ChikitsaVigorus AI
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NHCX · PMJAY · ClaimIQ

Claims that pass, the first time.

Chikitsa is a claim-workflow-ready HIMS - NHCX claim flows, PMJAY pre-auth, document readiness, ClaimIQ AI validation, claim status tracking and faster settlement, all in one place.

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NHCX claim lifecycle

From pre-auth to settlement,
tracked end to end.

Every claim event flows through NHCX. ClaimIQ AI validates documents and codes before submission and predicts rejection risk, so your team only fights the battles worth fighting.

How ClaimIQ works
Step 01
Pre-Auth Packet Sent
ClaimIQ auto-bundled & validated 102 clinical docs.
Bundle ID: NHCX-9821102 Docs
Clinical History✓
Lab Reports✓
Discharge Form✓
EMR
LIS
PACS
BUNDLED
SANCTIONED
Step 02
Pre-Auth Sanctioned
Insurer approved ₹84,000 instantly via NHCX.
Payer · Pol #12X9SLA: 2.4h
SANCTIONED
Requested
₹84,000
Approved
₹0
Step 03
Patient Discharged
Final bill & discharge summary automatically compiled.
Auto-Discharge Note
Dr. SharmaE-Signed
FINAL BILL
ICU Mgmt₹75,300
Pharmacy₹8,200
Consult₹500
TOTAL₹84,000
DISCHARGED
VERIFIED
Step 04
Final Claim Filed
ICD-10 codes and hospital tariffs strictly verified.
ICD-10 & Tariff EngineNHCX v1.2
J45.909Asthma✓
Z87.891Nicotine hist.✓
7.2.01ICU Tariff✓
PASS
Step 05
Insurer Adjudication
Claim in review. ClaimIQ rejection risk: 4%.
Live Risk AnalysisReviewing
4%
LOW RISK
Length of StayExpected
Tariff Variance0.0%
Prior AuthMatch
LOW RISK
SETTLED
Step 06
Final Settlement
Amount directly credited to hospital account (Expected T+2).
Final PayoutUTR: ...
Insurer
NHCX
Hospital
Approved
₹0
TDS
₹0
Settled
₹0
What's included

Everything your TPA & insurance team has been asking for.

NHCX claim flows

Native NHCX submission, response and reconciliation built into Chikitsa.

PMJAY pre-auth

Beneficiary verification, eligibility and pre-auth document workflows.

ClaimIQ AI

Automated validation, missing-doc detection & rejection-risk scoring.

Status tracking

Live dashboards by claim, doctor, department & insurer - drill all the way down.

Reduced rejection

97% first-pass approval typical · ↓ 64% rework on rejected claims.

Faster settlement

Cleaner claims = predictable cash flow · ↓ 11 days in claim cycle.

Document readiness

Auto-bundled discharge summary, investigations, bill & consent.

TPA workspace

Workqueues for TPA, insurance desk & finance - with SLAs & audit.

Claims questions

NHCX, PMJAY and ClaimIQ - answered.

Pre-auth flows, ClaimIQ validation, TPA workspace, and what claim cycle compression actually looks like.

Is Chikitsa NHCX compliant?

Yes. Chikitsa supports the full NHCX claim lifecycle - pre-auth, claim, response, payment and reconciliation - with native NHCX message formats and onboarded TPA/insurer connectivity.

How does ClaimIQ improve first-pass approval?
Does Chikitsa support PMJAY pre-auth?
Can our existing TPA team work in Chikitsa?
How much does the claim cycle shrink?