PreAuthPro

PPreAuthProOPD QR · Cashless pre-auth

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Pre-auth worklist

All live cases, soonest SLA-breach first. Red = breached/at-risk; chase those first.

Patient	Insurer	Status	SLA	Queries	Est.
No live cases

1 · Patient & clinical details

Fill the details, or scan a document to auto-fill — then open the pre-auth form to review & generate. You can also scan & type directly inside the pre-auth form.

📋 Documents needed — keep these in hand

Core for any cashless case (🔎 = scan to auto-fill):

🔎 Aadhaar card — front & back (name, DOB, address)
🔎 Policy / e-card (insurer, policy no, member/UHID ID)
🔎 OPD paper / consultation note (diagnosis, clinical details)
Cost estimate — auto-pulled from your saved tariff (room × days)

Reimbursement also needs:

🔎 PAN card · 🔎 Cancelled cheque (NEFT)
🔎 Discharge summary · Final bill · ICP (case papers) · Medicine prescriptions
If applicable: medicine/lab/radiology/implant bills & reports, pre/post-hosp bills, OT notes

Set up once (hospital):

Form C / ROHINI cert, tariff sheet, hospital seal, default doctor — done in the owner console.

The pre-auth form / Claim Form A&B is generated in-app — you don't bring it.

📄 Scan to auto-fill:

Accepts JPG, PNG, WebP, GIF or PDF. Extracted fields fill the form below — review before generating.

Patient name *

Date of birth (Aadhaar)

Age *

Gender *

Patient / UHID

Policy number

Insurer / TPA

Patient address (from Aadhaar)

ICD-10 diagnosis search

Diagnosis *

ICD-10 code *

Anaesthesia

Chief complaint *

Examination findings (O/e, P/R)

Treatment plan *

Complaint duration

Doctor name *

Qualification *

NMC / Reg no. *

Department *

2 · Pre-auth form & send

E-signatures

Patient signature

Doctor signature

Case documents auto-deleted after 24h

Store the case file (Aadhaar, policy, reports, AL) temporarily. Requires patient consent. ID numbers are masked in the record; files are permanently deleted 24h after upload.

Patient consents to temporary (24-hour) storage of these documents.

Consenting person's name

⬆ Upload document

Type	File	Ver	Expires in
No documents stored

3 · Pre-authorisation

Medical-necessity justification

Pre-empts the "could be managed OPD / not justified" query. Generates a draft from the case; edit & save — it prints on the pre-auth PDF.

Conservative/OPD management failed

For how long (conservative)

Key investigations

Comorbidities

Insurer query points (optional — scan the insurer query letter, or type one point per line)

Status & timeline

Insurer / TPA queries

Log every query; answer all before re-submitting. Each shows on the case history.

Query

Discharge readiness & enhancement

Tick each item before sending the final/discharge request. If the final bill exceeds the approved amount, raise an enhancement first.

Final bill prepared Discharge summary ready Investigation/OT reports Implant invoice/stickers Signatures captured

Final bill amount ₹

Stage

Enhancement ₹

Reason

Recent OPD records

Most recent records you have access to.

OPD No.	Patient	Diagnosis	ICD	Date
—

Insurance rate list

Set your negotiated package rates per insurer + procedure. A matching rate auto-fills the pre-auth cost. Leave ICD blank to apply to any procedure; pick "Any insurer" for a default rate.

Insurer

ICD-10 code (optional)

Procedure / package name *

Package amount ₹ *

+ Optional itemised breakdown (for the Part-C cost table)

Days

Room type

Room / day

Room charges

ICU

Surgeon

Anaesthesia

Consultation

Medicine

Diagnostic

Misc

Insurer	ICD	Procedure	Amount	Days
No rates yet — add one above

Doctors (for WhatsApp justification)

Add treating doctors with WhatsApp numbers. On any insurer query you can then send the justification request to the doctor on WhatsApp in one tap.

Doctor name *

WhatsApp number *

Qualification

Reg. no.

