PMJAY · Ayushman Bharat · NHCX

Hospital software for PMJAY and cashless claims

Government-scheme and insurance patients need pre-authorisation, package-based billing and timely claims. HISVention keeps all of it linked to the same patient bill.

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Payer-wise tracking

Track requests by payer, including government schemes and private insurers.

Package billing

Procedures and packages mapped to plans and tariffs.

Pre-auth to claim

Raise, follow and close requests from one screen.

Reporting

Approved amounts, pending requests and denials in revenue reports.

Why scheme billing is different

Scheme and insurance billing is package-driven, requires pre-authorisation before certain procedures, and is paid after claim review. Delays or rejections directly hit hospital cash flow.

How HISVention supports it

The RCM module provides NHCX operations — new case, pre-authorisation and claim — with status for each request (approved, pending, query, rejected). Package & Plan maps procedures to plans, and IP Billing applies them to the patient’s bill.

Coverage of specific schemes and payers depends on your region and integrations — confirm the current scope in a demo.

See it on your own scenarios

Free, no-obligation demo tailored to your hospital.

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FAQ

Frequently asked questions

Does HISVention track PMJAY requests?

The RCM workspace tracks pre-authorisations and claims payer-wise, including PMJAY. Confirm current integration scope for your state during a demo.

What is a pre-authorisation?

Prior approval from an insurer or scheme for a planned procedure and its estimated cost, needed before cashless treatment.