Hospital Revenue Cycle Management & Billing Software
Protect hospital cash flows with India's most advanced cloud billing system. Automate TPA cashless pre-authorizations, NHCX claim settlement, package tariff audits, and eliminate clinical billing leakages.
Built to Maximize Hospital Profitability & Collection Speed
Medical365 unifies clinical actions with billing registers. Every syringe, surgical blade, diagnostic scan, and bed hour is captured automatically.
Unified TPA Cashless Desk
Manage initial pre-authorizations, enhancement approvals, queries, and final settlements with Star Health, Medi Assist, ICICI Lombard, Vidal, and Paramount through one unified portal.
- ✓ Digital Pre-Auth Submission Tracker
- ✓ Automated Query Resolution Alerts
- ✓ Real-Time Co-pay & Deductible Bifurcation
National Health Claims Exchange (NHCX)
Pre-integrated with NHA and IRDAI's NHCX gateway. Facilitates instantaneous, paperless claims transmission and rapid insurance adjudication via standardized FHIR medical claim profiles.
- ✓ IRDAI & NHA Standard Machine Interchange
- ✓ Digital Hospital E-Signature Integration
- ✓ Automated Claims Status Callbacks
Automated Revenue Leakage Guard
Scans OT notes, nursing task logs, and doctor orders for services rendered but unbilled. Prevents patient discharge until all department charges are reconciled, safeguarding hospital revenue.
- ✓ Automated OT Consumable Reconciliation
- ✓ Unbilled Pharmacy Return Tracking
- ✓ Bed Hourly Midnight Audit Verification
Surgical Packages & Multi-Tariff Engine
Manage separate rate lists for Cash, Corporate, TPA, PM-JAY, RGHS, and CGHS. Configure fixed-price surgical bundles with automatic cap monitoring and surplus item billing.
- ✓ Unlimited Custom Tariff Schedules
- ✓ Government Empanelment Package Rules
- ✓ Direct Export to Tally & Accounting ERPs
Manual Hospital Billing vs. Medical365 Automated RCM
How hospital CFOs and billing managers eliminate delayed insurance reimbursements and claim repudiations.
| Billing Capability | Conventional Hospital Billing | Medical365 Automated Cloud RCM ★ |
|---|---|---|
| TPA Cashless Clearance Time |
✕ 4 to 8 Hours Patients wait anxiously in discharge lounges while billing staff faxes paper bills. |
✓ Under 45 Minutes One-click digital claim dossier generation and direct NHCX API upload. |
| Revenue Leakage Defense |
✕ 8% to 15% Lost Revenue Pharmacy items, implants, and OT consumables frequently slip unbilled into charts. |
✓ Automated Pre-Discharge Audit Real-time clinical order cross-checks prevent unbilled items from escaping invoices. |
| Government Scheme Empanelment |
✕ Cumbersome Manual Filing PM-JAY, RGHS, and ECHS claim packets require repetitive manual re-entry. |
✓ Native Scheme Rate Lists Pre-mapped package codes, diagnostic documentation bundles, and submission reports. |
| Interim Bed-Side Billing |
✕ Delayed Visibility Families receive surprise bill shocks at final discharge, leading to disputes. |
✓ Real-Time Daily Statements Automated interim bill updates sent to patient app and WhatsApp daily. |
| GST & Financial Audit Trails |
✕ Vulnerable to Discrepancies Manual accounting adjustments without role permissions or audit timestamps. |
✓ Strict Role-Based Accounting Immutable cancellation logs, OTP discount authorizations, and automatic Tally sync. |
Request Hospital RCM Consultation
See how Medical365 eliminates billing leakage and accelerates your TPA cashless claim cycle. Talk to a hospital billing architect today.
Hospital CFO Financial Guarantees
- ✓ 99.4% Clean Claims Rate: Built-in claim scrubber audits diagnoses against procedure codes before submission to eliminate insurance query delays.
- ✓ Multi-Entity Corporate Tariffs: Seamlessly maintain differing pricing contracts for dozens of empanelled corporate entities and PSUs.
- ✓ Advance Deposit Safeguards: Real-time patient balance tracking triggers automatic alerts when bills exceed patient deposits.
- ✓ Tally ERP & SAP Sync: Automated daily journal voucher sync reduces finance department month-end reconciliation to minutes.
Hospital Finance Advisory Desk
Speak directly with a healthcare RCM consultant about customized package billing and TPA workflow optimization.
📞 Call Finance Team: +91 77919 10007Frequently Asked Questions on Hospital RCM
Everything you need to know about cashless insurance processing, package pricing, and revenue leakage control.