Hospital Insurance Software — TPA Claims & Submissions | Vikas 2.0
Hospital Insurance Software — TPA Claims & Submissions | Vikas 2.0
Vikas 2.0 hospital insurance software manages the complete insurance claims cycle — pre-authorisation, TPA billing, GIPSA tariff management, claim submission, and settlement tracking — integrated directly into the central billing system. No duplicate entry, no manual follow-up sheets, no delayed settlements. Part of the Vikas 2.0 hospital ERP platform, deployed across 200+ hospitals in India and Africa.
What the Insurance Submissions Module Covers
Pre-authorisation and admission — insurance eligibility check at registration, pre-auth request generation, and approval tracking before patient admission. Disallowed services and product alerts flag billing errors at the point of entry, before the claim is submitted.
TPA and GIPSA billing — supports all major TPA providers and GIPSA-empanelled insurers. Multi-insurance provider tariff management handles different rate cards for each insurer without manual switching.
Ayushman Bharat / PMJAY — ABDM-integrated claim submission for government scheme patients, with ABHA ID linking at registration and automated health record sharing through the Health Information Exchange.
Claim submission and tracking — submit claims, view pending pre-authorisations, track long-pending claims, and follow up across providers from one dashboard. Integrated with Trueclaim for electronic settlement.
Settlement and reconciliation — insurance policy issuance, associated bill viewing, and full reconciliation against daily collections. Cash counter fraud alerts flag discrepancies before the end-of-day closing.
Results Across 200+ Deployments
- Claims settled in under 15 minutes for standard TPA cases
- Disallowed service alerts eliminate the most common cause of claim rejection at source
- Multi-insurer tariff management reduces billing errors across empanelled providers
- Clients have recovered crores in previously delayed or rejected claims through systematic follow-up tracking
Supported Insurance Types
Vikas 2.0 hospital insurance software handles all major insurance categories active in Indian hospitals:
- TPA-managed corporate health insurance
- GIPSA-empanelled public sector insurers
- Ayushman Bharat / PMJAY government scheme
- CGHS and state government health schemes
- Private health insurance direct billing
- Self-pay patients with insurance reimbursement documentation
Insurance Submissions Software for Clinics and Medical Centres
For group practices and speciality clinic chains, the same insurance submissions module is available in Vikas 2.0 Lite— covering OPD insurance billing, TPA claim tracking, and GST-ready pharmacy billing for clinic-level operations. For eye hospitals and ophthalmology chains, Netra 2.0 includes insurance billing integrated with IOL inventory and surgical workflow.
Book a demo — online or onsite, with a dedicated implementation manager assigned from day one.
