Clean claim — laparoscopic appendicectomy
Semi-private ward inside the cap, every report attached, intimated on the day of admission. Deductions limited to itemised non-payables and the contractual co-pay.
claim preflightexpect · ready expect · high risk expect · blocked
Find what the TPA will query, before you send it.
Upload the policy and the claim package. Every issue names the rule it came from and the clause it relied on, and every rupee deducted shows its arithmetic.
01Policyparse + cache
02Triageclassify pages
03Extractread + confidence
04Verifydeterministic
05Adjudicaterulebook + judgment
06Scorereadiness + payable
humanHuman checkapprove to submit
three claim files, ready to runLoad one in a click, or download the PDFs and upload them yourself.
Problem claim — laparoscopic cholecystectomy
Deluxe room against a ₹5,000 cap, a consolidated pharmacy head with no break-up, brand-name consumables, a member-ID mismatch, a CT referenced but not attached, intimated 81 hours after admission.
Benefit not covered — caesarean delivery
A clean bill against a policy whose schedule carries no maternity benefit. Not-covered is the largest single deduction reason in the real data, at a third of all deductions.
1 · policy document
The policy wording or benefit sheet. Parsed once and cached by content hash — re-uploading the same file is free.
2 · claim documents
Bills, discharge summary, prescriptions, reports, ID. Pages are classified by what they contain, not what they are named.
Pick a case above, or add your own documents.