CLM-2446 — Claim case file

On trackPre AuthLast updated 2026-04-22 14:12

Lifecycle

13%

Patient information

Arjun Nair

PT-2446

Age / Gender

42 · Male

Contact

+91 98xxx 4421

Admission date

2026-04-21

Discharge date

—

Insurance information

Insurer

New India Assurance

TPA

CGHS

Claim type

Cashless

Workflow type

Referral

Policy number

CGHS-44210

Sum insured

₹5,00,000

Hospital details

Hospital

AIIMS Panel, New Delhi

Empanelment

Network · Tier-1

Treating doctor

Dr. R. Kulkarni

Department

Cardiology

Procedure

Angioplasty (PTCA)

Room category

Single AC

Claim financial details

Claim amount

₹1,42,000

Pre-auth approved

₹1,27,800

Approved amount

₹18,105(incl. ₹18,105 enh.)

Total deductions

₹24,900

Co-pay

₹0

Net payable

-₹6,795

Completion

44%

Verified

Pending

Missing

Rejected

1 required document pending

Claim cannot be compiled until all required documents are verified.

Required documents

Insurance Card*
Insurance_Card.pdf · 212 KB
Verified
Aadhaar Card*
Aadhaar_Front_Back.pdf · 320 KB
Verified
Pre Authorization Form*
Pre_Auth_Form.pdf · 98 KB
Verified
Final Approval Letter*
Final_Approval.pdf · 76 KB
Pending review
Discharge Summary*
Discharge_Summary.pdf · 412 KB
Verified
Final Detailed Bill*
Final_Itemised_Bill.pdf · 188 KB
Pending review
Patient Receipt*
No file uploaded
Missing
Radiology Reports
MRI_Report.pdf · 2.1 MB
Pending review
Implant Stickers
Implant_Sticker_Scan.jpg · 640 KB
Rejected

Preview · Insurance CardVerified

File

Insurance_Card.pdf

Uploaded

2026-04-12

OCR extraction

98%

High confidence — fields auto-mapped to claim.

Compile claim file

Merge all verified documents into a single PDF for TPA submission.