No real-time visibility
Finance teams struggle to see claim status, ageing, ownership and payer bottlenecks in one view.
Unified Revenue OS · Healthcare
Hospital Credit Revenue & Claims Management Platform
Unified Revenue &
Claims Management Platform.
Streamline the complete hospital credit-bill lifecycle, from pre-intimation and dispatch to settlement, deduction recovery and live financial governance.
Channel partner: HealthcarePro
Healthcare Revenue Cycle
Automation & Analytics
HIS & Finance Integrated
Corporate
TPA / Insurance
PSU
CGHS
ECHS
CAPF
PM-JAY
Claim Fusion
REVENUE OS
Claim file
Checklist ready
Claims Desk
Evidence ready
Live DSO
Portfolio view
Deduction
Recovery queueOwner assigned
AR Watchlist
High priority
Settlement
MatchedShort-pay flagged
Platform Introduction
One platform for revenue, claims and finance.
ClaimFusion centralises data, automates manual workflows and gives every stakeholder a real-time, role-aware view of the revenue cycle. It acts as a unified digital backbone for hospitals navigating fragmented payers, manual workflows and rising DSO.
01
Unified digital platform
Centralise claim, credit, dispatch, settlement and deduction data across teams.
02
Automation & integration
Connect HIS and finance data while reducing spreadsheet handoffs and repetitive checks.
03
Real-time monitoring
Live dashboards help finance teams spot bottlenecks before they cascade.
04
Cross-functional usability
Role-aware work queues for CFOs, claims teams, finance users and recovery teams.
Common Operational Challenges
Four leakage points hospitals face today.
Traditional credit departments lose millions each year to uncoordinated handoffs, unmonitored deductions, and fragmented communication.
No standard SLAs / KPIs
Different departments follow different timelines, making escalation and accountability difficult.
Manual processes & errors
Paper files, email chains and spreadsheets increase rework, missing documents and reconciliation delays.
Revenue leakage & credit risk
Untracked deductions, short payments and ageing receivables extend DSO and weaken collections.
End-to-End Workflow
One operating layer from intimation to settlement.
A continuous, audit-locked lifecycle ensuring zero lost documentation, instant geo-tagging, and high-velocity reconciliation.
ClaimFusion
Credit Bill Cycle
Claim
Geo Dispatch
Settlement
Deduction Recovery
Live Analytics
01
Pre-Intimation
Early intimation capture to establish payer timelines and claim eligibility.
02
Geo-Tagging & Photo Evidence
Tamper-proof evidence capture for dispatch verification and physical submissions.
03
Document Preparation & Checklist Mapping
Payer-specific document checklists to ensure zero-defect docket submission.
04
Audit
Pre-submission verification queues to catch coding errors and missing attachments.
05
Dispatch & Submission
Automated submission manifests and delivery confirmation with track-and-trace.
06
Follow-up & Collection
Prioritised calling queues, escalation matrices, and automated aging reminders.
07
Payment Matching & Settlement
Automatic UTR matching, short-pay identification, and multi-bill reconciliation.
08
Deduction Management
Classification of disallowances with root-cause analysis and appeal queues.
09
Reports & Dashboards
Executive visibility into portfolio aging, DSO, payer recovery, and team TATs.
Core Functional Modules
Four modules, one revenue engine.
Modular design lets hospitals adopt the platform in stages. Every module shares the same data, owners, audit trail and dashboard layer.
Dispatch Management
Checklist-based docket creation ensures every submission is complete, traceable and ready for payer review.
Bill Settlement
Manage on-account payments, settlements, approvals, ageing and short payments without spreadsheet dependency.
Deduction Recovery
Identify, validate and recover deductions with reason codes, owner assignment and appeal-ready records.
Credit & Analytics
Configurable credit controls and real-time analytics power informed decisions across payer portfolios.
Competitive Advantage
A sharper operating system for Indian hospital credit revenue.
ClaimFusion combines the practical strengths hospitals expect from modern claim platforms: claim readiness checks, payer-wise documentation, government-scheme reconciliation, follow-up ownership and deduction recovery. The difference is focus: it is built around the credit revenue desk, not generic hospital administration.
01
Claim-ready before submission
Prepare files with payer-wise checklists, evidence capture and audit queues before dispatch.
02
Government and panel visibility
Track CGHS, ECHS, CAPF, PM-JAY, PSU, TPA and corporate claims in one collection view.
03
From receivable to realization
Connect follow-ups, payment matching, short payments, deductions and appeal action in one trail.
04
Hospital finance leadership view
Give CFOs a clean picture of aging AR, TAT, collections, payer performance and deduction risk.
Real-Time Metrics & Decision Support
Decisions backed by live data, not lagging reports.
ClaimFusion consolidates data across the institution and surfaces what is about to break, not just what already did.
- Live DSO and ageing across payers, TPAs and schemes
- Revenue forecasting and collection strategy planning
- Unified consolidation across HIS, finance and payer systems
- Payer-negotiation insight backed by portfolio performance
- Deductions, appeals and recovery queue monitoring
Revenue Command Center
Real-time hospital audit stream
AR Aging
Segmented
Collections
Tracked
Deductions
Actionable
Aging Bucket Distribution (Days)
98.4% Matched
Corporate Panels
36%
TPA / Insurance
32%
Govt (CGHS/ECHS/PM-JAY)
32%
Connected Revenue Operations
Integrate with the systems your hospital already runs.
ClaimFusion acts as an agile intelligence and execution layer without requiring a rip-and-replace of your core infrastructure.
Bill, patient, discharge and claim source data.
Ledger, receivable, finance approval and accounting workflows.
Payment files, UTR references and settlement records.
Structured data exchange for internal systems and reporting layers.
Stakeholder Impact
Built for the roles the cycle depends on.
Financial oversight
CFOs get portfolio visibility across ageing, exposure, cash-flow risk, collections and payer performance.
Recovery operations
Claims and recovery teams work from prioritised queues, structured workflows and guided task dashboards.
Finance operations
Finance users reduce manual reconciliation through audit checks, payment matching and structured approvals.
Security & Governance
Designed for controlled hospital revenue operations.
Clinical and financial data protection built with enterprise security standards, role partitioning, and immutable audit logs.
Role-based access
Limit visibility and actions by department, location, role and claim ownership.
Audit trail
Maintain traceability for document changes, approvals, submissions, follow-ups and settlement updates.
Process governance
Standardize approvals, exception queues and escalation paths across multiple payer types.
Book a Demo
See how ClaimFusion can organize your credit revenue desk.
Tell us about your hospital, payer mix and credit billing workflow. The ClaimFusion team will help map a practical demo around your current revenue cycle.