INTELLIGENT HEALTHCARE OPS

The Operating System
for Health Insurance Ops.

Increase healthcare ops efficiency by up to 40%. Our suite handles highly accurate digitization, agentic document gathering, and medical necessity prediction.

RxPay Assurance
Live Analysis

Claim #C-2024-892

Diagnosis: Viral Pneumonia (J12.9)

Pending Review
Medically Necessary
High confidence match with MCG guidelines
98%
Confidence Score

Patient presents with dyspnea and hypoxia (SpO2 88%). Chest X-ray confirms lobar consolidation. Inpatient care criteria met according to standard protocols.

The RxPay Intelligence Suite

A modular suite of tools designed to optimize TPA and Insurance workflows, delivering up to 40% efficiency gains.

Data

High-Accuracy Digitization

Transform manual scanned insurance documents into structured digital data with superior accuracy. We also predict the confidence score of approval for each case automatically.

97%
Accuracy
Auto
Prediction
Document Scanner
Processing
Scanning
Live Extraction
Patient Name
Rajesh Kumar
Verified
Policy Identifier
STR-2024-882910
Verified
Accuracy Score
97%
AI Coding

AI Medical Coding

Automatically assign accurate ICD-10 and CPT codes from clinical notes and discharge summaries. Eliminate manual coding errors and dramatically cut claim rejection rates.

95%
Code Accuracy
3x
Faster Coding
AI Coding Engine
Auto-Coding
Claim #C-2024-4092 • Suggested Codes
J18.9 — Pneumonia, unspecified
ICD-10 • Primary Diagnosis
98%
CPT 99233 — Subsequent Hospital Care
CPT • Procedure Code
94%

AI flagged Z87.891 as secondary — history of nicotine dependence supports higher reimbursement tier.

Decisioning

Clinical Decision Support

Empower your administrators to make approval/denial decisions without needing medical knowledge. We verify that claims filed by hospitals are medically necessary.

Instant
Verification
Safe
Decisions
Medical Necessity Check
Analysis Complete

Appendicitis Surgery

ICD-10: K35.80 • Patient: Meera Sharma

92%
Approval Score
Medically Necessary
Criteria met per standard clinical guidelines

Ultrasound confirms acute inflammation. WBC elevated at 14,200. Surgery indicated per MCG guidelines.

The RxPay Standard

We founded RxPay to transform the healthcare payment infrastructure in India. Operations shouldn't be a bottleneck for healthcare delivery.

We are building the intelligent layer that powers seamless claims adjudication. By automating digitization and verification, we enable a frictionless insurance ecosystem for TPAs and Payers.

Digitize Paper to Data
Verify Clinical Necessity
Approve Confident Decisions
Outcome 40% More Efficient
Hospital Admin
Medical Team

Why TPAs Choose RxPay

40% Efficiency Boost

Drastically reduce manual processing time. Our unified platform handles the heavy lifting, allowing your team to focus on complex cases.

No Medical Ops Needed

Admins don't need medical degrees. Our Clinical Decision Support enables anyone to make accurate approval/denial decisions based on guidelines.

Autonomous Collection

Stop chasing hospitals for missing pages. Our agentic system handles document completeness checks and retrieval automatically.

Common Questions

What is the Cashless Access Benefit?

Historically, cashless facilities were limited by manual processing. RxPay bridges this gap, enabling TPAs to offer instant cashless adjudication by handling the necessary documentation and verification protocols autonomously.

Is my data secure with RxPay?

Absolutely. We adhere to the strictest data compliance and security standards. All patient and adjudication data is encrypted and handled with the utmost confidentiality.

How fast is the integration process?

Our web portal allows for immediate onboarding. Once registered, your team can begin uploading claims within 24 hours. We provide full training and support.

Scale Your Adjudication Throughput

Join the TPAs using RxPay to automate verification and eliminate processing bottlenecks.