SurgySettle: Revenue Recovered

SurgySettle automates the hospital revenue cycle from discharge to settled insurance claim — it drafts the ICD-coded discharge summary, reconciles the bill against tariffs and packages, builds the insurer packet, uploads it to the TPA portal, risk-scores every claim before filing, and tracks payment follow-up until money lands. It runs alongside the existing EHR rather than requiring an integration project.

Under 48 hours in CSV/Excel mode: the hospital drops daily exports and SurgySettle starts working, with no IT lift. Hospitals that prefer automation can move to scheduled cron pulls from HIS exports, and groups with in-house IT can use the API / HIS deep-link mode later — the switch does not restart the rollout.

SurgySettle is built to compress accounts receivable from 60–90 days to 20–35 days, cut billing workload by 50–70%, and hold claim rejection below 4%. The mechanism is simple: claims leave the hospital pre-validated and correctly coded, so fewer come back and fewer are filed after the deadline.

AutoDischarge AI drafts an ICD-coded discharge summary from IPD data, the doctor reviews and e-signs it on WhatsApp from a mobile phone, and a patient copy is auto-translated into English, Hindi or Arabic with safety disclaimers preserved. This takes the cycle from 24–72 hours down to under 30 minutes, so the summary is ready before the patient reaches the billing counter.

No. SurgySettle works entirely from data exports in its CSV/Excel mode, which is why it can be live in 48 hours. Deeper integration is available when the hospital wants it, but it is never a prerequisite for getting value in the current quarter.

SurgySettle files to major Indian and GCC payers and TPAs including Star Health, HDFC Ergo, ICICI Lombard, MediAssist, Niva Bupa, Daman (UAE), Bupa Arabia (KSA) and Tawuniya (KSA), each with its own pre-built packet format and portal automation. Payer credentials are held in an encrypted vault.

RiskScore audits every claim before submission and marks it red, amber or green, with one-click auto-fix suggestions for the issues it finds — missing documentation, coding gaps, tariff mismatches. Rejections are prevented at the point of filing instead of being appealed weeks later.

The AR Command Centre shows ageing buckets, insurer scorecards and a 30/60/90-day cash forecast, TrackPay reports live claim status across TPAs with an automated follow-up cadence, and insurer queries are pushed on WhatsApp to the responsible owner within one shift. Every action is recorded in a single exportable audit trail for finance, compliance and statutory audits.

A TPA (third-party administrator) claim is a hospital's request for payment from an insurer, processed by the TPA that manages the policy. The hospital submits the discharge summary, bills and supporting documents; the TPA checks them and approves, queries or deducts. SurgySettle prepares and checks these documents before filing to reduce queries and deductions.