Insurance claim processing in Indian hospitals is one of the biggest sources of patient frustration and staff inefficiency. Automate pre-authorisation requests, document collection, status updates, and cashless discharge communication — all via WhatsApp.
The insurance claims process in most Indian hospitals involves phone calls, physical document submission, manual status updates, and anxious patients calling the billing desk every hour. WhatsApp changes the entire communication layer.
| Step | Current process | With WhatsApp (WA.Expert) |
|---|---|---|
| Pre-authorisation request | Phone call to TPA + email + 4–6 hr wait | Automated WhatsApp to TPA — 45–90 min turnaround |
| Document collection (reimbursement) | Patient carries physical copies or emails scans | Patient photos and sends via WhatsApp — auto-organised |
| Claim status updates to patient | Patient calls billing desk repeatedly | Auto WhatsApp update on every status change |
| Cashless discharge communication | Billing staff manually informs patient at desk | Auto WhatsApp with approved amount + any co-pay |
| Claim rejection notification | Verbal — patient often doesn't understand reason | WhatsApp in plain language with next steps |
| TPA query resolution | Back-and-forth phone/email chain — days lost | WhatsApp thread with hospital + TPA + patient |
| Metric | Manual process | WhatsApp automated | Change |
|---|---|---|---|
| Pre-authorisation turnaround | 4–6 hours | 45–90 minutes | −75% |
| Document collection completion rate | 72% (missing docs common) | 96% | +33% |
| Billing desk calls per admission | 8–12 calls avg | 2–3 calls avg | −70% |
| Claim rejection rate (missing docs) | 18% | 4% | −78% |
| Patient billing satisfaction | 3.2/5 | 4.4/5 | +38% |
| Time to final claim settlement | 18–25 days avg | 10–14 days avg | −44% |
From pre-auth to settlement — automate every step of the insurance communication chain on WhatsApp.