Every claim
decision, cited & signed.
A deterministic engine applies the policy to the bill — no black box. Every field carries its citation. Every decision gets stamped into a tamper-evident record.
Health claims are still stuck in spreadsheets.
Every deduction, turn it over.
No line is cut without a clause behind it. Flip a card to read the exact policy citation and why it applied.
One engine. Every claim, defensible.
Computed, not guessed
A deterministic knowledge-graph engine walks the policy against the bill, rule by rule. Same claim, same inputs, same number.
Cited & stamped
Every field carries its citation. Every decision writes an HMAC-signed, hash-chained audit row. Tamper-evident by construction.
In your portal
A Chrome copilot reads the payer portal, drafts the pre-auth, and fills the fields — so desks stop retyping.
Policy reco engine
Compare health policies across insurers on the IRDAI wording corpus — from the real documents, not a brochure.
Fits your stack
IHX, Medi Assist, Vidal, and TPA back-offices. HL7/FHIR aware. JSON in, cited decision out.
Reviewer console
Ask any claim why, pull up precedent, and search every past adjudication — claim-scoped chat over your own decisions.
The copilot that lives in the portal.
It docks onto the payer/TPA portal you're already on — reads the claim, drafts the pre-auth from the patient's documents, and fills the fields. You review and submit. Every value cited, every action on the signed audit trail.
Every portal and inbox — one dashboard.
Hover a source to trace it. Hit sync to stream the board in.
From inbox to settled — end to end.
Drop the docs
Policy, hospital bill, discharge, pre-auth letter. PDFs or photos — the flow your reviewers already run.
Adjudo adjudicates
The engine reads the policy and walks the bill line-by-line, applying every rule deterministically — each field cited.
Signed decision out
Approve / query / deny with reasoning, cited clauses, and a tamper-evident audit row your compliance team will love.
Copilot fills the portal
The Copilot types the decision straight into the insurer / TPA portal (IHX & co.) — you review and submit, no re-keying.
Query? Reply, cited
When the insurer raises a query, Adjudo drafts the response with the exact clause and document that answers it — ready to send.
Eval-grade. Not vibes.
A small team, senior at the seams.
Engineers who've shipped regulated infra and adjudicators who've cut claims for a living — across Pune and Ahmedabad.
Pune · Ahmedabad — ex-infra, ex-health backend & ML
In production with payers and TPAs.
Mean turnaround dropped from 4.5 hrs to 1.3 hrs; same headcount handled 6× the cashless queue.
Caught NPPA price breaches, unbundled procedures, and missed sub-limits on ~12% of claims.
The IRDAI-grade HMAC-signed audit chain cleared internal compliance review on the first pass.
Put Adjudo behind your claims.
A small cohort of payers, TPAs, and hospital networks. Sandbox access and locked-in Year-1 pricing.