for their hard work and 5.98

(second line development Trained to develop for Technical
and delegation) Works.

6. Internal/External Customer ROI( Release of Information) 5.98

Orientation (Specific First check IPSG-I (patient
activities taken to solve Identification) and given to
customer problems, work information on timely basics
done in the customer within 72 hours.
delight) Co ordinate Prepare for Genunity
Section C: Personal Development Plan

Attributes Self Assessment by Appraise Appraiser’s Remarks

Hard work,
1. Strengths (Minimum 3) Love of Learning,
ICD coding
2. Areas of Improvement (Minimum 3) ACE Data
Data Analysis

3. Personal Development Plan(PDP) –

Please including training, seminars, on- PG Diploma in Legal Documentation
the-job training projects etc
4. Areas for job rotation/career growth Admisistration

Section: D
To be completed by the Appraiser

1. Overall comments and recommendation :

2. Overall performance rating: (Please tick) to be based on performance against KRAs only

Outstanding Good Satisfactory Below Average Poor

Appraiser’s Signature:- Appraiser’s Signature:-

Date:- Date:-

Section: E
To be completed by the Reviewer

Comment’s by Reviewer:

Reviewer’s Signature Date:-