Product Features
Built to Solve Real Claim Challenges
ClaimGenie was designed with hospital finance teams in mind. With an intelligent engine and scalable architecture, it brings unmatched efficiency, visibility, and automation to your claims and reconciliation processes.
Core Features
Claims Upload & Extraction
ClaimGenie allows you to upload settlement files from various sources, including emails, Excel sheets, ZIP folders, and third-party portals. It also uses intelligent OCR technology to extract data from PDFs and structured formats, supporting a wide range of payers.
Bank Statement Integration
Payments are seamlessly reconciled using both uploaded and auto-fetched bank statements. The system supports multiple statement formats across various banking partners, ensuring smooth and efficient financial processing.
Automated Reconciliation Engine
ClaimGenie matches claim amounts, received payments, TDS, and disallowed values in real time. It supports both bulk reconciliation and single-patient workflows, ensuring accuracy and flexibility for all claim types.
TDS & Disallowance Handling
The system automatically identifies and categorizes deductions, streamlining the reconciliation process. It also tracks unresolved disallowed amounts, making it easier to escalate and review them promptly.
Real-Time Claim Tracking
Every claim is tracked from upload through to final settlement, ensuring complete visibility at each stage. Visual dashboards and real-time status alerts help reduce follow-up delays and keep teams informed.
Mismatch & Exception Handling
Mismatches in UTRs, claim amounts, and payment IDs are automatically flagged for quick resolution. Escalation workflows are triggered instantly, routing issues to the appropriate teams or departments for timely action.
BI Dashboards
ClaimGenie provides comprehensive BI dashboards and reports that offer a complete view of revenue, claims, payments, and outstanding balances — segmented by region, third-party administrators (TPAs), short-paid claims, TDS, disallowances, claim tracking and more.
Scheduled Alerts & Reports
ClaimGenie delivers automated alerts and scheduled weekly and monthly reports, directly to your inbox. From claim status updates to reconciliation summaries, you’ll always have the reports handy.
24 x 7 Support
Our expert support team is available around the clock to ensure smooth, uninterrupted use of ClaimGenie.
Customization and Role based Access
Your team has the flexibility to define user roles and permissions, ensuring secure and controlled access to financial data. Additionally, product features, dashboards, workflows, and reports can be fully customized to align with your organization’s internal processes and preferences.
Claim Genie Autobots
Automation that quietly does the heavy liftingSettlement Bot
Eliminates manual downloads from TPA portals — automatically fetches settlement advices using IDs, freeing your team from repetitive portal work.
Payment Bot
Matches payments with invoices in real time for accurate ledgers and rapid month-end close — drastically cuts reconciliation time.
TDS Bot
Classifies, matches, and reports tax deductions automatically with full auditability — no spreadsheets, no hand-work.
Why Choose Claim Genie?
Autobot-Driven Reconciliation
Automates matching payments, claims, TDS & disallowances — saving time and reducing human errors.
Multi-Source Data Handling
Extracts claim & payment data from emails, Excel, ZIPs, PDFs, and bank statements — no format limitations.
Bulk & Single Claim Processing
Handles high-volume or one-on-one claims with equal ease — ideal for multi-specialty and chain hospitals.
Real-Time Claim Tracking
End-to-end visibility into claim status with alerts for delays, rejections, and mismatches.
Exception Handling & Escalation
Automatically flags mismatches and routes unresolved issues to the right team for timely action.
Advanced Analytics with Power BI
Interactive dashboards for claim aging, TPA analysis, revenue, and outstanding balances.
TDS & Disallowance Management
Built-in logic to classify and reconcile tax deductions and disallowed amounts accurately.
Plug & Play Integration
Seamlessly integrates with HIS, ERP, TPA portals, and bank APIs — minimal IT dependency.
Enterprise-Grade Security & Compliance
AES-256 encryption, access controls, and compliance with HIPAA, GDPR & Indian regulations.
Why Choose ClaimGenie?
Tailored to your workflows
We understand that every organization has unique workflows and pain points — that’s why all features in ClaimGenie are fully customizable. Whether it's existing functionality or new capabilities, we tailor the platform to meet your specific operational needs.
Let our team show you how ClaimGenie can transform your revenue cycle.