From accurate claim preparation to settlement follow-up and revenue reconciliation, iServices Alliance Solutions helps hospitals manage the post-approval insurance lifecycle with greater speed, control and visibility.
Getting an insurance approval is not the finish line. The claim still needs to be:
iServices Alliance Solutions manages these critical post-approval activities through a structured combination of technology, RPA, professional review and dedicated quality control. The result is a more controlled process from claim submission through settlement and reconciliation.
Assess Your Current Claims Process →A claim is only as strong as the information submitted with it. Incomplete documentation, incorrect information or avoidable inconsistencies can lead to queries, deductions, delays or disallowances. iServices Alliance Solutions follows a structured claim preparation and review process before submission.
Relevant medical, billing and administrative documents are collected and organized.
Patient, policy, treatment and billing information is checked for consistency.
The claim is prepared with the required supporting information.
A qualified professional reviews the claim before it proceeds further.
Every claim undergoes a final quality check by a dedicated doctor before submission.
Technology-enabled checks support the identification of process or information gaps.
The completed claim is submitted through the applicable insurer or TPA process.
Post-submission queries and additional requirements are tracked and addressed.
For hospitals, faster claim submission can mean earlier movement toward settlement. iServices Alliance Solutions has an operational capability to process and submit eligible claims within 24–36 hours, subject to documentation availability, internal processing requirements and applicable insurer/TPA procedures.
The focus is on reducing avoidable submission delays through:
Required information is organized systematically.
Potential gaps are identified before submission.
Claims undergo qualified review before proceeding.
A dedicated doctor performs the final quality check.
RPA-powered workflows help streamline repetitive processing activities.
Delayed submission can push the entire claims cycle further out. A disciplined submission process helps hospitals:
*The 24–36 hour timeline represents iServices Alliance Solutions' operational processing capability and may depend on documentation completeness and applicable insurer/TPA requirements.
A claim can be submitted quickly and still create problems if the underlying information is incomplete or inaccurate. Common issues include:
Missing or inconsistent records may trigger additional queries.
Differences between treatment, billing and supporting documentation can require clarification.
Errors in patient, policy or claim details can delay processing.
Incorrect or insufficient documentation may contribute to deductions.
Certain claim components may be disallowed based on applicable policy, documentation or payer requirements.
Unresolved queries can keep claims outstanding for longer periods.
This is why iServices Alliance Solutions places multiple levels of review before the claim reaches the insurer or TPA.
Submission is only one part of the revenue cycle. Once a claim has been submitted, hospitals need continuous visibility into its progress and timely follow-up with the relevant stakeholders. iServices Alliance Solutions supports the settlement stage through:
Submitted claims are followed up through the applicable process.
Communication with TPAs is managed to address pending requirements and claim status.
Where applicable, the team coordinates with insurers regarding outstanding claim matters.
Pending queries and documentation requirements are identified and followed through.
Claim progress and settlement status are monitored through the relevant workflow.
Settlement amounts are reviewed for potential deductions or differences requiring further attention.
The payment status of processed claims can be tracked to improve visibility for hospital teams.
Outstanding or delayed claims can be identified for appropriate follow-up and escalation.
iServices Alliance Solutions works toward structured settlement follow-up with an operational TAT of 21–22 working days. This helps create a defined process for monitoring claims after submission rather than leaving settlement dependent on occasional manual follow-ups.
The process focuses on:
Important: The 21–22 working day figure represents the applicable iServices operational follow-up/process capability. Actual insurer or TPA settlement timing can vary based on payer response, documentation, queries and other external factors.
A claim should not be considered complete simply because a payment has been received. The hospital must also establish whether the amount received matches the amount that was approved and expected. This is where hospital insurance claim reconciliation becomes critical.
iServices Alliance Solutions helps hospitals compare and validate:
Verified from pre-auth records
Actual hospital billing
Net payment credited
Payer deductions identified
Non-covered co-pays
Pending balance to collect
Actionable appeals & short-settlement recovery
The objective is to identify discrepancies that may otherwise remain hidden within large volumes of settled claims.
A meticulous 8-step verification process to ensure every single rupee billed is accounted for and settled.
The settlement information is captured for review.
The approved amount is established from the available claim information.
