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Payer Management

Pre-authorisation shouldn't run separately from care.

Payer Management brings pre-authorisations, claims, and payer communication into a single, transparent workflow, so an admission, a procedure, or a discharge doesn't wait on a parallel paperwork process nobody can see the status of. Built on top of your existing HIS.

See how it works

40%

reduction in claim denials

35%

faster pre-auth turnaround

30%

ARPOB through fewer delayed claims

Insurance status is often the least visible part of an inpatient stay.

Pre-authorisation status is invisible to the care team.

Whether a procedure is actually approved often isn't visible to the people deciding when to proceed with it.

Payer communication happens over email and phone.

Requests for additional documentation or clarification get lost in threads, adding days to an approval that was otherwise ready.

Claims wait behind manual paperwork.

A claim can't go out until the right documentation is assembled, and assembling it is often a manual, late-stage task.

Denials surface after the fact.

A rejected claim or a denied pre-auth often isn't discovered until well after the care decision it was tied to has already happened.

How it Works

Prodoc · Payer Management

Pre-authorisation request

Knee arthroscopy · Star Health

Raised against patient record · Ananya Desai · 11 Sept

Submitted
Policy numberSH-482910
Treating doctorDr. Iyer · Ortho
Estimated stay2 days · OT-3
Documents attached4 of 4
Expected payer response24–48 hours

The care team and the finance team see the same payer picture.

Pre-authorisation workflow

Raise and track pre-authorisation requests against the same patient record the care team is already working from.

Unified payer communication

Every request for documentation or clarification lives in one workspace, instead of scattered across email and phone.

Claims assembly as the stay progresses

Documentation builds throughout the stay, so claims don't have to be assembled from scratch at discharge.

Status visibility for care and finance teams

See where a pre-authorisation or claim actually stands, without a call to the insurance desk.

The care team and the finance team see the same payer picture.

Pre-auth

35%

faster pre-authorisation turnaround

Denials

40%

reduction in claim denials

ARPOB

30%

ARPOB through fewer lost claims

Communication

50%

less time on payer follow-up

01

Faster pre-authorisation turnaround

Requests move faster when documentation gaps are visible early, rather than discovered after a delay.

02

Fewer claim denials

Claims built from a continuously assembled record are more complete, reducing the errors that lead to denial.

03

Less time on payer communication

Requests and responses are tracked in one place, rather than chased across email and phone.

Frequently asked questions

No. It gives your insurance desk a shared workflow to manage pre-authorisations and claims in, the relationships and negotiations with payers stay with your team.

Insurance status shouldn't be the part of the stay nobody can see.

Book a demo and we'll show you how it runs on your payer mix and your existing systems.

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