For hospital networks

Catch deductions before you submit the bill.

Adjudo runs your bill through the same engine the TPA or payer will. You see the deductions, the cited clauses, and the defensible counter-arguments — before submission.

30s
Pre-submission review
↑22%
First-pass approval
↓41%
Disputed lines
8 yr
Audit retention

The pain we hear, every week.

Reimbursement leakage

Every avoidable deduction is leakage. NABH tariffs, NPPA caps, and policy-specific sublimits all bite at submission time. We show you which lines will get cut, before the bill leaves your billing desk.

Disputes you can't defend

When a TPA cuts a line and you have 60 minutes to respond, you need the citation. Adjudo gives you the same cited-clause output the TPA's officer is looking at.

Cash-flow drag

Reimbursement cycles stretch when claims bounce. Pre-bill review lifts first-pass approval rates — which directly tightens your DSO.

How it fits your workflow

1

Connect your HIS

We integrate with the major Indian HIS / EHR platforms (and US ones). Bills come to us as they're generated, before TPA submission.

2

Pre-submission review

Adjudo runs the bill through the same model your TPA will. You see expected deductions per line, expected approval, and the citation behind each call.

3

Fix or defend

Some deductions are real (e.g., NPPA cap exceeded) — you fix the line before submission. Others are debatable — Adjudo prepares the citation-backed counter for your appeal.

4

Track reimbursement

Dashboard tracks first-pass approval %, average deduction per claim, and disputed-line win rate over time. Per-doctor, per-department, per-payer.

Frequently asked

Will TPAs / payers know we're using this?

Only if you tell them. The output is yours. Most networks use it as an internal pre-submission check.

Does it work on US billing?

Yes. The same engine handles X12 837 + payer policies + CMS rules. We've scoped it for both Indian TPA workflows and US payer workflows.

How accurate is the prediction?

On benchmark Indian TPA data, line-item agreement is 96%+ with what the TPA actually did. We're conservative on edge cases — better to flag a debatable line than hide it.

Can we run on-prem?

Yes. NABH-bound hospitals can run Adjudo air-gapped on a single GPU appliance inside the hospital network. Same product, same model.

Want to see it on a real claim?

Send us one (de-identified). We'll adjudicate it live and walk you through the decision.

Talk to us