Add New Claim

Claim type

Cashless

Hospital settles directly with the insurer / TPA via pre-auth.

Reimbursement

Patient pays upfront and claims back after discharge.

Patient information

Patient name*

Gender*

Age*

Phone number*

Patient ID / UHID

IP number*

Patient photo

Optional · JPG or PNG, max 2 MB

Hospital details

Hospital name*

Hospital location

Treating doctor

Insurance / panel information

Select a hospital first — only panels mapped to that hospital will be available.

Panel name*

Panel type

Auto-filled

Insurance company

Policy number*

Insurance card number

Admission details

Admission date*

Discharge date

Treatment type*

Diagnosis*

Claim details

Estimated claim amount (₹)*

Final bill amount (₹)

Workflow type

Auto-populated from panel

Assignment

Assigned executive

Claim priority

Documents (optional at creation)

Insurance cardPDF, JPG up to 5 MBAadhaarPDF, JPG up to 5 MBPre-Auth formPDF, JPG up to 5 MB

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