Insurance
Insurance Approvals and Claims, Under Control
Insurance revenue does not usually get denied. It gets forgotten — an approval that expired before the treatment, a claim nobody chased past day ninety.
Book Your Free DemoApprovals & claims
2 approvals expire before the booked treatment date
| Patient | Insurer | Amount | Status |
|---|---|---|---|
| K. Rahman | Bupa | 2,400 | Approved |
| N. Farouk | Tawuniya | 1,150 | Expires in 3 days |
| A. Zayed | MedGulf | 3,900 | Submitted |
| R. Salem | Bupa | 640 | Approved |
Claims ageing
- 0–30 days18,400
- 31–606,200
- 60+1,900
The problem
How earned revenue quietly stays with the insurer
- An approval expires between the consultation and the appointment, and nobody notices until after the treatment.
- Claims are submitted and then tracked, if at all, in a spreadsheet with no ageing.
- Per-patient coverage limits are checked by phone, one case at a time.
- When a contract comes up for renewal you have no data to negotiate with.
What it does
Insurance Approvals and Claims, Under Control
Insurance company profiles and procedure mapping
Each insurer's covered procedures and pricing mapped once, so eligibility is a lookup rather than a phone call.
Approvals with expiry alerts
Approvals are tracked with their validity period, and you are warned before one lapses — while the treatment can still be rescheduled or the approval renewed.
Claims management with ageing analysis
Every claim from submission to settlement, with ageing so the ninety-day-old claim surfaces itself instead of waiting to be noticed.
Per-patient coverage periods and limits
Coverage windows and limits held against the patient, so the front desk knows what is available before treatment is planned rather than after it is delivered.
Utilisation and company-performance reporting
Which insurers actually pay, how fast, and what share of your capacity each consumes. That is the analysis that changes a renewal conversation.
What changes
Fewer treatments delivered against dead approvals
The expiry alert arrives while it is still a scheduling problem rather than a write-off.
Ageing claims stop aging quietly
Follow-up is driven by a report rather than by whoever remembers a specific patient.
Renewals become a data conversation
You arrive with utilisation and settlement-speed figures instead of an impression.
Common questions
Does this work with the insurers in our market?
Insurance companies, their covered procedures and their pricing are configured by you rather than shipped as a fixed list, so it adapts to whichever insurers you actually work with. Setup is part of onboarding.
Can we see how much revenue is sitting in unsettled claims?
Yes — claims ageing shows outstanding claims by age bracket, alongside the outstanding-balance ageing in the billing module.
Does the approval alert reach the right person?
Alerts and the reports behind them respect your roles and permissions, so they land with whoever owns insurance in your clinic rather than with everyone.
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See this module with your own data
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