Insurance desk overview
Claims-readiness dashboard
AI-assisted review of clinical and billing documentation before cashless pre-authorisation, final discharge authorisation, TPA query response, and claim submission.
128
Cases reviewed
+18 this week
74%
Ready for TPA submission
after AI review
31
Documentation gaps found
across active cases
42
TPA queries avoided
vs. prior 30 days
₹18.6L
Revenue at Risk Identified
Potential deductions flagged before submission
38%
Discharge clearance faster
average time saved
Recent cases
Latest cases routed to insurance desk and back-office team
| Patient | Specialty | Case type | Stage | Readiness | Risk |
|---|---|---|---|---|---|
| Patient R.S. | Orthopaedics | Cashless pre-auth | Pre-auth pending | 62/100 | High |
| Patient A.K. | Cardiology | Cashless insurance | Discharge pending | 68/100 | Medium-high |
| Patient M.J. | Oncology | Cashless pre-auth | TPA query | 71/100 | Medium |
| Patient S.V. | General Surgery | Final claim | Resubmission | 84/100 | Low |
| Patient N.D. | ICU | Cashless insurance | Discharge pending | 59/100 | High |
Cases by specialty
Active back-office review queue
Cardiology34
Orthopaedics28
Oncology22
General Surgery18
ICU14
Others12
Top claim-risk categories
Most common documentation gaps detected
- 1Implant/device details18 cases
- 2Medical necessity14 cases
- 3Investigation evidence11 cases
- 4Final bill mismatch9 cases
- 5Length of stay justification7 cases
Cases awaiting back-office action
Next step required before TPA submission
- Patient R.S.Reconcile implant quotation with surgery estimate
- Patient A.K.Verify ICU stay justification in discharge summary
- Patient M.J.Attach histopathology report to TPA response
- Patient N.D.Confirm room category and consumables for cashless packet