ClaimsLens insurance module

Insurance claims as a governed financial system.

Turn hospital insurance claims from a margin-eroding scramble into a predictable, documented, trackable process — on the HMIS you already run, built on India's NHCX rails.

NHCX-ready · works on any HMIS · hospital-aligned

Insurance workflows shouldn't erode your margins. They should strengthen your governance and your cashflow.

The platform

Three pillars of governed insurance.

Clean claims, fewer denials

Revenue predictability across the claim lifecycle.

Eligibility & coverage capture
Pre-authorisation workflow support
Structured claim assembly from captured records
Documentation-completeness checks before submission
NHCX-ready submission
Settlement & TAT visibility
Reconciliation and UTR/UTC matching
Follow-up until payment lands

OUTCOME →Fewer documentation-driven denials. Faster settlement. Less leakage. More predictable cashflow.

Works on the system you already run

Synchronise clinical and financial workflows with zero disruption.

Bolts onto any HMIS (API / DB / HL7 / document-capture)
Includes legacy & no-HMIS sites via document capture
Zero duplicate data entry
ABDM & NHCX compliance built in
Discharge-to-claim assembly from captured records
Intelligent documentation validation

OUTCOME →No rip-and-replace, no added workflow - and reach into hospitals the big platforms can't serve.

Insurance as a board-level view

Turn insurance data into executive insight.

CXO dashboards (claims funnel, ageing)
Denial-pattern analysis
Revenue-at-risk alerts
Department- and doctor-level performance
Collections / recovery tracking

OUTCOME →Insurance becomes a governed, visible financial system - not an operational afterthought.

The engine

ClaimsLens Core

One console for your insurance desk. NHCX connectivity. Structured claims from any HMIS. It turns manual coordination into documented, trackable predictability.

Any HMIS

API, database, HL7, or document capture - including closed legacy systems

NHCX-native

Multi-payer reach via the national claims exchange - not direct integrations

Get-paid follow-through

We chase UTC, eFile chain, and reconciliation until payment lands

The claims lifecycle

Discharge to settlement - every step documented and tracked.

From eligibility capture through to reconciliation, ClaimsLens follows each claim through its full lifecycle.

Step 1

Eligibility & coverage

Patient coverage captured at admission

Step 2

Pre-authorisation

Prepared and tracked through approval

Step 3

Treatment & documentation

Records captured across the stay

Step 4

Claim assembly

Bill + discharge summary + diagnostics structured

Step 5

Completeness check

Documentation validated before submission

Step 6

NHCX submission

Sent on the national claims exchange

Step 7

Settlement & TAT visibility

Status tracked in real time

Step 8

Reconciliation

UTR/UTC matching + follow-up until paid

The ClaimsLens Difference

Built for everyone else.

The national platforms serve large hospitals with modern systems and deep payer integrations. ClaimsLens is built for everyone else - any HMIS, even closed legacy ones; local, hospital-aligned support; and we chase the money through to your account instead of stopping at “submitted.”

Their segment

Large hospitals with modern HMIS

Our segment

Any hospital, any HMIS maturity

Our edge

We follow the money to your account

See your hospital's number in 20 minutes.

A 20-minute demo shows your volumes, your integration path, your readiness gaps, and where your claims are leaking.

The ABDM mandate is the reason to move now.