Smarter Claims. Fewer Rejections.
AI-assisted ICD-10/11 coding and multi-country DRG pre-submission audit — co-developed with a leading Hong Kong insurance group to reduce claim rejection rates.
End-to-End Claim Intelligence
From documentation completeness to final code submission — Insurance TPA is designed to reduce the 10–40% claim rejection rates common across Asian health systems.
ICD-10/11 Coding Suggestions
AI surfaces relevant ICD-10 and ICD-11 codes from clinical documentation. Coders review, confirm, and submit — AI accelerates, experts decide.
Multi-Country DRG Support
Supports diagnostic-related grouping across multiple national systems including Indonesia (INA-CBGs/iDRG), Hong Kong, Thailand, Singapore, Malaysia, Philippines, Vietnam, and Mainland China.
Documentation Completeness Check
Flags missing or insufficient clinical documentation before submission — designed to reduce rejection rates by catching gaps at source.
Pre-Submission Error Detection
Identifies coding inconsistencies and documentation mismatches before claims are submitted to insurers or national health systems.
V2N Synergy
Higher-quality SOAP notes generated by V2N produce more accurate coding inputs — the two products are designed to work together across the documentation-to-claim workflow.
Audit-Ready Output
Every coding suggestion carries an explainable rationale. Full audit trail maintained for compliance and dispute resolution.
Built for the Complexity of Asian Health Systems
Each market has distinct DRG frameworks, coding standards, and claim submission rules. Insurance TPA handles the complexity so your team doesn't have to.
Indonesia
INA-CBGs / iDRG · BPJS national health system
Hong Kong
Private insurance · Hospital Authority framework
Singapore
MediShield Life · Private health insurance
Malaysia
MySalam · Perkeso · Private insurance
Thailand
NHSO · Civil Servant Medical Benefit Scheme
Philippines
PhilHealth · Private insurance
Vietnam
BHYT National Health Insurance
Mainland China
Urban Employee Medical Insurance · NRCMS
Indonesia / BPJS: Insurance TPA supports Indonesia's BPJS Kesehatan national health system as part of a broader multi-country platform — not as a standalone BPJS-only tool. INA-CBGs and iDRG coding rules are included alongside commercial insurance coding standards.
For Every Link in the Claims Chain
Insurance TPA is designed for insurers, hospital claim departments, and third-party administrators managing multi-country claim portfolios.
Insurance Companies
Insurers handling high claim volumes benefit from pre-submission completeness checks that reduce rejection rates and administrative overhead.
Hospital Claim Departments
Hospital billing and claims teams use Insurance TPA to validate documentation before submission, reducing rework and claim delays.
Third-Party Administrators
TPAs managing claims across multiple insurers and health systems benefit from unified multi-country coding support in a single platform.
Discuss your claims challenge with our team
Insurance TPA is being co-developed with insurance partners. Contact us to explore how it fits your organisation's claim workflow.