Adjudicate claims end-to-end, coordinate provider networks, enforce compliance, and deliver real-time visibility to every stakeholder — all from one intelligent platform.
Purpose-built for TPAs who need speed, accuracy, and compliance at every stage of the claims lifecycle.
Rule-based engines automatically approve straightforward claims, reducing manual workload by up to 60%.
Onboard hospitals, manage tariff agreements, track empanelment status, and coordinate cashless authorizations.
OCR-powered document ingestion, auto-extraction of claim details, and intelligent validation against policy terms.
Pattern-matching algorithms flag suspicious claims, duplicate submissions, and anomalous billing in real time.
Track incurred claims ratio, utilization trends, disease-wise breakdowns, and provider performance dashboards.
Built-in IRDAI reporting templates, audit trails, TAT monitoring, and automated escalation workflows.
Monitor every claim from intake to settlement. Drill into TAT breaches, pending authorizations, and provider performance — all in real time.
Manage pre-authorization requests, real-time approvals, enhancements, and final discharge — all digitally coordinated between hospitals, insurers, and members.
Hospitals submit pre-auth digitally with diagnosis, procedure codes, and estimated costs — no paperwork.
Auto-approve eligible requests within minutes based on policy terms, sub-limits, and utilization history.
Handle cost revisions, extended stays, and additional procedures without restarting the approval cycle.
Auto-calculate final payable, apply co-pay/deductibles, and trigger settlement to the hospital.
A streamlined claims pipeline from intake to settlement — designed to minimize TAT and maximize accuracy.
Receive claims digitally from hospitals, members, or insurers with automated document validation.
Cross-check policy terms, coverage limits, pre-existing conditions, and supporting documents.
Auto-approve eligible claims or route to medical reviewers with all relevant data pre-populated.
Process payments, generate settlement letters, and update MIS reports — all automated.
See how Jiffy Benefits helps TPAs process claims faster, detect fraud earlier, and stay compliant effortlessly.