Deduction analysis

Review deductions made by TPAs after settlement, justify them, and raise recovery tickets.

Total deducted
₹86,800
8 deduction lines
Justified
₹14,000
Closed — no recovery
Not justified
₹39,000
0 recovery tickets
Pending review
3
Awaiting auditor decision

Deductions by category

Distribution of deducted amount

Medical justification₹33,200
Billing issue₹12,600
Policy limitation₹28,500
Documentation issue₹12,500
Total deducted: ₹86,800
4.8% of submitted value · target < 2.5%

Deduction ledger

8 of 8 entries

Claim IDPatientClaimApprovedDeductionReasonCategoryTagAction
CLM-2444
DED-301
Vikram Joshi
Apollo Hospitals
₹89,400₹85,200- ₹4,200Non-payable consumables (gloves, syringes)Policy limitation
Justified
CLM-2442
DED-300
Ishaan Gupta
Fortis Memorial
₹67,200₹61,800- ₹5,400Tariff variance against PPN rateBilling issue
Not JustifiedRCV-1042
CLM-2449
DED-299
Meera Iyer
Manipal Hospital
₹2,45,000₹2,30,500- ₹14,500Room rent capping (1% sub-limit)Policy limitation
Pending Review
CLM-2451
DED-298
Ananya Rao
Apollo Hospitals
₹1,84,500₹1,72,000- ₹12,500Pharmacy bill mismatch with itemised billDocumentation issue
Pending Review
CLM-2440
DED-297
Aarav Bose
Manipal Hospital
₹1,54,300₹1,44,500- ₹9,800Pre-existing condition clause invokedPolicy limitation
Justified
CLM-2438
DED-296
Sanjay Kulkarni
Kokilaben Hospital
₹3,12,800₹2,86,400- ₹26,400Implant cost beyond approved rangeMedical justification
Not JustifiedRCV-1041
CLM-2436
DED-295
Lakshmi Pillai
Narayana Health
₹78,900₹72,100- ₹6,800Investigation not relevant to diagnosisMedical justification
Pending Review
CLM-2433
DED-294
Rohit Verma
Fortis Memorial
₹1,42,000₹1,34,800- ₹7,200Service tax / GST calculation errorBilling issue
Not JustifiedRCV-1040

Recovery tickets

Generated automatically when a deduction is marked Not Justified

No recovery tickets yet. Tag a deduction as Not Justified to raise one.