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.
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
Every OneCity module ties into the same shared patient record and compliance tracking, not a separate silo. For how this fits your broader accreditation planning, see our guide to NABH accreditation software. If you are still working out rollout timing, our guide to realistic ERP implementation timelines covers how modules like this one typically get sequenced. Pricing for this module is included from the Starter tier upward — see the full pricing breakdown, or the complete module list for how it fits alongside everything else.
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
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