Odoo Insurance Pre-Authorization & Claims Automation
Automate pre-authorizations and claims for faster approvals and stronger cash flow.
See How We Build for Complex BusinessesInsurance-driven healthcare depends on fast, accurate handling of pre-authorizations and claims. When hospitals and clinics rely on manual paperwork, email threads, and disconnected systems, delays become common. Missing documents, repeated submissions, and unclear claim status slow down patient admissions and disrupt cash flow. An automated Insurance Pre-Authorization and Claims Management system centralizes documentation, communication, and billing workflows to ensure smoother approvals and faster reimbursements.
Who This Is For
We usually work best with teams who know building software is more than just shipping code.
This is for teams who:
Hospitals handling insured and TPA patients
Multi-speciality clinics with insurance billing
Healthcare groups managing high claim volumes
Insurance desks seeking digital claim workflows
This may not fit for:
Clinics handling only cash patients
Hospitals without structured EMR systems
Organizations not working with TPAs or insurance providers
Facilities seeking only basic billing software
the real problem
Automate pre-authorizations and claims for faster approvals and stronger cash flow.
Hospitals and clinics often manage pre-authorizations and claims through manual forms, email exchanges, and repeated document submissions. Insurance desks struggle to track claim status, manage rejections, and reconcile payments with billing data. Poor coordination between EMR, billing, and TPA communication increases rejection rates and delays settlements. Without a unified workflow, administrative workload increases while revenue realization slows down.
how this is usually solved
(and why it breaks)
common approaches
Manual pre-authorization form filling
Email-based communication with TPAs
Separate systems for EMR, billing, and claims
Manual tracking of claim status in spreadsheets
Where these approaches fall short
Delayed approvals and patient admissions
High rejection rates due to missing documents
Poor visibility into pending or aging claims
Revenue leakage due to delayed settlements
Core Features & Capabilities
01
Automated Pre-Authorization Forms
Pre-auth forms auto-filled using EMR, diagnosis, procedures, and billing data.
02
Document & Clinical Attachment Management
Attach lab reports, prescriptions, discharge summaries, and notes in one workflow.
03
TPA Communication Dashboard
Centralized communication log with reminders and status tracking.
04
Claim Lifecycle Management
Track claims from submission to approval, pending clarification, rejection, and settlement.
05
Difference & Settlement Calculation
Automatic calculation of payable difference between insurance and patient share.
06
Analytics & Aging Reports
Claim aging, rejection trends, approval turnaround time, and settlement performance dashboards.
how we approach it
01
Assess existing billing, EMR, and insurance workflows
02
Design integrated pre-auth and claim automation processes
03
Configure TPA-specific documentation and rules
04
Deploy dashboards, reporting, and reconciliation workflows
How We Build at PySquad
We build Odoo-based Insurance Pre-Authorization and Claims Automation systems that integrate EMR, billing, discharge summaries, and finance into a single workflow. The system auto-generates pre-auth forms, attaches required clinical documents, tracks TPA communication, manages claim lifecycle stages, and supports reconciliation with accounting modules.
outcomes you can expect
Faster insurance approvals and smoother admissions
Reduced claim rejections and rework
Improved cash flow through timely settlements
Lower administrative workload and clearer visibility
Automate your insurance approvals and claims.
let's build yoursFrequently asked questions
Yes. Patient, clinical, and billing details auto-fill the forms.
Yes. A dashboard shows approval, pending, or rejected claims.
Yes. Clinical notes, reports, and invoices can be uploaded.
Yes. Automated documentation significantly reduces errors.
Yes. Settlement reports and reconciliation tools are included.
About PySquad
PySquad works with businesses that have outgrown simple tools. We design and build digital operations systems for marketplace, marina, logistics, aviation, ERP-driven, and regulated environments where clarity, control, and long-term stability matter.
Our focus is simple: make complex operations easier to manage, more reliable to run, and strong enough to scale.
Strategic Solutions in This Domain
Integrated platforms and engineering capabilities aligned with this business area.
have an idea? lets talk
Share your details with us, and our team will get in touch within 24 hours to discuss your project and guide you through the next steps