TPA / Insurance Claims
Insurance & TPA Processing
Insurance claim lifecycle: pre-authorization, claim submission, tracking, settlement, rejection handling, and TPA-wise analytics. Supports PMJAY/CGHS/ECHS government schemes.
Screenshot slot — drop the live ERP capture for "Insurance & TPA Processing" in /public/shots/tpa-insurance-claims-insurance-tpa.png
Key fields
- Insurance company & TPA master
- Policy mapping to patient at registration
- Pre-authorization request & approval tracking
- Claim form generation (standard + TPA-specific)
Workflow
- 01Map Policy at Registration
- 02Submit Pre-Auth
- 03Track Pre-Auth Status
- 04Discharge
Compliance
- IRDAI
- NHCX
Related reading
External references
- MoHFW — Ministry of Health — Government of India — health policy and regulation
- NHA — National Health Authority — Implements ABDM, PMJAY and national health stack
More in TPA / Insurance Claims
Pre-AuthorisationClaim Submission & SettlementNHCX Claims ExchangePMJAY / CGHS / ECHS All of TPA / Insurance Claims →
See Insurance & TPA Processing live.
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