Finance
TPA & Insurance Software for Modern Hospitals
Manage TPA and insurance-sponsored patients from admission to settlement, with claim amounts, approvals and TDS tracked against every case.
Key Features
Everything You Need to Run TPA / Insurance
Sponsor & scheme tracking
Record the sponsoring TPA, insurer or government scheme (such as a state health scheme) against an admission.
Claim amount tracking
Track claimed, received and pending amounts per case.
TDS handling
Record TDS deductions as part of the settlement calculation.
Settlement status
Move a claim through pending, received and settled states.
Admission-linked claims
Every claim is tied directly to the relevant IPD admission.
Settlement notes
Keep a record of settlement communication and notes per claim.
How It Works
TPA & Insurance Workflow
Raise
A claim is raised against the sponsor once treatment and estimated cost are confirmed.
Approve
Approval status and any pre-authorization details are recorded.
Treat
Treatment proceeds while the claim remains linked to the admission.
Settle
The claim is reconciled and marked settled once payment is received.
Benefits
Why TPA / Insurance on Neptune HMIS
- Clear visibility into pending vs. settled claims
- Fewer disputes from missing claim documentation
- Faster reconciliation of TPA/insurance receivables
- One place to track every sponsored admission
Who Should Use It
Built For
- Hospitals empanelled with TPAs and insurers
- Hospitals under government health schemes
- Multi-specialty hospitals with high insured patient volume
- Hospital accounts teams managing receivables
Related Modules
Works Seamlessly With
Billing & Accounts
Bill consultations, lab tests, pharmacy sales and IPD stays from one consolidated invoice, with clear visibility into payments, dues and daily collections.
IPD Management
Give your inpatient teams one connected view of every admitted patient — bed status, nursing notes, doctor visits, medication and billing — from admission to discharge.
MIS & Analytics
See how your hospital is performing right now — revenue, occupancy, OPD volume and department activity — without waiting for someone to compile a report.
CRM
Neptune's CRM for growing businesses — capture inquiries and leads, send GST-ready quotations, track calls and follow-ups, and collect payments in one connected workflow.
Further Reading
Guides Covering TPA / Insurance
TPA / Insurance FAQs
Yes, the admission type and sponsor fields can record government scheme details alongside standard TPA and insurance claims.
Ready to See TPA & Insurance in Action?
Get a personalized walkthrough of the TPA / Insurance module mapped to your hospital's workflow.