Name	WhatsApp	Qualification
No doctors added

Insurer submission portals

Set each insurer's provider-portal link and/or pre-auth email. The pre-auth screen then gives a one-click "Submit" that opens the portal / email with the PDF ready to attach. (The app does not auto-login to insurer portals.)

Insurer

Provider portal URL

Pre-auth email

Notes

Insurer	Portal	Email
No portals configured yet

Room-rate tariff

Per room category for your hospital. Cashless tariff drives Cashless & Cashless-Everywhere pre-auths; Hospital tariff drives Reimbursement. Add or remove rooms, then Save.

Insurer mail — auto-pull (Gmail)

Pull insurer / TPA replies (cashless approvals, queries, denials) into PreAuthPro and link them to the case, so none are missed. The app reads your inbox read-only over a secure connection — it never sends, deletes or moves mail. Uses a Gmail App Password (not your login password), stored encrypted.

Reimbursement claims

Patient paid first, claims back from the insurer after discharge. Build the document checklist during the stay so the packet is ready to dispatch the moment they're discharged — no delay.

Patient	Insurer	Docs	Status
No claims yet

New reimbursement claim

Open a claim at admission, then attach documents as they're generated so nothing is hunted for at discharge.

Auto-fill from Aadhaar (front & back): 📁 Upload file(s)

Patient name *

Phone

Insurer

Policy number

Admitted on

Discharged on

Cashless Everywhere

Cashless at a non-network hospital (GI Council initiative). The clock is everything — intimate the insurer 48h before a planned admission / within 48h of an emergency, and the IRDAI 1-hour auth / 3-hour discharge TATs apply.

Patient	Insurer	Type	Intimation	Status
No cases yet

New Cashless Everywhere case

Open at (or before) admission so the intimation deadline starts tracking immediately.

Auto-fill from documents: 📁 Aadhaar 📁 Policy 📁 OPD paper

Patient name *

Phone

Insurer

TPA (if any)

Policy number

Member ID / UHID

Admission type

Planned admission date

Actual admission (YYYY-MM-DD HH:MM)

Provisional diagnosis

ICD-10

Est. cost ₹

Bed count

Estab. reg no.

PreAuthPro · standalone service · QR-signed OPD & multi-insurer cashless pre-auth, Cashless Everywhere & reimbursement automation

Pre-auth worklist

1 · Patient & clinical details

2 · Pre-auth form & send

Estimated cost of hospitalisation — edit if needed

E-signatures

Case documents auto-deleted after 24h

3 · Pre-authorisation

Medical-necessity justification

Status & timeline

Insurer / TPA queries

Discharge readiness & enhancement

Recent OPD records

Insurance rate list

Doctors (for WhatsApp justification)

Insurer submission portals

Room-rate tariff

Insurer mail — auto-pull (Gmail)

Reimbursement claims

New reimbursement claim

Claim

Claim data · Form A & B

Generate insurer form

Cashless Everywhere

New Cashless Everywhere case

Case

Compliance clock — record each event when it happens

Documents

Actions

Know Your Policy (KYP)

Policy

Insured members

Remark & sign-off

Pre-auth worklist

1 · Patient & clinical details

2 · Pre-auth form & send

Estimated cost of hospitalisation — edit if needed

E-signatures

Case documents auto-deleted after 24h

3 · Pre-authorisation

Medical-necessity justification

Status & timeline

Insurer / TPA queries

Discharge readiness & enhancement

Recent OPD records

Insurance rate list

Doctors (for WhatsApp justification)

Insurer submission portals

Room-rate tariff

Insurer mail — auto-pull (Gmail)

Reimbursement claims

New reimbursement claim

Claim

Claim data · Form A & B

Generate insurer form

Cashless Everywhere

New Cashless Everywhere case

Case

Compliance clock — record each event when it happens

Documents

Actions

Know Your Policy (KYP)

Policy

Insured members + member

Remark & sign-off

Insured members