Frequently Asked Questions
Find answers to common questions about our services for patients and hospitals.
For Patients (Reimbursement Services)
Payton handles the entire medical reimbursement process on your
behalf — from collecting documents and filling claim forms to submitting them
and following up with your insurance company until the claim is settled.
Yes. Reimbursement claims apply for any
hospital (network or non-network). Payton works
independently to represent you and ensure your claim is filed and settled
properly.
No. Everything can be done remotely and digitally.
After the form is filled, our team will contact you and will manage
the rest on your behalf.
We'll respond to the insurer's queries and rejections with
legitimate responses and re-submission considering proper explanations and
supporting proofs — all done on your behalf.
Typically, 15-30 working days, depending on your insurance
provider. Since we continuously follow up, we help you get
faster settlements.
Yes. We assist patients with legitimate appeal
and re-submission processes for rejected claims. Our team
carefully reviews the insurer's rejection reason, identifies any genuine
documentation or communication gaps, and helps prepare a compliant and accurate
re-submission. We do not modify or create false
information — our role is to ensure your genuine claim gets the fair review it
deserves.
All your documents and medical information are stored securely and
confidentially. We never share your data without
consent.
Yes. We handle primary and secondary claim
filing on your behalf, ensuring maximum claim benefit.
For Hospitals (Cashless Claim Services)
Payton provides end-to-end Cashless Claim Management Services —
ensuring smooth coordination between hospitals, insurance TPAs, and
patients. We help your billing and insurance teams reduce
delays, rejections, and manual workload.
We handle:
- Pre-authorization requests and documentation verification
- Coordination with TPAs/insurers for approvals
- Real-time follow-ups to speed up authorization
- Monitoring discharge approvals and final settlements
- Handling shortfall queries and justifications
- Faster pre-auth and discharge approvals
- Fewer cashless claim rejections or deductions
- Reduced administrative burden on your staff
- Better patient experience with real-time claim status updates
- Dedicated cashless coordination team representing your hospital professionally
Yes. We coordinate with all major TPAs and
insurance companies in India, ensuring seamless cashless processing regardless
of the insurer.
Absolutely. We assist your billing or insurance desk in getting
final approval from the insurer, preventing discharge delays.
Payton primarily partners directly with hospitals to provide backend
cashless claim management services, and no cost is passed on to the
patient. However, when a patient independently avails
reimbursement services, the service fee is borne by the patient based on the
scope of support required.
Yes. We can set up an on-site Payton claim
desk or offer remote claim coordination support, depending on your hospital's
volume and preference.
All submissions follow relevant TPA guidelines.
We maintain an audit-ready process with transparent documentation
and time-stamped communication.
Hospitals & Patients
Yes. Payton is an independent healthcare
support organization that coordinates with all major insurers and TPAs across
India.
No. Payton is not an insurer or TPA — we are your service and
coordination partner, ensuring smooth claim communication and faster
settlements.
We provide professional claim management, proper documentation, and
transparent communication — not just submission. Every
process is handled on your behalf, with regular updates and full
accountability.
Yes. For partner hospitals, we provide daily, weekly and monthly
claim status dashboards. For patients, we offer regular
claim progress updates via email.