Automated Healthcare Billing, Cashless TPA Claims, and Revenue Management
Our Billing & Insurance Claims module eliminates revenue leakage and accelerates financial reconciliation across outpatient, inpatient, and emergency services. Pre-configured tariff masters handle tiered room charges, surgery packages, nursing fees, and doctor consultation shares.
Manage cashless mediclaim for private TPAs and government schemes including Ayushman Bharat (PM-JAY). The system tracks pre-authorizations, query responses, interim bills, and final discharge settlements with complete document attachments.
- Cashless TPA & Insurance Claim Tracking
- Ayushman Bharat (PM-JAY) & Govt Scheme Billing
- Consolidated OPD, IPD, Pharmacy & Lab Invoicing
- Cashier Shift Handover & Reconciliation
- Doctor Incentive & Referral Sharing Engine
- Multi-Level Discount Authorization Rules
- Full GST Compliance & Audit Trail Logging
Key Advantages & Capabilities of Advanced Billing & Revenue Control
Daily cashier shift handover tallies, automatic discount approval authorization, and audit logs prevent unauthorized billing edits, ensuring strict accounting transparency and speeding up insurance reimbursement cycles by 40%.
Accelerated Insurance Settlements
Track pre-auths, claim submissions, queries, and final settlements to cut reimbursement cycles by 40%.
Zero Revenue Leakage
Every consumable, diagnostic test, and clinical procedure is auto-billed to patient folios, preventing unbilled charges.
Fraud-Proof Cashier Controls
Shift collection handovers with blind reconciliation prevent cashier discrepancies and safeguard daily cash flows.
Frequently asked questions
Yes, you can configure distinct rate charts and package tariffs for cash patients, private corporate accounts, and individual TPA insurers.
Discounts require role-based OTP or manager approval permissions, and all modifications are logged in a permanent audit trail.
Yes, advance deposits, interim installment receipts, and refund vouchers are tracked with automated ledger adjustments.
Yes, itemized bills with standardized billing codes, pharmacy breakup, and procedure notes are formatted to meet all insurance claim requirements.
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