For Healthcare

TPA reimbursements. Outlet collections. Reconciled live.

Multi-outlet collections via CMS, TPA insurance reimbursement cycles, doctor + staff payroll, medical inventory financing, NMC / NABH compliance. Open is built around the way clinical networks actually operate.

Outlets · 340 · live Live
Group revenue · today across outlets
₹4.18 Cr
▲ Insurance settlements ₹84.2 L
Star · Cigna · ICICI Lombard Recon
Star Health reimbursed · ₹14.2 L32 claims settled · today
Outlet performance · 340 outlets · live
Live
Group revenue · today across outlets
₹4,18,42,000
▲ Insurance settlements ₹84.2 L
OPD · cash + UPI
340 outlets
₹2,84,40,000
POS
IPD · billed
84 IP-active outlets
₹84,21,000
BILLED
Insurance · TPA
Star, Cigna, ICICI Lombard
₹46,40,500
AGED 42d
Pharma counter
all outlets
₹14,80,000
POS
Diagnostics · lab
central + 84 outlets
₹14,10,000
BILLED
Outstanding insurance receivables?
₹2.84 Cr · 42d avg · biggest is Star Health at ₹62L.
LIVE OPEN AGENT · v2.4

The hardest part of healthcare finance, solved.

Insurance reimbursement cycles run 30-90 days. Each TPA has different EOB formats. Outlet-level cash + UPI + card collections fragment by branch. Open's substrate handles all of it.

  • 01TPA insurance reimbursement — Star, Cigna, ICICI Lombard, Care, Niva Bupa, ManipalCigna — each TPA's claim status tracked. EOB reconciled against expected amount. Short-paid claims flagged.
  • 02Multi-outlet CMS — every outlet's POS collections, UPI receipts, cash deposits — auto-reconciled to bank credits per branch. Branch P&L live.
  • 03Doctor + staff payroll — split between salary + consultation fees + revenue share. Per-doctor net realisation tracked. TDS + ESI + PF auto-deducted.
  • 04Medical inventory financing — pharmacy + diagnostics inventory funded against settlement cycles. Drawdown automatic. Per-SKU economics surfaced.
  • 05NMC / NABH compliance — clinical accreditation tracked alongside financial compliance. Single health-score dashboard for the board.
−18 d
average insurance receivable cycle reduction
340 outlets
in our largest hospital-chain deployment
Live
Outlet-level P&L · refreshed continuously
Insurance receivables · by TPA ✦ DSO 42d
Star Health
248 claims · 36 d avg
₹62.4 L ACTIVE
ICICI Lombard
184 claims · 42 d avg
₹48.2 L ACTIVE
Cigna · India
142 claims · 48 d avg
₹38.4 L AGED 60d+
Care Health
96 claims · 52 d avg
₹24.8 L AGED 60d+
Niva Bupa
84 claims · 38 d avg
₹18.2 L ACTIVE
ManipalCigna
62 claims · 44 d avg
₹14.8 L SHORT-PAY

Built around the clinical operating model.

OPD, IPD, pharmacy, diagnostics, insurance, payroll — every revenue stream and every cost stream reconciled live, outlet by outlet, doctor by doctor.

TPA insurance recon

EOB matched

Star, Cigna, ICICI Lombard, Care — each TPA's EOB reconciled against expected. Short-paid claims auto-flagged.

Multi-outlet CMS

Branch P&L live

Every outlet's POS, UPI, cash, card auto-reconciled to bank credit per branch. Roll up to group on demand.

Doctor payroll

Salary + share

Split between fixed salary + consultation fees + revenue share. Per-doctor net realisation tracked. TDS automatic.

Pharmacy + diagnostics

Inventory financing

Pharmacy + lab inventory funded against settlement cycles. Drawdown automatic. Per-SKU economics surfaced.

NMC / NABH compliance

Clinical + financial

Compliance score for both clinical accreditation and financial filing. Single dashboard for the board.

Multi-state GST

OPD vs IPD vs pharma

GST split correctly between exempt OPD, taxable pharma, mixed IPD. State-wise compliance live.

✦ For Healthcare

The clinical OS.
For everything that isn't medicine.

TPA reimbursements · outlet collections · doctor payroll · NMC compliance — reconciled live, every day.

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HUMAN AGENT