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From discharge to payment: making cashless claims settle faster

How linking eligibility, pre-authorisation and clinical evidence on one exchange removes the back-and-forth that delays cashless claims.

1 min readBharathiExchange Team

This is an illustrative scenario showing how the platform is designed to work.

Cashless claims often stall on the same problems: an eligibility detail was wrong, the pre-authorisation lacked a report, or the final bill codes don't match what was authorised.

One connected flow

Step Transaction What BharathiExchange adds
Registration Eligibility check (270/271 or FHIR) Benefits cached with the admission
Pre-authorisation 278 or FHIR pre-auth Clinical notes and reports attached from the HIE record
Discharge Claim (837 or FHIR Claim) AI pre-check for coding and package mismatches
Settlement Remittance (835) Automatic posting and denial reason tracking

Why it's faster

  • No missing documents: evidence is pulled from the record, not scanned and emailed.
  • Fewer queries: codes are checked against the authorised package before submission.
  • Visible status: hospital billing teams see every claim's status in one queue.

Read more about our EDI integration.

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