New Claim

Admin settings

Roles, SLAs, integrations and workspace configuration.

Workspace

Round-robin to executives

Notify on breach risk

Required for all users

Roles & permissions

  • Claim Processing Executive
    Claims: edit · Documents: upload · Queries: respond
    24 users
  • Audit Team
    Audit: full · Claims: read · Reports: full
    6 users
  • Hospital Relationship Executive
    Hospitals: edit · Claims: read · Queries: raise
    12 users
  • Reconciliation Team
    Reconciliation: full · Reports: read
    5 users
  • Operations Manager
    All modules: read · Approvals: yes
    4 users
  • Admin
    Workspace: full
    2 users

SLA targets

StageTargetCurrent avg.Status
Pre-Auth review4 hours3.2 hrsOn target
Document verification24 hours21 hrsOn target
TPA submission48 hours52 hrsWatch
Query response72 hours68 hrsOn target
Settlement30 days28 daysOn target

Integrations

  • NHA / PMJAY portalConnected
  • CGHS gatewayConnected
  • ICICI Bank statementsConnected
  • WhatsApp Business APIPending
  • Tally accountingDisconnected