Now in early access

Claims desk

One record, from the front desk to the bank.

Start with your insurance desk. Every cashless claim goes out complete, on time, with proof. Admission, bill and claim share one record, so nobody types anything twice.

Needs action

14 open3 due in 1h₹6.2L awaiting

Case	Payer	Clock	Status
Knee replacementWard 3 · ₹1,42,000	TPA A	Overdue 12m	Discharge late
Dengue, ICU day 4ICU · ₹68,500	Insurer B	0h 22m left	Query open
AppendectomyOT · ₹55,200	TPA C	Sent 10:42	Submitted
C-sectionMaternity · ₹38,000	Insurer D	Done	Approved

Blocked: Appendectomy discharge needs the histopathology report before it can be sent.

Before anything goes out

Incomplete claims never leave the hospital.

Each insurer and TPA has its own document checklist. A request with a missing report is blocked, and the reason sits on the case until it is fixed.

Pre-send check

Appendectomy · TPA C

Admission and ICD-10 diagnosisDone
Final bill with GST linesDone
Discharge summaryDone
Histopathology reportMissing

Blocked: this claim will not be sent until the report is uploaded.

One record

Nobody types anything twice.

Claims tools sit outside your hospital system and copy data in. Chola Care is the system, so the desk sees the live bill and the claim matches what was charged.

Case CH-1042

Same patient record

Admission · Ward 3Treating doctor, ICD-10 diagnosis, planned procedure

Interim bill · ₹1,42,000Every line, with GST flags

Claim · TPA AChecklist complete, pre-auth sent 10:42

Built for India

Your data stays in India, with a full trail.

Chola Care is in early access with a small group of private hospitals. We are building the claims desk first, then adding the rest in stages.

What you get

Data stays in India

Patient data is stored and processed in India.

Full audit trail

Who changed what, and when, on every clinical and claim record.

IRDAI clocks

The 1-hour pre-auth and 3-hour discharge limits are tracked on each case.

ABDM and FHIR ready

ABHA is captured at registration. ABDM certification is planned.

Get early access See how it works

Data stays in India Full audit trail Built for IRDAI's 1-hour and 3-hour rules

One patient record

Patient

Admission

Admit with the details the insurer will ask for. The cashless request starts here.

Bill

Every charge on one running bill, entered by billing staff or imported from Excel.

Claim

Pre-auth, queries, enhancement, discharge and the final claim, each one complete before it's sent.

Settlement

Close the loop: what was paid, what was cut, and why.

The same record runs through every department: front office, doctors, wards, pharmacy, lab and billing.

Where the money goes

Cuts cost hospitals more than rejections.

Most claims get paid. What goes missing is the part that gets cut: room-rent caps, non-payable items, tariff disputes. Chola Care records every cut with its reason, so you can see which insurer, which item and which document cost you.

Claimed

₹1,32,488 cr

Paid

₹94,248 cr

Cut (disallowed)

₹18,521 cr

Rejected

₹11,412 cr

IRDAI figures for FY2024-25 as reported in published summaries. 71.1% of claimed value was paid.

The claims desk

Complete the first time. Every rupee explained.

A checklist for each insurer

Each insurer and TPA has its own document list. Chola Care blocks sending until every required document is attached.

The clock, with proof

IRDAI gives insurers 1 hour for pre-auth and 3 hours for discharge. Chola Care records when a complete request left your desk.

Every cut, by reason

Record each payment with its UTR, TDS and every deduction, and see what's still unpaid after 30, 60 and 90 days.

Bill against approvalKnee replacement · Ward 3

Approved₹1,20,000

Running bill₹1,42,000

Gap₹22,000

Room-rent capRoom ₹6,500/day, policy cap ₹5,000. Other charges may be cut in proportion.
Non-payableConsumables ₹3,200 are not covered by this policy.

View billRequest enhancement

Claims assistant

AI does the paperwork. Your team makes the decisions.

Checks documents before sending

Reads the discharge summary, bills and reports, and flags what's missing or doesn't match.

Drafts replies to TPA queries

Writes the reply from the patient's record and attaches the right documents. Your staff review it and send it.

Query from TPA CReply due in 40m

Appendectomy · received 11:20

Please share the histopathology report and confirm how long the patient had symptoms before admission.

Draft by assistant

Please find attached the histopathology report dated 05-11-2026. As recorded in the admission notes, the patient had abdominal pain for 2 days before admission.

Histopathology report.pdfAdmission notes.pdf

EditApprove and send

How a pilot works

Start with one desk. Measure what changes.

Step 1

Show us your desk

A short call with your insurance desk head. Bring the claims that cause the most trouble.

Step 2

Run it on real cases

We import your open claims and set up the insurers you work with most. Your desk works from one queue.

Step 3

Compare the numbers

Queries per claim, amount cut, days to settlement. If they don't move, you stop.

Questions

Common questions

What is Chola Care?

Chola Care is hospital management software for private hospitals in India. It includes an electronic medical record, and the front office, wards, billing and insurance desk all share one patient record.

Is Chola Care available now?

Chola Care is in early access. We are working with a small group of private hospitals. Write to hello@cholacare.in to join.

What are the IRDAI time limits for cashless claims?

Under the IRDAI Master Circular on health insurance (May 2024), insurers must decide on a cashless pre-authorisation within 1 hour and on final discharge within 3 hours of receiving the request. Chola Care records when a complete request left the hospital, so the desk has proof of the time.

Does it work with our insurers and TPAs?

Yes. Chola Care keeps a document checklist for each insurer and TPA and prepares a complete packet to upload to their portal or send by email.

Do we have to replace our billing software?

No. You can import admissions and bills from Excel or CSV and run the insurance desk on Chola Care alongside your current system.

Get early access.

We're opening Chola Care to a small group of private hospitals. Write to us to join.

Email hello@cholacare.in