CareNav India is a claims management platform that streamlines hospital insurance workflows by consolidating documents, checks, communication, and status tracking into a single interface. It integrates with hospital management systems via HL7/FHIR or operates through WhatsApp uploads, reducing manual review load by 30-40% and accelerating claim closure by 20-30%. The platform also validates submissions for ABDM compliance and provides an AI assistant to resolve insurer queries faster.
Funding
Funding not disclosed
Founders
Product
Problem
Hospital claims processing is slowed by fragmented information across documents, communication channels, and status tracking systems. This fragmentation increases manual review workload, delays claim closure, and leads to higher rejection rates due to incomplete or non-compliant submissions.
Solution
CareNav India provides a unified claims workflow platform that consolidates documents, checks, communication, and status into one clean interface. It connects directly to hospital management systems via HL7/FHIR feeds, or operates standalone through WhatsApp uploads when no HMIS integration is available. The platform validates all documents for completeness and ABDM compliance before submission, reducing rejections and ensuring submission-ready claims. An AI assistant actively monitors claims, catches insurer queries, and responds with the right information attached, while a centralized dashboard shows every active claim, its priority, and what needs attention.
Target Audience
Primary users are hospital billing and claims teams, including medical records departments and insurance coordinators at hospitals of varying sizes, from those with modern HMIS to those operating on manual or WhatsApp-based workflows.
Features
- HL7/FHIR integration with modern HMIS for automated data exchange, plus WhatsApp upload for hospitals without HMIS
- Document validation engine that checks discharge summaries, hospital bills, and lab reports for completeness and ABDM compliance before submission
- Unified claims dashboard showing active claims, priority flags, due dates, and approval status in real time
- AI assistant that monitors insurer queries, drafts responses, and attaches relevant documentation for faster resolution
- Automated workflow that reduces manual review load by 30-40% and accelerates claim closure by 20-30%