TPA Reconciliation
Insurance claim payment reconciliation and deduction analysis
Total Billed (Jun)
₹4,50,000
Approved Amount
₹3,92,000
Total Deductions
₹58,000
Pending Collection
₹2,02,000
| Claim ID | Patient | TPA | Billed | Approved | Deducted | Reason | Status | Remittance |
|---|---|---|---|---|---|---|---|---|
| CLM-2026-0841 | Rajan Kumar, 58M | Star Health | ₹1,55,000 | ₹1,48,000 | ₹7,000 | Non-covered consumables per policy | Received | 22 Jun 2026 |
| CLM-2026-0832 | Gopal Mehta, 65M | ICICI Lombard | ₹1,85,000 | ₹1,50,000 | ₹35,000 | Implant cost above TPA tariff — partial approval | Pending | Pending |
| CLM-2026-0825 | Priya Sharma, 34F | United HealthCare | ₹42,000 | ₹42,000 | — | — | Received | 23 Jun 2026 |
| CLM-2026-0818 | Sunita Bose, 52F | Medi Assist | ₹68,000 | ₹52,000 | ₹16,000 | Pre-authorisation not raised for add-on procedure (SLNB) | Discrepancy | Pending |