Insurance claims
Medical Insurance Claims Management Software
Every rejected claim is revenue that arrives late or not at all. AndroHealth builds the claim from the visit itself, checks it before sending, and tracks it until the payment arrives, through a certified NPHIES connection.
Fewer rejections before you send
- Every field checked before it goes to NPHIES.
- Only valid, current ICD-10 codes accepted.
- Missing required fields flagged.
- Eligibility checked at registration, and prior authorization obtained before the service.
- A history of past rejection reasons, so they don't repeat.
Track every claim
- A claims dashboard with the number and value of claims in each status: ready, submitted, approved, failed and rejected.
- Failed claims resubmitted once corrected.
- Supporting documents attached, with normal or deferred priority.
- Messages with the insurer about any claim.
Finance
Payment reconciliation
Each insurer's payments are listed with message date, settlement period, amount and NPHIES fee, and matched against submitted claims, so finance sees the differences right away.
Inside the system
Claims screens in AndroHealth
FAQ
Medical insurance claims: frequently asked questions
What are the most common reasons claims get rejected?
Wrong or outdated diagnosis codes, missing fields, and services delivered without prior authorization. The system checks for these before sending.
Can a rejected claim be resubmitted?
Yes. Failed claims are resubmitted once corrected, with the rejection reason shown.
Does it handle pharmacy claims?
Yes, from the AndroHealth pharmacy workflow.
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