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.

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Outlets · 340 · live Live

Group revenue · today across outlets

₹4.18 Cr

▲ Insurance settlements ₹84.2 L

Star · Cigna 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 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

I. Built for clinical networks

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 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

Niva Bupa

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

II. Six workflows for hospitals + clinics

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 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.