The hospital bill is compared against the amount settled.
Relevant deductions are identified and categorized.
Differences between expected and received amounts are reviewed.
Potential errors, unexplained differences or applicable deductions are assessed.
Where recovery is applicable, the relevant follow-up process is initiated.
The claim is reconciled after the applicable differences have been addressed.
Hospitals can process thousands of insurance claims while still having limited visibility into where revenue is being lost. Reconciliation helps bring those gaps to the surface.
Potential areas of review include:
Identify amounts deducted from settlements.
Compare expected settlement values with actual payments.
Review differences associated with applicable package rates.
Identify deductions linked to documentation or process requirements.
Separate applicable non-payable items from potentially recoverable discrepancies.
Identify settlement differences requiring additional validation.
Better reconciliation gives hospital management greater visibility into where claims are under-settling and where recovery opportunities may exist.
Explore Revenue Recovery Opportunities →iServices Alliance Solutions uses RPA-powered processing to support repetitive activities throughout the claims lifecycle.
Structured technology for insurance workflow management.
Better connection between hospital systems and claims operations.
Qualified professionals validate claims and manage exceptions.
Final quality review before claim submission.
This creates a model where automation handles repetitive work while experienced professionals focus on quality, judgement and exceptions.
Explore RPA-Powered Claims Management →Transforming insurance claims from an administrative burden into a predictable, accelerated revenue stream.
A structured process helps move claims from preparation to submission without unnecessary internal delays.
Multiple review levels help identify potential issues before submission.
Technology and dedicated operational teams reduce repetitive manual activities.
Hospitals gain greater visibility into outstanding and settled claims.
Reconciliation helps identify deductions, short settlements and discrepancies.
Potentially recoverable differences can be identified and followed up.
Defined workflows create greater visibility across large volumes of insurance claims.
13+ years of clinical and operational depth dedicated to recovering hospital revenue.
Founded in 2013, bringing over 13 years in healthcare insurance operations.
Founders bring 70+ years of combined health insurance industry expertise.
Significant volume of claims successfully managed and processed.
Over ₹600 crore in revenue recovered through claims and reconciliation.
Consistently high claim acceptance across all major insurers and TPAs.
Industry-low disallowance rate compared to 8–12% industry average.
Final quality check conducted by a dedicated doctor before submission.
Proprietary software, HRMS/HMIS integration and RPA automation.
iServices Alliance Solutions can support hospitals across diverse operational setups.
The service can complement existing hospital teams or provide structured support across the claims lifecycle.
Discuss Your Claims Volume With Us →Clear answers regarding submission TAT, doctor-level QC, settlement tracking, and short-settlement recovery.
It is the process of preparing and submitting a hospital's insurance claim, along with the required medical, billing and supporting documentation, to the relevant insurer or TPA.
iServices Alliance Solutions has an operational capability to process eligible claims within 24–36 hours, subject to documentation availability and applicable insurer/TPA requirements.
Common causes can include incomplete documentation, missing information, unresolved queries, data inconsistencies, additional requirements and delays in communication with the relevant payer.
Claims undergo structured documentation checks, professional review, technology validation and a final quality check by a dedicated doctor before submission.
The claim moves into follow-up and settlement tracking. Relevant queries are addressed, status is monitored and outstanding matters are followed up with the applicable TPA or insurer.
It is the process of comparing the billed and approved amounts against the actual settlement received to identify deductions, short settlements, discrepancies and potential recovery opportunities.
It provides visibility into settlement differences and helps identify amounts that may require validation or further recovery follow-up.
Yes. TPA and insurer coordination, claim follow-up, query management and settlement tracking form part of the claims management process.
Submitting a claim is only one step. Hospitals need a process that protects claim quality, follows every outstanding case, tracks settlement and identifies revenue that may otherwise be lost through deductions or short settlements.
Discover how claims management integrates seamlessly with our complete suite of hospital revenue solutions.
GIPSA, GIC, CGHS, ECHS, PSU and private insurer network onboarding.
Learn more →Verify policy limits and educate patients before admission to eliminate authorization friction.
Learn more →2-hour pre-authorization and 5-hour final discharge approval to ensure claim readiness.
Learn more →