Cashless decisions in 30 seconds — with the audit trail IRDAI wants.
Built for Indian TPAs and the hospital networks that bill them. NABH-aware, NPPA-priced, IRDAI-grade signed audit on every decision. Hindi reply support in chat.
The pain we hear, every week.
Cashless approval queues
TPA officers triage 80–150 cashless requests a day. Each one needs policy lookup, NABH tariff cross-check, NPPA price cap verification, and exclusion review. Adjudo does it in seconds.
Hospital push-back
When a hospital disputes a deduction, the officer has 60 minutes to defend it. Cited clauses + NPPA references on every Adjudo decision means the answer is already written.
IRDAI audit fire-drills
8-year retention, every decision reproducible from prompt + model version, signed and hash-chained. We don't just store logs — we make tampering mathematically detectable.
How it fits your workflow
Plug into your claims platform
We integrate with the major Indian TPA platforms. Pre-auth requests, final bills, discharge summaries — they all come in via API or SFTP.
Shadow mode pilot
1–2 weeks adjudicating in parallel without enforcement. Your senior officers compare Adjudo's calls to theirs and tell us where to tune.
Officer console
Each officer gets a console: claim card, AI decision with cited clauses, claim-scoped chat for follow-ups, and an approve/override button. Every action is logged.
IRDAI-ready audit pack
One click exports a regulator-ready bundle: signed adjudications, prompt hashes, model versions, officer overrides, hash-chain verification report.
Frequently asked
We meet IRDAI's audit-trail expectations: append-only adjudication ledger, 8-year retention, signed and hash-chained, with full prompt + model version provenance.
Yes. NABH tariffs are encoded as policy clauses; NPPA caps are enforced at the line-item level. Both are cited explicitly on every deduction.
The reviewer console supports English UI today; chat replies in English by default but the underlying model can produce Hindi when the officer asks.
Yes. NABH-bound hospitals and TPAs with strict data residency rules can run Adjudo entirely inside their VPC or on a single GPU appliance.
Want to see it on a real claim?
Send us one (de-identified). We'll adjudicate it live and walk you through the decision.
Talk to us