TPA cashless workflow —
built for the way Indian insurance actually works.
Manages your cashless workflow end-to-end: TPA master, pre-authorisation lifecycle, approval / partial-approval splits, billing reconciliation, and final-bill submission. Tightly integrated with billing, credit register, and patient outstanding.
HIS module
Insurance & TPA
AI inside
AI MediScribe
TPA-grade clinical notes
AI Discharge
NABH-grade, TPA-ready
AI Document Extraction
Insurance card capture
−40%
TPA query rate
The TPA / insurance desk is where Indian hospitals lose the most money — silently.
Pre-auth files sit unsubmitted because clinical data is missing
TPA approves ₹80K of a ₹1L estimate — and nobody updates the bill split
Patient told “insurance will cover” then asked to pay ₹20K at discharge
Final-bill submission delayed 7–15 days because discharge summary is incomplete
Claim rejection rate is 8–12% — almost entirely documentation gaps
AR over 60 days from TPAs accumulates to lakhs nobody is actively tracking
The TPA cycle isn't just a finance issue. It's a patient-experience issue, a compliance issue, and a working-capital issue.
Every workflow you'd expect.
Plus the AI parts you don't.
TPA / Insurer master — corporate, retail TPA, government schemes (Ayushman Bharat, ECHS, ESIC, state schemes)
Pre-authorisation workflow — initiate, submit, query, approve, partial-approve, reject
Approval split — TPA approved amount vs. patient share auto-applied to bill
Pre-auth → Credit Bill Register — TPA payable surfaces automatically
Final-bill submission — discharge summary, lab reports, OT notes, drug list — bundled
Query & rejection workflow — track every TPA back-and-forth
Reconciliation — payment received from TPA matched to claim
Insurance card capture at admission — policy details, validity, sub-limits
Cashless vs. reimbursement — workflows differ; both supported
Specialist agents,
not generic AI.
AI MediScribe
TPA-grade clinical notes
Clinical notes complete enough to satisfy TPA documentation requirements out of the box.
AI Discharge
NABH-grade, TPA-ready
Discharge summaries that pass TPA review the first time — reducing the query loop.
AI Document Extraction
Insurance card capture
Captures insurance card and policy details at admission with one photo.
The full checklist — nothing missing.
Not a silo. A connected workflow.
Before vs. after — measured in real hospitals.
Built for these hospitals in particular.
Hospitals with significant cashless TPA business (>20% of revenue)
Hospitals empanelled with corporate clients
Hospitals serving Ayushman Bharat / state-scheme patients
Specialty hospitals with high-value insurance procedures (cardiac, ortho, oncology)
Hospital chains needing centralised TPA visibility across units
Questions hospital teams actually ask.
More questions? Bring them to the demo — we'll walk through the workflow on a real hospital scenario.
Compress your TPA cycle. Stop financing your insurer's working capital.
Book a demo and see the pre-auth → approval → final-bill flow on a real cashless case.