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Customer stories/Large Health Insurer

Transforming health claims processing into a unified digital experience

How a large health insurer built a single, unified portal for claims, pre-authorization, and real-time SLA monitoring across hospital networks.

Transforming health claims processing into a unified digital experience
  • 3-hour SLA actively monitored

  • 15 MB multi-format document uploads

  • 100% unified claim visibility

Company

Large Health Insurer

HQ / Location

New Delhi, India

Industry

Healthcare & Life Sciences

Department

Operations

Scale

11M insureds

The challenge

At a major health insurer, claims were processed through fragmented workflows that forced hospital staff to navigate multiple screens and complex logins. Without real-time monitoring, claims pending beyond three hours often went unnoticed. Manual data entry and rigid document rules slowed approvals and delayed patient discharge.

Use cases transformed into AI-Native

With UnifyApps, the insurer replaced fragmented hospital workflows with a unified, AI-native portal for claims, documents, and real-time SLA tracking:

Niva Bupa IHX - TPA claims portal

IHX - TPA claims portal

  • BEFORE Multi-screen navigation with repeated logins

  • COST Delayed approvals and missed SLAs

  • AFTER Single-tab portal with enabling approvals within 3 hours

Business Impact

Faster approvals and proactive SLA management

Niva Bupa Document management & pre-authorization

Document management & pre-authorization

  • BEFORE No post-submission document updates; limited file support

  • COST High rejection rate due to uncorrectable uploads

  • AFTER Editable submissions with support for 7 file formats up to 15 MB

Business Impact

Reduced rework and faster authorizations

Rapid interface deployment

Traditional TPA portals take months. UnifyApps delivered production workflows in weeks.

Scalable, Reusable Foundation

By reusing integrations and data objects—including Claims, Patient Records, and Treatment Details—the team built a foundation that supports active monitoring and seamless data flow:

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AI doesn’t scale through pilots. It scales through architecture.

See how UnifyApps helps operations and claims department teams build once and scale AI everywhere.