Every Claim Takes Too Long to Settle
A claim that should settle in minutes sits in queues for days — eligibility, code validation, and policy checks all done manually.
Award-Winning Claims Processing AI
What Is Actually Breaking Your Claims Operation
Accepted as normal, these problems compound daily.
Fraud Is Outpacing Your Detection Tools
Beyond duplicate claims and upcoding, billing rings, AI-generated documents, and synthetic identities slip past rule-based systems.
Denial Rates Are Too High for the Wrong Reasons
Preventable denials — wrong codes, missing documents, eligibility errors — drive rework, appeals, and provider frustration.
Your Team Is Doing Work a Machine Should Do
Skilled analysts key data, cross-check policies, and route simple claims that need no human judgment — an expensive use of experts.
No Real-Time View of Fraud Risk
By the time fraud surfaces in a post-payment audit, the money is gone — recovered only in fractions, cycle after cycle.
How the Platform Works — Stage by Stage
From intake to settlement, AI cuts manual work and catches fraud.
What You See in the Claims Dashboard
A live view of the full claims operation your team can act on.
Live Claims Pipeline
Every claim, every stage, in real time.
Fraud Risk Heatmap
Where fraud risk concentrates, flagged before payment.
Financial Leakage Report
Savings, denials, and recovery trended for leadership.
What Teams Are Experiencing After Going Live
Each result traces to a specific operational problem we fixed.
Book a Live Demo85%
Claims settled within 24 hours — up from 40%. Settlement time dropped from 22 days to under 6. Provider satisfaction up 30 points in one quarter. — Regional Health Insurer, Hyderabad
₹4 Cr
Fraud losses prevented in 6 months. Pre-payment scoring caught suspicious claims before a single rupee went out. — Chief Risk Officer, TPA, Delhi
4%
Denial rate after 3 months — down from 14%. Coding validation caught preventable rejections before submission. — Revenue Cycle Head, 450-bed Hospital, Kochi
75%
Reduction in resolution time. From 30-day cycles to under 8 days — straight-through processing handles routine claims without human review.
Zero
Prior auth backlog after automation. Routine decisions in minutes. Clinical escalations assembled with full context — no digging required.
10×
Increase in analyst productivity. Staff moved from routine data entry to complex cases that actually need human judgment.
Who This Platform Serves
Built for insurers, TPAs, government schemes, hospital billing teams, and self-insured employers.
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Health Insurance Companies
Health Insurance Companies
AI adjudication and fraud detection improve your loss ratio.
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Third Party Administrators
Third Party Administrators
Speed, accuracy, and fraud prevention at client SLAs.
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Government Health Schemes
Government Health Schemes
NHCX, ABHA, and ICD-10 coding handled at national scale.
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Hospital Billing & Revenue Cycle Teams
Hospital Billing & Revenue Cycle Teams
Higher clean claim rates, fewer denials, automated appeals.
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Corporate Self-Insured Employers
Corporate Self-Insured Employers
Insurer-grade fraud protection without the IT budget.
Built to the Standards That Health Insurance Actually Runs On
Every standard is scoped during implementation and built into the platform, covering privacy, transaction, coding, and security frameworks for claims processing.
Data Privacy
Healthcare Data Privacy
Data privacy and security across every data store and access control.
Indian Health Insurance
NHCX & Ayushman Bharat
NHCX standards and government scheme integrations for India.
Coding Standards
Clinical Coding & Classification
Coding standards validated at intake, review, and pre-adjudication.
Transaction Layer
EDI Transaction Standards
How eligibility, claims, remittance, and authorization data move.
Security
Security & Audit
Security certifications and audit trails for PHI and claims data.
Cashless & Reimbursement
Both Claim Types Supported
Cashless and reimbursement workflows, SLAs, and document needs.
Claims Should Take Minutes, Not Weeks. Fraud Should Be Caught Before Payment, Not After.
Manual review, rule-based fraud tools, and 20-day settlement cycles cost you every day — in overhead, fraud losses, and provider frustration. Our Claims Processing AI is the upgrade that pays for itself.
Book a Claims Demo
Award-Winning AI Development & Consulting
100 Fastest Growth Companies
Global Spring Winner
Top App Development Company
AWS Partner Network
Google Cloud Partner
Highly Rated on Trustpilot
Verified Agency
Top App Development Company
ASSOCHAM Member
Frequently Asked Questions
[ 1 ]
How does the AI know what is fraudulent versus what is just unusual?
It scores specific fraud risk signals and explains every flag.
[ 2 ]
What coding standards and systems does the platform support?
ICD-10, CPT, SNOMED, LOINC, NHCX, ABHA, and Ayushman Bharat.
[ 3 ]
Can hospitals use this on the provider side for claim submission?
Yes — the provider module validates claims before submission.
[ 4 ]
How long does implementation take?
Most insurers and TPAs go live within 6–10 weeks.
[ 5 ]
What happens to the claims that the AI cannot adjudicate automatically?
They route to your team with a full case summary.
[ 6 ]
Is the system auditable for regulatory compliance?
Yes — every decision is logged, IRDAI-ready, and auditable.
Global presence
