ClaimBook, developed by ABI Health, is a cloud-based hospital insurance claims management solution that streamlines the entire claims process. It covers insurance desk management, pre-authorization, claim submission, query handling, and settlement collection, speedup settlements, Improving TPA accountability, Prevent revenue leakage and reducing rejections. ClaimBook also supports international patient treatment, enabling medical tourism with dedicated workflows.

AI-powered agents automate data extraction, verification, and fraud detection, ensuring accuracy and minimizing fraudulent claims. The solution integrates seamlessly with Hospital Information Systems and requires no additional server or hardware costs. With paperless processing and intelligent email parsing for easy TPA management, ClaimBook enhances efficiency, security, and cost-effectiveness in claims management.

ClaimBook is an ideal revenue cycle management (RCM) tool for any hospital that partners with one or more TPAs and/or insurance companies for providing cashless healthcare services to its patients.

• AI Agents: From patient documentation and discharge coordination to settlement reconciliation and expense management and many more
• Rules Engine: Ensures only completed requests are submitted, improving accuracy, efficiency, and turnaround time.
• Smart Data Extraction: Automates data entry by extracting relevant information from documents and hospital systems.
• Automated Case Progression: Categorizes, calculates claim amounts, and forwards approved cases for finance processing.
• Notifications: Timely pop-up notifications for items requiring attention, enabling one-click actions."
• Claim Status Tracking: Categorizes claims into fully-paid, partially-paid, and outstanding, streamlining reconciliation and preventing revenue leakage.
• One-Click Actions: Easy transition from pre-authorization to claim submission with a simple one-click process.
• Comprehensive Reporting: Daily and monthly reports on case statuses, TPA performance, and business insights for negotiations.
• Hassle-Free Enhancement: Seamlessly adds documents or revises amounts to enhance claims as treatment plans change.
• Information Display: Integration with hospital display boards for real-time updates on claim status for patients and caregivers.
• Courier Tracking: Record and track courier details for physical documents sent to TPAs for settlement.
• Single Window Credit Management: Manage all credit businesses from initiation to settlements (Insurance, Government, and Corporate claims) in a single platform, avoiding the need for multiple channels for claims management.
• Patient ID-Based Claim Tracking: With our advanced HIS integration kit, manage credit businesses based on patient ID alone. Even multiple claims for the same patient event are tagged to the same ID, simplifying reconciliation by linking base and top-up policies.
• Real-Time Status Communication: Provide real-time status updates to patient families through SMS, WhatsApp, QR codes, and display monitors.
• ABDM & NHCX Compliance: Ensure ABDM and NHCX compliance with ABHA creation and claim exchange through NHCX. ClaimBook is the default payer adopter for 24+ insurance companies and TPAs.
• Aegle: A newly built management dashboard, designed with feedback from enterprise hospitals, allows HODs and CXOs to monitor the complete credit cycle from a single window.