aadjudo.
Healthcare · Live in production

Insurance claims, adjudicated
like an officer would — cited and signed.

Pre-auth. Final-bill adjudication. Reimbursement. Three workflows, one engine, one signed audit trail. Built for India's TPAs, insurers, and the hospital networks that bill them.

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Healthcare workflows

Built for
India's payers.

Not a generic claims tool. Adjudo was trained on Indian policy schedules (IRDAI structure, NABH/non-NABH distinctions), hospital tariffs and SOC rate cards, and the actual deduction logic your reviewers apply.

01

Pre-authorization

  • Hospital submits pre-auth with policy + diagnosis + estimated cost
  • Adjudo matches to the policy schedule, applies tariff rates and sub-limits, returns approval / query
  • Returns a cited approval / query decision, not a queue ticket
02

Cashless · Final bill

  • On discharge, hospital pushes final bill (itemised) + discharge summary
  • Adjudo re-adjudicates against approved pre-auth + new line items
  • Flags scope creep, unbundling, room-rate overruns, tariff drift
03

Reimbursement

  • Member uploads bill + discharge + investigations on portal
  • Adjudo runs full adjudication: policy match, exclusions, sub-limits, co-payment, deductions
  • Outputs an itemised settlement letter ready for ops review
Before vs After

The reviewer's day,
cut in half.

DimensionTodayWith Adjudo
Decision consistency Varies reviewer to reviewerDeterministic — same inputs, same answer
Benefits / sub-limit application Manual lookup, often missedAutomatic, every clause cited
Audit trail Spreadsheet + emailsHMAC-signed, hash-chained · IRDAI-grade · NABH-aware
Multi-language docs Reviewer translates manuallyNative English + Hindi OCR & understanding
Inter-reviewer consistency Varies 18–30%Deterministic + cited
ROI calculator

What does Adjudo save
your team?

Move the sliders. Numbers update in real time. Conservative model: 80% adjudication-time reduction and 4-percentage-point leakage reduction (typical from our pilots).

Indian TPA
Claims per month5,000
Hours per claim (reviewer time)2 hrs
Blended hourly cost₹450/hr
Current leakage8%
Estimated annual savings
₹24,72,00,000
Reviewer hours saved per month8,000 hrs
From 10,000 to 2,000 hrs
Adjudication cost saved / month₹36,00,000
Leakage reduction / month₹1,70,00,000
Caught sub-limits, tariff rates, unbundled line items
Monthly savings₹2,06,00,000
Get a tailored estimate

Conservative · 80% time reduction · 4pp leakage reduction · ₹85k avg ticket

Put Adjudo behind your claims.

A small cohort of payers, TPAs, and hospital networks. Sandbox access and locked-in Year-1 pricing.

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