Live claim intelligenceDraftPRU-PA-2026-001142
Your cashless care is already moving.
Dr. Rao recommended phacoemulsification with monofocal iol — right eye for Vinod Sharma. Prudential has pre-filled the cashless packet for Fortis Memorial Research Institute.
HospitalFortis MemorialProcedurePhacoemulsification with monofocal IOL — right eyeLikely approved₹40.0KYou pay₹20.0K
AI confidence
Coverage decision quality
90%
Packet reviewed1.4s
Rules checked17
Hospital syncNetwork
Next updateSubmit packet
AI concierge
What Prudential is handling for you
Today
I am watching the hospital packet, policy rules, and likely counter payment.
I have the patient, diagnosis, hospital estimate, and cataract sub-limit ready. Submit pre-auth when the family confirms the Fortis package.
Review AI summary
See what was extracted from the hospital packet.
Ask about coverage
Get a clause-backed answer in plain English.
Member effort removed
Forms, uploads, and follow-ups automated
82%
Autonomous claim pathway
A live view of the systems working behind the scenes
Care recommended
Vinod Sharma's cataract package is ready for cashless pre-auth.
2
Hospital initiated
Fortis Memorial Research Institute submitted the pre-auth packet.
3
AI adjudication
Policy, clinical, network, and fraud checks completed.
4
Cashless approval
Approval letter and conditions are available to the TPA desk.
5
Admission and care
Enhancements and stay events are monitored automatically.
6
Final bill and payout
Discharge bill is reconciled and hospital settlement is prepared.
Next best action
Start cataract pre-auth
Review the pre-filled packet and send it to the hospital TPA desk.
ContinueNo-surprise money view
What is likely covered, paid, and collected
Expected member payable
₹20,000
Mostly non-medical or sub-limit items. The app explains every rupee before discharge.
Bill₹60.0KLikely approved₹40.0K
Hospital estimate₹60,000
Likely approved by Prudential- ₹40,000
Non-medical items₹2,400
Room/sub-limit impact₹17,600
Expected at counter₹20,000
Digital policy twin
Your cover as a live system
Prudential Shield · Family Floater
₹10,00,000
Total usable cover with NCB: ₹12,00,000
Valid till
31 Mar 2027
Policy
PRU-FF-2025-008821
Premium
₹28,450 / yr
Utilised this year₹0 / ₹10,00,000
Family care layer
5 covered lives
RS
Rohan Sharma
Self · 39y
PS
Priya Sharma
Spouse · 36y
AS
Aarav Sharma
Son · 9y
AS
Ananya Sharma
Daughter · 6y
VS
Vinod Sharma
Father · 67y
AI policy assistant
Embedded from the policy Q&A experience
Will I pay anything at discharge?
AssistantBased on the active claim, the likely member payable is only for non-medical or sub-limit items. I can show the clause and line-item split.
Benefit signals
The policy facts most useful during care
Room rent / day
₹10,000
ICU rent / day
₹20,000
Ambulance / event
₹2,000
Co-pay
None
Restoration
Available
No-claim bonus
+20%