Module Deep-Dive
Insurance & TPA Management
Simplify the complexities of health insurance billing. Manage cashless claims, TPA contracts, and settlements with efficiency and transparency.
TPA & Corporate Contracts Management
Manage agreements with various Third-Party Administrators (TPAs) and corporate clients. Define specific rates, packages, and credit limits for each, ensuring accurate billing for cashless services.
Cashless Pre-authorization Workflow
Digitize the entire pre-authorization process. Generate and send pre-auth requests to TPAs directly from the system and track their status in real-time, reducing delays in treatment approval.
Automated Insurance Claim Generation
The system automatically compiles all necessary documents and bill details to generate accurate insurance claims based on the patient's treatment. This eliminates manual compilation errors and speeds up submission.
Claim Status Tracking & Follow-up
Track the status of every submitted claim—from 'Sent' to 'Approved' or 'Rejected'. The system helps you manage resubmissions and provides reports on your claim settlement ratio with different TPAs.
Streamlined Settlements & Reconciliation
Easily record payments received from TPAs and reconcile them against outstanding claims. Manage partial payments and rejections efficiently, ensuring a healthy revenue cycle for your corporate and insured patients.
Maximize Your Revenue Cycle
The Insurance module reduces claim rejection rates, speeds up payment cycles, and minimizes the administrative burden of dealing with TPAs, directly impacting your bottom line.