We build AI agents and software for hospitals and clinics: pre-authorisation packs filled from the doctor’s notes, appointments booked on WhatsApp and every insured case tracked, admin only, with your staff approving each submission.
The agent does the legwork. A person makes the one decision that’s theirs.
At Sunrise Multispeciality Hospital, the doctor’s admission note, the cost estimate and a photo of the insurance card reach the TPA desk for a planned knee replacement. The agent fills the TPA’s pre-authorisation form from them, copying the diagnosis and procedure exactly as written, and checks the pack against the TPA’s list: the signed consent form is missing. The TPA desk asks the ward for it, and submits the pack once it arrives.
We fix these one workflow at a time.
Then we tell you plainly what will work well, what needs a person, and what isn’t worth automating.
Reads the doctor’s admission note and estimate, the patient’s policy and the payer’s form and checklist, fills the request and lists what’s missing. The TPA desk reviews and submits, and the agent never writes or changes clinical content.
Answers patients’ WhatsApp messages about appointments, timings, fees and the preparation notes your staff wrote, in the languages we’ve tested with you, and books, reschedules or cancels. It handles admin only: anything else, including symptoms or anything urgent, goes to staff, and every chat says it’s an AI assistant and tells patients to call the hospital in an emergency.
One board for every insured case across TPAs, insurers and PM-JAY: pre-auth, queries, enhancements, final approval, settlement and deductions, with reminders on anything pending. Updates come from the letters and emails payers send, and from your desk.
KareXpert, Insta by Practo, MocDoc and others you may run. We check what each allows first, and nothing gets ripped out.
Works with: KareXpert, Insta by Practo, Practo Ray, MocDoc, HealthPlix, Bahmni, CrelioHealth, Marg ERP, TallyPrime, WhatsApp Business, Epic, Oracle Health, athenahealth, eClinicalWorks, NextGen, ModMed, Tebra, Dentrix, Open Dental, Waystar, QuickBooks.
Anything outside your rules waits for a person, and every step is on record.
ID, insurance cards and referrals read into registration fields.
Reads clear photos of ID and insurance cards, policy schedules, referral letters and faxed referrals, and pre-fills registration and coverage fields. The front desk confirms before saving.
Insurer queries and deduction letters answered with the right papers.
Reads insurer and TPA queries and deduction letters, matches them to the bill, the policy and the documents on file, and drafts a reply with the right attachments. The billing lead approves before it goes.
The draft final bill checked against what was actually used.
Compares the draft final bill with pharmacy issues, implant stickers and room changes, and flags possible missed or non-payable items for the billing team to decide, so the patient hears their share before discharge.
Payments checked against agreed rates, with appeals drafted.
Compares payments with agreed tariffs and package rates, groups denials and deductions by reason and payer, and drafts appeals. Staff review every appeal.
Stock, expiry and distributor invoices watched, with orders drafted.
Watches stock, expiry and usage, drafts purchase orders to distributors, flags near-expiry stock for return, and checks distributor invoices against POs for rate, batch, expiry and scheme. The purchase manager approves orders, and only the pharmacist dispenses.
Rosters drafted from your rules, and cover found by message.
Drafts shift rosters from your rules (skills, ward needs, leave, night-shift limits), and when someone calls in sick, messages eligible staff to find cover. The nursing superintendent approves rosters and swaps.
Home collections booked and routed, reports sent once released.
Takes home collection requests on WhatsApp, books slots, plans phlebotomists’ routes, sends the fasting instructions your lab wrote, and shares reports only once they’re released in the LIMS, as a secure link. It never interprets results.
Patient estimates from your tariff and their cover.
Cost estimates from your tariff, package rates and the patient’s cover, for staff to approve and send. In the US, Good Faith Estimates for self-pay patients.
Partner centres book tests, track samples and get invoices.
Collection centres and corporate clients book tests, track samples and download invoices.
Reminders on WhatsApp, and cancelled slots offered to the waitlist.
Confirmations, reminders and recalls go out on WhatsApp or SMS to patients who’ve agreed to them, and cancelled slots are offered to the waitlist.
Patients told when reports are released, with a secure link.
Sends patients an approved message with a secure, authenticated link once a lab report is formally released.
Bills, receipts and settlements into Tally, matched to the bank.
Bills, receipts, TPA settlements and TDS are posted to Tally, Zoho or QuickBooks once accounts approves each batch, and matched against bank credits.
No. It handles bookings, paperwork, billing and stock, and anything about symptoms or treatment goes to your staff. Every chat tells patients to call the hospital in an emergency.
Usually, yes. We check what your HMIS and each insurer allow first, then connect through an API or a file export. Where neither exists, we tell you plainly, and your TPA desk keeps submitting on the portals as it does today.
We design it to support your obligations: minimum data, access by role, audit logs and your own accounts. We don’t claim certifications, and we agree in writing how patient data is handled before we start.
Only the information each workflow needs, with access by role and every access logged. It stays yours, stored securely, and we show your team exactly where it lives.
Printed documents and clear photos, yes. Anything it can’t read clearly goes to a person, and it never guesses at clinical details. In the pharmacy, it only prepares work for the pharmacist.
We build that as a separate version, because US payers, forms and rules differ from Indian TPAs. It works from your EHR and your payers’ requirements, and your staff review and submit every request.
