Your hospital is owed money it will never collect.
TPA deductions happen silently. ClearCycle surfaces them before submission and improves first-pass acceptance from 68% to 88%.
42 behavioural profiles mapped across major Indian TPAs
₹8,000 Cr
lost by Indian hospitals to TPA denials every year
34%
of ortho claims rejected for missing implant documentation
₹20-36L
recovered per month by hospitals on ClearCycle
The problem
Manual billing is breaking your revenue cycle.
₹15-25%
Revenue lost silently
Not rejected outright. Quietly deducted. Room upgrades, missing invoices, coding mismatches. Most hospitals find out 60 days later when the remittance comes in short.
45-90 days
Cash flow paralysis
Once a claim goes into the TPA portal, it disappears. Your billing team checks status manually. Denials arrive with vague reason codes. Nobody is watching.
3-5 hrs
Per appeal, per denial
Research the denial. Find the policy clause. Draft the letter. Resubmit. For a billing team of 3, that's a full-time job just to chase what you were already owed.
See it in action
The full picture.
How it works
From admission to settlement - nothing falls through.
Every step in the claim journey automated, every decision auditable, every rupee tracked.
Admission
Pre-auth sent
During stay
Coding runs live
Discharge
ClearCheck scan
Approval
3-gate sign-off
Submission
TPA portal
Settlement
7–14 days
All versions logged · IRDAI audit trail
Admission
Pre-auth sent
During stay
Coding runs live
Discharge
ClearCheck scan
Approval
3-gate sign-off
Submission
TPA portal
Settlement
7–14 days
All versions logged · IRDAI audit trail
Know exactly which claim lines will be cut before you submit.
Trained on carrier rejection history across 42 payer profiles. Every claim line gets a deduction probability, a predicted rupee amount, and a fix.
CLEARCHECK — LIVE DEMO
Try it — see deduction risk before you submit
Sample claim: knee arthroplasty · ₹1,21,500 billed
Claim Lines
| Procedure | Amount |
|---|---|
Total Knee Arthroplasty CPT 27447 · M17.11 | ₹85,000 |
Anaesthesia – Major Orthopaedic CPT 00400 · M17.11 | ₹12,000 |
Inpatient Room (4 nights) CPT 99232 · M17.11 | ₹18,000 |
Post-op Physiotherapy (6 sessions) CPT 97110 · M17.11 | ₹6,500 |
| Total billed | ₹1,21,500 |
Risk Assessment
Select a payer and click Run Pre-Check
42
Payer profiles in ClearCheck
Star Health, ICICI Lombard, SBI General, Bajaj Allianz, Tata AIG, Medi Assist and more.
68% → 88%
First-pass acceptance
The 20-point gap between what hospitals get and what they should. ClearCheck closes it before the claim leaves.
Learns over time
Trained on your data
ClearCheck fine-tunes on your hospital's own remittance history. Predictions get sharper every month.
The platform
One platform. The entire claim lifecycle.
AI Medical Coding
Reads discharge summaries and assigns ICD-10 and CPT codes with confidence scores, CCI edit validation, and MUE checks.
Policy Adjudication
Evaluates coding against TPA rule sets. Calculates exact insurer payment and patient liability before discharge.
ClearCheck
Per-line deduction probability scoring before you submit. Flags high-risk lines with the exact reason and fix.
3-Gate Approval Workflow
Doctor approves via SMS OTP. Billing reviews financials. Admin gives final sign-off. All digital, all auditable.
Autonomous TPA Submission
Submits to TPA portal automatically after approval. Status tracked daily. Denial triggers appeal letter instantly.
Appeal Letter Generation
IRDAI-compliant appeal letter in 60 seconds. Cites denial reason, clinical evidence, and policy terms.
The impact
What changes at a hospital billing ₹2 crore per month.
| Metric | Before | After ClearCycle |
|---|---|---|
| Claim processing time | 3-5 days | 4-6 hours |
| First-pass TPA acceptance | 65-70% | 85-90% |
| Appeal turnaround | 3-5 days | Same day |
| TPA portal work per claim | 45-60 minutes | Automated |
| Revenue recovered monthly | Baseline | +₹20-36 lakhs |
Built for Indian healthcare
Healthcare-grade compliance. Built in.
Data never leaves India
Encrypted at rest and in transit. Patient data is processed and stored on Indian servers only — no exceptions.
7-year audit trail
Every coding decision, approval, and submission logged with timestamps. IRDAI-mandated retention, fully searchable.
Medicolegal sign-off
Doctor OTP approval on every claim. Every decision is timestamped and defensible if a dispute arises.
IRDAI & DPDP ready
NHCX-compatible claim bundles. DPDP Act 2023 processing basis documented for every patient data touch.
Find out exactly how much your hospital is losing.
Share 6 months of remittance data. We'll map your deduction patterns, identify the biggest recoverable amounts, and show you what ClearCycle would change. No pitch until you've seen your number.
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