PMJAY Hospital Software for Zero-Rejection Claims
Purpose-built for Ayushman Bharat empanelled hospitals — from beneficiary verification at admission to claim approval, every step is aligned to PMJAY guidelines to eliminate delays and rejections.
End-to-End PMJAY Workflow
- Beneficiary verification at admission — eligibility check and scheme registration at the point of registration, not as an afterthought.
- Package-based billing — pre-mapped PMJAY Health Benefit Packages (HBPs) with auto-filled rates and codes. No manual lookup.
- Claim documentation builder — structured digital records for every required field — discharge summary, investigation reports, consent forms.
- Pre-submission claim validation — system checks completeness before the claim is sent. Missing or wrong fields flagged automatically.
- Faster approval tracking — claim-ready file reduces average approval time. Status tracked within the system.
- ABDM integration — PMJAY workflows connected to ABDM's digital health ecosystem for future-proof compliance.
- Scheme MIS reports — package-wise utilisation, claim status, and Ayushman Bharat revenue — at a glance for management.
Why PMJAY Claims Get Rejected — And How to Stop It
Incomplete Documentation
The most common rejection reason. CureNearMe makes all required fields mandatory — missing discharge summary fields or consent forms trigger alerts before submission.
Wrong Package Codes
Incorrect HBP mapping leads to instant rejection. CureNearMe's package library is pre-mapped to PMJAY guidelines and verified against NHA's latest package list.
Beneficiary Mismatch
Eligibility verified at admission — not discovered at billing. Scheme status, card validity, and entitlement confirmed upfront.
Late Claim Submission
Automated discharge triggers claim preparation. Staff are guided through every step, reducing submission delays to a minimum.
Full PMJAY module included. Same price for all hospital sizes.
Frequently Asked Questions
What is PMJAY hospital software?
PMJAY hospital software is a Hospital Management System (HMIS) built with Ayushman Bharat Pradhan Mantri Jan Arogya Yojana workflows — beneficiary verification, package-based billing, claim-ready documentation, and government reporting.
How does CureNearMe reduce PMJAY claim rejections?
CureNearMe includes a pre-submission claim validation engine that checks every required field, package mapping, and documentation before the claim is submitted. Missing or incorrect data is flagged before submission, eliminating the most common rejection causes.
What is package-based billing in PMJAY?
PMJAY reimburses hospitals based on pre-defined Health Benefit Packages (HBPs) rather than itemised billing. CureNearMe maps your hospital's services to the correct PMJAY packages automatically, ensuring accurate billing and faster reimbursements.
Can PMJAY and private patients be managed in the same system?
Yes. CureNearMe handles PMJAY, ESI, CGHS, TPA, and private patients in the same workflow. The billing engine automatically applies the correct rules based on the patient's scheme or insurance.
Is CureNearMe recognised for PMJAY hospitals?
Yes. CureNearMe is an ABDM-compliant, NHA-recognised platform aligned with PMJAY guidelines, designed specifically for Ayushman Bharat empanelled hospitals across India.
