The patient is told directly
Status, what is still needed and what a decision means go to the member on WhatsApp or email, in their own language — so fewer of those questions arrive at your counter.
Gooclaim OS
Use case · Hospitals
For hospitals. When your TPA runs this, your desk stops being the help line.
Gooclaim OS is bought by the TPA or the insurer, not by you. But your front desk is where the patient asks, so what it changes is worth knowing — and worth asking your TPA for.
Nothing to install hereBought by your TPA or insurerEvery message on the record
The problem · in one number
3 hours
allowed from your request to the final authorisation on discharge
That window belongs to the insurer, but the patient is sitting in your bed and asking your staff. Today the only way to know where the request stands is to call, so your billing desk spends the three hours on hold and the patient blames the people in front of them.
IRDAI circular, 5 September 2024 — clause 3(iii)
What Gooclaim OS does for Hospitals
Documents stop going through you
The TPA asks, the member gets an upload link, the file is checked on arrival and lands in the TPA's own folder. Your desk is not the courier.
The clock is counted, not guessed
Every claim carries its 1 hour, 3 hour and 15 day windows with the time left on each — so a request that is about to breach is visible to the TPA before you have to chase it.
Nobody has to remember
Reminders go on day 7, day 14 and a final notice on day 21, and the claim is never closed for a missing document. Discharge paperwork stops depending on who was on shift.
A record you can point at
What the member was asked, when, and what they were told is on the claim with its timestamps. The “TPA said / hospital said” argument has an answer.
Nothing to install
There is no hospital system to roll out, no portal to learn and no integration on your side. It runs where your TPA runs it.
Who this is for
Three people own this in your org.
Gooclaim OS shows up first for these roles — but the platform serves the entire claim chain.
Hospital Administrator
Owns bed turnover and how the wait feels to the patient.
Billing / Insurance Desk
Spends the day on hold with TPAs for statuses the patient has already asked for.
Group IT Head
Would rather not add a seventh portal to the four already on the desk.
Ask your TPA whether they run this. Or tell us who they are.
A hospital-facing surface is not built yet, and we would rather say so than sell you one. If the wait at your desk is worth fixing, the fastest route is the TPA your network already works with — and we are happy to talk to them with you.