Question 1

Do we need servers, IT staff, or new computers?

Accepted Answer

No. Claimslens is fully cloud-based. If you have a computer and internet, you're ready.

Question 2

Will our staff need training?

Accepted Answer

Very little. Most hospitals learn the system within 30 minutes. The interface is simple and similar to what they already use.

Question 3

Will Claimslens replace our current TPA portals?

Accepted Answer

No — Claimslens works with all existing workflows. You can continue using your current system while Claimslens organizes and speeds up your submissions.

Question 4

Can Claimslens reduce our claim delays?

Accepted Answer

Yes. Most delays happen due to missing documents and small errors. Claimslens prevents these before submission, which leads to much faster approvals.

Question 5

Does Claimslens handle both pre-auth and final claims?

Accepted Answer

Yes. We support the full cycle — from pre-auth → enhancement → final claim → settlement.

Question 6

Is my hospital's data safe?

Accepted Answer

Absolutely. All data is encrypted and stored securely. Only authorized staff can access it.

Question 7

How soon can we go live?

Accepted Answer

Most hospitals are ready in 48 hours. No integration or installation required.

Question 8

Can Claimslens help with reconciliation?

Accepted Answer

Yes — our reconciliation module shows: fully paid claims, partially paid claims, pending amounts, follow-up items.

Question 9

Does Claimslens support all insurers and TPAs?

Accepted Answer

Yes. One dashboard handles all insurers, TPAs, and all claim types.

Question 10

What if we want to cancel?

Accepted Answer

No problem. You can cancel anytime. There are no lock-ins or penalties.

Question 11

Does Claimslens integrate with hospital information systems (HIS) like KareXpert, Mediface, or custom systems?

Accepted Answer

Yes. Claimslens integrates with major HIS systems including KareXpert, Mediface, and custom hospital systems through API connections. The integration can be set up without requiring changes to your existing HIS infrastructure. Claimslens pulls patient and admission data automatically, reducing manual data entry by up to 70%.

Question 12

How does Claimslens work with HCX (Health Claims Exchange) protocol?

Accepted Answer

Claimslens is fully HCX-compliant and supports HCX protocol for seamless integration with insurers and TPAs using the HCX standard. The platform automatically formats claims according to HCX specifications, handles HCX acknowledgments, and tracks HCX-based claim status updates in real-time.

Question 13

Can Claimslens handle claims for Star Health, HDFC ERGO, ICICI Lombard, and other major insurers?

Accepted Answer

Yes. Claimslens works with all major insurers and TPAs in India, including Star Health, HDFC ERGO, ICICI Lombard, Bajaj Allianz, New India Assurance, and others. One unified dashboard manages claims across all insurers and TPAs, eliminating the need to switch between multiple portals.

Question 14

What happens if a claim is rejected after using Claimslens validation?

Accepted Answer

If a claim is rejected despite Claimslens validation, the system immediately alerts you with the rejection reason. You can view the insurer's feedback, upload additional documents if needed, and resubmit with one click. Claimslens tracks all rejection patterns to help prevent similar issues in future claims.

Question 15

Does Claimslens work for hospitals in smaller cities or only metro areas?

Accepted Answer

Claimslens works for hospitals across India, including tier-2 and tier-3 cities. Since it's cloud-based, location doesn't matter as long as you have internet connectivity. Hospitals in cities like Coimbatore, Indore, Lucknow, and smaller towns use Claimslens successfully.

Question 16

Can Claimslens handle emergency admission claims differently from planned admissions?

Accepted Answer

Yes. Claimslens has specific workflows for emergency admissions, including faster pre-auth processing, telephonic approval tracking, and priority claim handling. The system recognizes emergency cases and applies appropriate validation rules and submission timelines.

Question 17

How does Claimslens extract data from scanned documents and PDFs?

Accepted Answer

Claimslens uses advanced OCR (Optical Character Recognition) technology to automatically read and extract information from scanned documents, PDFs, and images. It identifies patient names, policy numbers, dates, amounts, ICD codes, and other key data, reducing manual entry time by 70%.

