Query Tracker
Payer and TPA queries linked to missed revenue and required claim support
Open Queries
4
Due in < 12 Hours
2
Missed Revenue Linked
₹22K–₹43K
Cashless Discharge Queries
3
Escalation Required
1
Resolve short-SLA queries first to protect missed revenue
Missing investigation reports and pre-auth reconciliation are the most common issues this week.
Query Status Flow
Every query moves through a clear operational path
Open
Needs Hospital Input
Evidence Uploaded
Ready to Respond
Submitted
Escalated
Active Payer Queries
4 open| Case ID | Hospital | Payer | Query Type | SLA | Risk | Missed Revenue Linked | Claim Support Needed | Status | Next Action | |
|---|---|---|---|---|---|---|---|---|---|---|
| IND-CLM-1052 | Apex Care Hospital | Private TPA | Final bill mismatch | 11 hrs | High | ₹8K–₹16K | Pre-auth approval, OT note, final bill reconciliation | Needs Hospital Input | Reconcile approval with final bill | |
| IND-CLM-1061 | City Heart Centre | CGHS | Missing investigation report | 6 hrs | High | ₹5K–₹10K | Angiography report, cardiologist note | Needs Hospital Input | Attach angiography report and validate bill line | |
| IND-CLM-1048 | Shree Multispecialty Hospital | Ayushman Bharat / PM-JAY | Documentation support required | 18 hrs | Medium | ₹8K–₹15K | Surgeon implant note, radiology report, OT consumables slip | Open | Attach missing supporting documents | |
| IND-CLM-1074 | Lotus Hospital | ESIC | Pharmacy bill clarification | 28 hrs | Medium | ₹3K–₹6K | Itemized pharmacy bill, medication chart | Ready to Respond | Upload medication chart and pharmacy bill |
AI Recommended Prioritization
- 1Resolve IND-CLM-1061 first — only 6 hours remain and the angiography report is critical.
- 2Resolve IND-CLM-1052 next — reconcile pre-auth approval with the final bill.
- 3Handle IND-CLM-1048 after — surgeon note and radiology support pending.
- 4Follow up on medium-risk items after high-priority responses.
Missed revenue estimates are directional and require RCM validation. Items should only be added if supported by payer rules, package terms, hospital tariff, and final documentation. Syauctus does not auto-add charges or submit claims.