Bill & Tariff Audit
Every hospital bill audited line by line against agreed tariffs and packages, every deduction cited.
Why it matters
Itemised bills run to hundreds of lines; auditors sample them, and unbundled packages, inflated rates and items not matching treatment slip through.
How the solution handles it
Agents read the itemised bill, match each line to agreed rates, find items billed separately inside packages, check bills against the treatment recorded and write a cited audit note. A medical auditor confirms each deduction.
How a bill moves
Five agents read, match tariffs, unbundle packages, check against treatment and write the audit note; a medical auditor confirms each deduction.
What it reads, and what it hands back.
What goes in
- Itemised hospital bill
- Agreed tariff and package list
- Discharge summary and case notes
- Pharmacy and consumables list
What comes out
- Audited bill with deductions
- Cited audit note
- Provider pattern report
Who uses it
The difference, in numbers.
Every figure is labelled: a target the solution is built to, an estimate, a typical published result, or a proven one.
“Target” = design goal, measured in the live solution · “Estimated” = our estimate · agents = the live solution’s configuration
5 specialist agents. One person decides.
More in this division.
Every cashless request checked against policy and tariff, ready for a doctor well inside the 1-hour clock.
Discharge SettlementEvery final bill checked against the pre-auth and tariff, so final authorisation lands well inside 3 hours.
Reimbursement ClaimsEvery reimbursement claim read, checked and priced, with a cited file ready for decision in a day.
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