how it works
Two engines.Every claim, ruled twice.
Arogya rules on the way in: should this admission happen, and does the policy cover it. Lekha rules on the way out: is every rupee of the discharge file right. Here they are, end to end.
see it in action
From bill to settlement,in one engine
Watch a ₹1,00,000 hospital bill get scored, financed, and tracked to settlement, the same engine that powers every Bridge case.
Hospital submits bill of ₹1,00,000
with patient policy details
AI engine decodes the policy
coverage, co-pay and sub-limits checked
Medical appraisal complete
₹96,400 approved for financing
ClaimFriendy disburses ₹96,400
directly to the hospital
Claim file submitted to insurer
patient discharged
Insurer settles ₹96,400
to the patient's account
Patient repays ClaimFriendy
cycle closed
₹0
approved on a ₹1L bill
- 10 min
- AI appraisal
- Same day
- Hospital paid
- 30 days
- Insurer settles
- ₹0
- Patient fees
the engines · at admission
Arogyarules on the way in.
Before a patient is admitted, Arogya reads the whole case, clinical file and policy together, and decides whether the admission deserves a yes.
Turns a messy file into a clean case
Scanned prescriptions, hospital notes, lab reports and policy documents, all pulled into one structured record: diagnosis, procedure, medications with dose, duration of stay.
Understands the case, not just the words
From primary diagnosis, treatment category and disease trajectory, the engine builds the clinical picture the way a reviewing doctor would read it.
Judges whether admission is warranted
Severity, hospital infrastructure required, timeline, and whether the procedure is needed now, all measured against clinical thresholds by age and condition.
Decodes the policy line by line
Insurer, product, sum insured, cumulative bonus, effective cover, co-pay, room-rent capping, sub-limits, day-care eligibility, inception date and vintage, then matches the patient to the covered member.
Checks the clock on every rule
Waiting periods, pre-existing disease, moratorium and portability continuity, each checked in order, on the dates that actually apply to this policy.
The engine recommends. A person decides.
Every verdict carries its reasoning and a full audit trail. No authorisation goes out without a human behind it.
the engines · at discharge
Lekharules on the way out.
It reads the discharge file the way a senior claims officer does, not as a bill-scanner but as a file-reader, and makes every rupee prove itself.
It reads the file, not just the bill
Final bill, pharmacy and lab breakups, implant invoices, discharge summary and PAC notes, read whole, the way a senior claims officer reads them.
Pre-auth versus discharge, line by line
PED declared at admission against PED found in the summary. Procedure sanctioned against procedure performed. Diagnosis in, diagnosis out. When the story changes on the way to discharge, Lekha is the one who noticed.
Every rupee is made to prove itself
Breakups must reconcile to the head they explain. Implants are checked against the supplier's own invoice, not the hospital's markup. Nothing gets counted twice, and nothing gets paid twice over.
The deduction chain, in the order the industry actually applies it
Struck in sequence, because the sequence is what decides the number. Get the order wrong and you're off by lakhs.
AI recommends. The human decides.
Every figure lands with its reasoning attached, in sanction-letter form. The engine carries the arithmetic. The person carries the signature.
who is it for
Built for hospitalsand policyholders
Hospitals
Turn claim bottlenecks into a growth lever.
Retain non-network patients with a near-cashless experience via Bridge
Enable same-day discharge for cleared patients via Express
Reduce claim chaos with document QC and tracking via Assist
Policyholders
Your claim, explained, supported and funded.
Get treated at your preferred hospital even if it's not on the panel
Understand your coverage clearly before committing to treatment
Zero fees: costs are covered through partner hospitals