AI-Powered Claims Intelligence for Indian Health Insurance

ClaimManager by Omnivero Health Solutions helps TPAs, insurers, and hospitals process cashless and reimbursement claims faster—from FNOL to payout—with evidence-driven AI and auditable outcomes.

IDP
Intelligent Document Processing
ICD-10
Medical Coding
AI
Evidence-Driven Analysis

Claims Dashboard

● Live
247
Total Claims
92%
Avg Confidence
₹42.8L
Total Value
CLM-2025-0001
Under Review
Patient: Rahul Sharma
Hospital: HOC Vedanta
Amount: ₹15,600
Processing: 85% Complete
Live Dashboard Preview

Real-Time Claims Management

Track, process, and validate claims with complete transparency

Total Claims
247
Pending Review
38
Approved
189
Total Value
₹42.8L

Recent Claims

All Claims ▼
CLAIM
PATIENT
TYPE
AMOUNT
STATUS
CONFIDENCE
CREATED
CLM-2025-0001
HOC Vedanta
Rahul Sharma
N/A
Reimbursement
₹15,600
Under Review
85%
13 Dec 2025

Approval Summary

Approval Rate 76.5%
Approved Amount ₹32.7L
Average Claim Value ₹1,73,200

Processing Statistics

Approved 189
Under Review 38
Rejected 20
How It Works

End-to-End Claims Processing Workflow

From FNOL to payout—automated, auditable, and India-ready

1
Patient Information
Enter patient details
2
Claim Details
Enter claim information
3
Link Documents
Select supporting documents
4
Review & Submit
Review and submit claim
01

Document Intake (FNOL)

Multi-source ingestion from hospitals, agents, TPAs, and insurance employees. Documents are automatically bundled with patient and policy information.

02

Document Organization + IDP

Intelligent Document Processing with automatic classification, deduplication, and extraction—including handwritten elements and Hindi documents. Works with messy scans and mixed layouts.

Clinical / Non-Clinical / Forms
03

Collation + Understanding

Cross-document understanding converts scattered information into a consistent claim view—patient demographics, diagnosis, billing, doctor notes, and policy coverage.

🔗
Cross-document data collation
Consistent claim view generation
Patient + Provider + Clinical + Billing Unified
04

Verification + Summary

Intelligent verification of policy clauses, business rules, and IRDAI guidelines. Generates an auditable claim summary with extracted facts, exceptions, and checks performed.

Auditable Claim Summary

Policy Check: ✓ Verified
Business Rules: ✓ Passed
IRDAI Guidelines: ✓ Compliant
Citations: Page-level references
Document Processing

Intelligent Document Processing with Confidence Scoring

Upload and manage patient documents for claim processing

Total Documents
1,523
Processed Successfully
1,487
Currently Processing
36
Avg. Confidence
92.3%
doc_20251212_2123...
843.73 KB
Processed
📄 Medical Bill
Processing Status: ✓ Processed
IDP Status: ✓ Processing Complete
Confidence Score: 100%

Extracted Data Preview

Patient: RAHUL SHARMA
Date: 2025-07-09
Hospital: The Oriental Insurance Company Limited
Uploaded: 13 Dec 2025, 02:53 am
Processed: 13 Dec 2025, 02:54 am
doc_20251212_2123...
3.23 MB
Processed
📄 Medical Bill
Processing Status: ✓ Processed
IDP Status: ✓ Processing Complete
Confidence Score: 100%

Extracted Data Preview

Patient: Rahul Sharma
Date: 2025-10-02
Hospital: HCG Aastha Cancer Centre
Uploaded: 13 Dec 2025, 02:53 am
Processed: 13 Dec 2025, 02:53 am
doc_20251212_2119...
653.28 KB
Processed
📄 Medical Bill
Processing Status: ✓ Processed
IDP Status: ✓ Processing Complete
Confidence Score: 85%

Extracted Data Preview

Patient: RAHUL SHARMA
Date: 2025-06-30
Amount: ₹15600
Hospital: HOC HEMATO ONCOLOGY CLINIC VEDANTA
Uploaded: 13 Dec 2025, 02:49 am
Processed: 13 Dec 2025, 02:49 am
Smart Extraction

AI-Powered Confidence Scoring

Every document is processed with a confidence score, giving you complete transparency into extraction accuracy. Review extracted data before approval.

Real-time Confidence Metrics

Track IDP accuracy from 85% to 100% for every document processed

Extracted Data Preview

View and verify all extracted information before final submission

IDP Status Tracking

Monitor processing stages from upload to completion

Multi-Document Processing

Handle multiple documents simultaneously with batch processing

Document Processing Status

✓ Processed
92%
Confidence
IDP Complete
Data Extracted
Validation Passed

Extracted Information

Patient Name RAHUL SHARMA
Date 2025-06-30
Amount ₹15,600
Hospital HOC Vedanta
Document Type Medical Bill
Key Features

What Makes ClaimManager Different

Human-in-the-loop intelligence with evidence-driven decision support

🎯

Claims-First IDP

Designed around claim adjudication outcomes, not just "extract text from PDFs." Every feature serves the decision-making process.

📖

Evidence-Driven AI

Answers with page-level citations and confidence scores, not black-box outputs. Full auditability and transparency in every decision.

💬

Ask the Claim (Q&A)

Human-in-the-loop by design. Ask questions like "Is this procedure covered?" and get answers with exact document citations and confidence scores.

🇮🇳

India-Ready

Built for India's reality: messy scans, handwritten parts, Hindi support, and multi-party workflows (hospital ↔ TPA ↔ insurer).

🔄

ABDM/NHCX Ready

FHIR-first ecosystem alignment. Onboarded to ABDM and NHCX for standardized, machine-readable claims exchange and faster cashless processing.

⚙️

Configurable for Each Payer

Set your checks once and evolve them over time. Custom business rules, policy clauses, and TPA-specific checklists built into your workflow.

India-First

Built for India's Health Insurance Ecosystem

Purpose-built technology and workflows for TPAs, insurers, hospitals, and ecosystem partners

Who We Serve

🏢

Third-Party Administrators (TPAs)

Handle large volumes with faster TAT and consistent adjudication across teams.

🏛️

Health Insurance Companies

Modernize adjudication and meet IRDAI timelines with evidence-driven support.

🏥

Hospitals

Smoother pre-authorization and faster cashless claim settlements.

🔄

Ecosystem Partners

ABDM/NHCX-ready with FHIR-based claims interoperability.

India-First Technology

Document Classification & Deduplication

Automatic bundling, classification, and duplicate removal

Multi-Language IDP (Hindi + English + Handwritten)

Intelligent extraction from messy scans, stamps, tables, handwritten elements

Cross-Document Understanding

Collates scattered information into consistent claim view

Policy Clause Mapping & Verification

Configurable TPA-specific rules and IRDAI guidelines

FHIR-Based Data Exchange (ABDM/NHCX)

Standardized exchange for faster cashless processing

Meet the Team

Let's Talk About Your Claims Workflow

Connect with our founders to see how ClaimManager can transform your claims processing

Dhairya Shah

Dhairya Shah

Co-Founder

IITGN 2024 CSE Graduate

Siddhesh Kanawade

Siddhesh Kanawade

Co-Founder

IITGN 2024 EE Graduate

Want to see how ClaimManager can transform your claims workflow?

Schedule a 30-Minute Demo

Remote + on-site demos available across India