TariffGuard™ & PolicyMind™: Hospital Contract Intelligence
Health insurers lose over ₹18.2 Crores per ₹1,000 Crores of claims to unbundled consumables and unauthorized tariff markups. TariffGuard™ cross-references every billed line item against negotiated hospital rate cards in 200 milliseconds.
Eliminating Package Unbundling at Scale
Hospitals often charge pre-negotiated package rates (e.g. ₹3,96,000 for dual-stent angioplasty) but add separate "unbundled" line items for catheter kits, guide wires, and OT disposable trays that are contractually included.
PolicyMind™ — Automated Clause & Sublimit Extraction
Extract and apply policy clauses, waiting periods, and proportionate deductions without manual claims officer policy searching.
Room Rent Sub-Limits
Automatically calculates proportionate deductions on doctor fees, OT charges, and nursing when the patient chooses a room exceeding their policy tier.
Waiting Periods & PED
Cross-references policy inception dates against 24-month and 48-month waiting periods for specific diseases (e.g. joint replacements, hernia, cataracts).
Day-Care Inclusions
Matches day-care surgeries against the 540+ eligible day-care list to ensure 24-hour hospitalization minimum requirements are waived accurately.
Co-Pay & Deductibles
Calculates mandatory zonal co-payments, voluntary aggregate deductibles, and cumulative bonus adjustments with zero mathematical error.
Stop Contractual Leakage on Hospital Bills
Schedule an enterprise demonstration to see TariffGuard™ benchmark your hospital rate cards.