Question 18

Does Claimslens support ABDM (Ayushman Bharat Digital Mission) and PHR (Personal Health Records) integration?

Accepted Answer

Yes. Claimslens supports ABDM and PHR integration capabilities, allowing hospitals to connect with India's national health infrastructure. The platform can map patient data to ABDM standards and facilitate seamless data exchange with government health systems.

Question 19

What types of documents can Claimslens validate and organize?

Accepted Answer

Claimslens validates and organizes all claim-related documents including insurance cards, ID proofs, admission notes, discharge summaries, investigation reports, X-rays, CT scans, lab reports, bills, invoices, and TPA-specific forms. The system automatically categorizes documents by type and checks for completeness.

Question 20

How does Claimslens reduce claim rejections by 40-60%?

Accepted Answer

Claimslens reduces rejections through automated pre-submission validation that checks for missing documents, incorrect codes, mismatched amounts, incomplete forms, and policy eligibility issues. By catching these errors before submission, hospitals avoid the most common rejection reasons, resulting in 40-60% fewer rejections.

Question 21

Can multiple staff members use Claimslens simultaneously?

Accepted Answer

Yes. Claimslens supports multiple users with role-based access. Different team members can work on different claims simultaneously. The system tracks who made which changes and maintains a complete audit trail of all activities.

Question 22

Does Claimslens work offline or require constant internet connection?

Accepted Answer

Claimslens requires an internet connection to sync data and submit claims. However, you can upload documents and prepare claims offline, and they will sync automatically when internet connectivity is restored. The system is optimized to work with intermittent connectivity common in some hospital settings.

Question 23

How does Claimslens handle claims for cashless vs reimbursement scenarios?

Accepted Answer

Claimslens handles both cashless (pre-authorization) and reimbursement claims. For cashless, it validates pre-auth requirements and tracks approval status. For reimbursement, it ensures all post-discharge documents are complete before submission. The system applies different validation rules based on claim type.

Question 24

Can Claimslens generate reports for hospital management and CFOs?

Accepted Answer

Yes. Claimslens provides comprehensive reporting and analytics including daily/weekly claim status reports, rejection trend analysis, team performance metrics, TAT (Turnaround Time) analytics by insurer/TPA, cashflow projections, and reconciliation dashboards. Reports can be exported to Excel or PDF.

Question 25

What happens to our data if we stop using Claimslens?

Accepted Answer

You own your data. If you cancel your subscription, you can export all your claims data, documents, and reports before the subscription ends. We provide data export in standard formats (CSV, PDF) and ensure a smooth transition if you choose to switch systems.

Question 26

Does Claimslens support multiple hospital branches or only single locations?

Accepted Answer

Claimslens supports multi-location hospitals. You can manage claims for multiple branches from one dashboard, with branch-specific views and consolidated reporting. Each branch can have its own team members while maintaining centralized oversight.

Question 27

How does Claimslens handle insurer queries and enhancement requests?

Accepted Answer

When an insurer sends a query or enhancement request, Claimslens immediately alerts your team with the specific requirements. You can upload additional documents directly in the system, add notes explaining the enhancement, and resubmit with one click. All query history is tracked per claim.

Question 28

Can Claimslens be customized for our hospital's specific workflow?

Accepted Answer

Yes. While Claimslens works out-of-the-box for most hospitals, it can be customized for specific workflows, approval processes, and reporting requirements. The platform is flexible and can adapt to your existing processes without disrupting operations.

Question 29

Does Claimslens work with government health insurance schemes like CGHS, ESI, or state health schemes?

Accepted Answer

Yes. Claimslens supports government health insurance schemes including CGHS, ESI, and various state health schemes. The platform handles scheme-specific requirements, document formats, and submission processes for both central and state government health insurance programs.

Question 30

How secure is patient data in Claimslens?

Accepted Answer

Claimslens uses bank-level encryption for all data in transit and at rest. Access is controlled through role-based permissions, and all activities are logged for audit purposes. The platform complies with data protection regulations and follows healthcare data security best practices.

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