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HomeCase StudiesPM-JAY Claims AI — 34-Hospital India Chain
AI AUTOMATIONInsuranceIndia

PM-JAY Claims AI — 34-Hospital India Chain

Pre-auth 3 days→2 hours | Rejection -64% | ₹8.4Cr fraud recovered
12 weeks

The Problem We Were Brought In To Solve

34-hospital chain: 1,800 monthly Ayushman Bharat claims, 3-day pre-auth wait, 22% rejection rate, ₹2.1Cr annual fraud from inflated submissions.

How Revino Delivered

AI PM-JAY platform: NHA eligibility verification, treatment code validation, duplicate claim detection, pre-auth document generation integrated with NHA portal.

Measurable Business Impact

Pre-authorisation: 3 days→2 hours
Rejection rate: 22%→8% (-64%)
Fraud recovery: ₹8.4Cr in Year 1
Claims admin staff time: -68%
NHA review compliance: 100%
PythonNHA APIAWSFastAPIPostgreSQL
Insurance IndustryAI Automation & AnalyticsBusiness Process Management
KEY METRICS
2 hrs
Pre-auth time
-64%
Rejection rate
₹8.4Cr
Fraud recovered
100%
NHA compliance
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