Claims and submissions decided on the page,
inside the regulator's clock.
Gothink reads the files your teams re-key today, holds for a person what it cannot be sure of, and seals every decision as evidence an examiner can check.
Which of these sounds like this week?
Start with the one that costs you most today. That is where a pilot starts.
“Submissions sit in inboxes for days.”
Broker submissions, SOVs and loss runs read into checked fields, each cited to its page; anything uncertain goes to an underwriter, not into your system.
“Every claim file is a stack of different documents.”
Gothink Claims takes a claim from first notice to closing in seven checks, each cited and sealed. No step can deny a claim: a person closes it.
“Cashless approvals breach the IRDAI 1-hour and 3-hour limits.”
The IRDAI clock runs from your request time to your decision, alerts the moment a request is late, and reports turnaround by hospital.
“We pay hospitals more than the agreed tariff.”
Itemised bills read from the bill itself and checked against each hospital's tariff you load: above the rate, not payable, duplicates, totals. A person decides.
“Half our documents are handwritten or in Hindi.”
Printed Hindi through an in-region engine; every field read from handwriting goes to a reviewer, whatever the score.
“Examiners ask how the AI decided — and we cannot show them.”
One signed, replayable receipt per AI decision, yours or a vendor's; a sample becomes the case file an examiner reads.
Health claims in India, prior authorization in the US
Both markets, one platform. Status said plainly on every line.
India · insurers and TPAs
- Cashless pre-authorisations, hospital bills, discharge summaries and claim forms read into checked fields, with ICD codes and amounts.
- The IRDAI clock: 1 hour for cashless, 3 hours for discharge, measured from your request to your decision, with a report by hospital.
- Hospital tariffs you load, checked line by line against itemised bills.
- A signed receipt for every approval, partial approval or repudiation, with the policy clause and the committee that approved it.
- Aadhaar never kept in full; health identifiers masked by default; only the model and OCR providers you approve.
Status: built, reaching customers with a coming release. The health-claims pack is a draft until it is calibrated on a design partner's labelled documents: until then, every field goes to a reviewer.
United States · health plans
- A receipt per prior-authorization decision: the AI recommendation beside the final decision, reason code, criteria, and the reviewer's credential and licence.
- Each decision checked against CMS-0057-F time frames (72 hours urgent, 7 days standard).
- The prior-authorization metrics of 42 CFR 422.122(c), per line of business and plan contract.
- A UM oversight report for the 2026 state laws on AI in utilization review (Maryland, Colorado); the filing stays the plan's.
- Protected fields sealed under your key; providers and storage kept in the US.
Status: built in Gothink Witness, offered to design partners ahead of general release. Not legal advice; confirm your obligations with counsel.
Read. Decide with a person. Prove it.
Read
Gothink AIR turns your documents into checked records. Every value carries its file, page and box.
Decide with a person
A threshold per field decides what goes straight through. Anything below it goes to your people, never silently into your systems.
Prove it
Gothink Witness seals each decision as a signed, replayable receipt your examiners and auditors can check without us.
Bring the documents that cost you most.
Send 25 of them. Get back scored, page-cited fields before you buy anything — or ask us a question first.