Snap the bill.
Get paid.
Saw a doctor outside the network? Photograph the bill and the prescription. You'll watch it get read, checked and decided — and the money lands in your bank with a reason for every rupee.
Claim CLM-20481
City Care Clinic, Pune
Rahul Mehra · fever, out of network
Paid to you
₹1,200
₹250 not payable · see why
- SubmittedBill + prescription · 21 Oct, 18:02
- Bill read4 lines found · City Care, Pune
- Checked against your policyPharmacy & consult rules applied
- Decided₹1,200 of ₹1,450 approved
- PaidTo HDFC ••21 · 23 Oct
Not payable
Multivitamin · ₹250
Not on the prescription you uploaded
Disagree? Add a document and reopen
0
claims to file for a network visit
2
photos to file one outside it
1
written reason for every rupee not paid
5
stages you can watch it move through
The claim on this page is one illustrative visit, followed from the photo to the bank.
From a photo to your bank.
Six things happen to every claim, in this order. You can see which one yours is at, and who has it, the whole way through.
Photograph the bill
Bill and prescription, from the app, for yourself or a dependant. No form, no courier, no originals sent anywhere.
The bill is read
Clinic, doctor, date and every line item are pulled off the photo. If a line can't be read, you're asked about that line — not to start again.
Each line meets your policy
Who was treated, which category, what's left in that pocket, the co-pay, and what your plan excludes.
It's checked before it's paid
Duplicate, tamper and doctor-registration checks run on every claim. A flag sends it to a person, never to an automatic no.
A doctor looks, when it needs one
Anything clinical — a test without an obvious reason, a long course of medicine — is read by a CheckMed doctor, not a rule.
Paid to your bank
To the account verified in your app, with the wallet showing exactly what it drew and a decision you can read line by line.
Inside the network none of this happens — the wallet pays at the desk and there is no claim to file.
A reason on every rupee not paid.
A claim isn't approved or rejected as a lump. Each line is held against the policy on its own, so one supplement doesn't sink a consultation — and you see exactly which line, and why.
What the bill says
read from the photoChecks run
before payment- Member covered on 21 Oct
- Doctor's registration verified
- Bill not seen on any other claim
- No signs of an edited image
- Amounts within the clinic's usual range
- Prescription dated before the bill
₹1,200 is on its way to HDFC ••21. We couldn't pay ₹250 for the multivitamin because it isn't on the prescription you uploaded. If Dr Kulkarni prescribed it separately, add that prescription and reopen this claim.
Lines, not lumps
Three lines paid, one held. The decision is as granular as the bill.
Plain words to the member
The reason is written for the person who paid, not coded for an auditor.
Reopening is one tap
Add the missing document and the claim returns to a different reviewer.
Every claim, in one register.
Where claims are, and why money wasn't paid — in aggregate. The pattern in the reasons is usually a communication problem HR can fix in one email.
Statuses and reasons are counted, not named. Bills, prescriptions and diagnoses stay with the member and the reviewing doctor.
Where claims are
567 this monthWhy money wasn't paid
share of held lines- Item not on the prescription38%
- Category cap already reached27%
- Excluded by the plan21%
- Bill dated outside cover14%
An illustrative month. Exported in a shape that reconciles against the insurer's own file.
When do I need to file a claim?
Only when you were treated outside the CheckMed network — travelling, an emergency, a doctor you already see. Anything at a network clinic, lab or pharmacy is paid at the desk from your wallet, and there is nothing to file.
What do I need to upload?
A clear photo of the itemised bill and the prescription it relates to. For lab tests, the doctor's request; for medicines, the prescription that lists them. If something is missing, the app tells you which document and holds the claim rather than rejecting it.
How long until I'm paid?
The app shows which stage the claim is at and who has it, as it moves. If it needs a doctor's review or another document, you hear that day — not at the end. We'd rather show you the clock than print a number in a brochure.
What if I disagree with a decision?
Every line that wasn't paid has its reason next to it. Add the document that answers it — a corrected prescription, a referral — and reopen the claim. A reopened claim goes to a different reviewer from the one who decided it.
Does this cover hospital admissions?
No. In-patient claims stay with your insurer and their TPA, under IRDAI's cashless rules for hospitals. This handles the everyday, out-patient care your employer's wallet funds — the part a hospital policy never pays for.
Make the claim the easy part.
Book a walkthrough and we'll run a claim through your own policy rules, from the photo to the payout.