> _insight_detail
Hospital Revenue Cycle: Why TPA Claims Stall and How Automation Fixes It
>Leads for hospitals are not Instagram DMs — they are TPA pre-auths, insurer packets, and corporate referrals. A revenue-cycle layer does OCR on authorizations, validates Ayushman/TPA packets, RPA-follows the portal, and tracks each claim from pre-auth to settlement with denial prediction. Corporate tie-ups and doctor referrals get a pipeline with SLA. For a 150-bed hospital, this cut follow-up from 22d to 9d and packet completeness from 71% to 96% — without adding billing headcount. If you run 500+ admissions/month, a claim tracker alone pays for itself in unlocked beds.
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