Insurance billing and claims, from the front desk to the payment
Insurance patients bring revenue and paperwork. Hospify Pro puts the policy, the approval, the bill split, the claim and the insurer’s payment on one record, so nothing is claimed twice, nothing is forgotten and the patient is never chased for the insurer’s share.
Hospify Pro Insurance & Claims keeps each patient’s policy on file, splits every bill into the insurer’s share and the patient’s share, tracks pre-authorisation for admissions, opens the claim with its documents when the bill is issued, and records each payment from the insurer with any cuts. It is included in the Hospital plan and costs Tk 1,000 a month$15 a month for Clinic and Diagnostic.
Everything insurance & claims needs, on one patient record
Insurers for your country
Popular insurers, TPAs and schemes for Bangladesh, India, the Gulf, the UK, the US, Africa and international plans in one tap — each set up as direct billing, reimbursement or company credit.
Patient policies
Policy and member number, employer, validity, yearly limit and what is left, co-pay, deductible and room entitled, recorded once at the front desk.
Pre-authorisation
Send the diagnosis, treatment and estimate, record the approved amount and letter, ask for enhancements, and warn the ward at 80% of the approval.
The split on every bill
Lines are marked covered or not covered; the deductible, co-pay, approval and limit are applied, so the patient pays only their share. One click bills as self-pay.
Claims with documents
The claim opens when the bill is issued, with a checklist of what that insurer asks for, a printable claim form, queries, approvals and rejections in one history.
Payments and money owed
One payment over many claims, tax kept by the insurer, cuts written off or returned to the patient, posted to accounts — with ageing, days to pay and cut % for each insurer.
How insurance & claims works, step by step
- Policy added at the front desk
- Pre-authorisation for admissions
- Bill split — patient pays their share
- Claim sent with documents
- Insurer pays — cuts recorded
Availability: Included in Hospital and Enterprise. Add-on for Clinic and Diagnostic: Tk 1,000 a month$15 a month. See pricing →
Insurance & Claims: frequently asked
Which plans include Insurance & Claims?
It is included in the Hospital and Enterprise plans. Clinic and Diagnostic plans can add it for Tk 1,000 a month$15 a month.
Does it work when the patient claims back themselves?
Yes. Set the insurer as reimbursement and the desk prints certified claim papers: itemised bill, receipts, discharge summary, reports list and the doctor’s statement, with a QR code to check them.
Does the insurer’s share show as a patient due?
No. It is tracked as money owed by the insurer. Only the patient’s share is their due, so lab work starts and reports are released when the patient’s share is paid.
Can claims go to NPHIES, NHCX or eClaimLink?
Claims are prepared in a structured form and printed or emailed today. A direct electronic link to a national exchange is switched on per country when the facility is registered with it.
Modern care deserves modern software.
The team that wrote Hospify Pro is the team that answers when you message. Open the live demo for your kind of facility, sign up for a 14-day free trial with no card, or ask us which modules fit the way you already work.
