.png)
Digital Healthcare & Medical Claims Management Platform
Connecting Clients · Hospitals · Insurers · Intelligence
Zor Med Insurance is a digital healthcare and medical claims management solution designed to simplify, automate, and modernize the entire medical insurance lifecycle connecting clients, hospitals, insurers, claims teams, and healthcare stakeholders through a unified digital ecosystem.
Making healthcare benefits more accessible
Our objective is to make healthcare benefits more accessible to clients while enabling insurers and healthcare organizations to manage claims more efficiently, transparently, and securely.
Client & Member Management
-
Client & member registration
-
Beneficiary / dependent management
-
Policy & benefit configuration
-
Coverage limits & eligibility
-
Benefit utilization tracking
-
Claim history
-
Digital membership / medical card
-
Document management
Hospital & Provider Onboarding
-
Hospital / provider registration
-
KYC & document management
-
License & accreditation info
-
Provider approval & activation
-
Contract & tariff management
-
Service configuration
-
Profile & performance tracking
Digital Medical Claims Management
-
Digital claim submission
-
Eligibility verification
-
Benefit & coverage validation
-
Medical document management
-
Claim assessment
-
Approve / reject / query / partial
-
Settlement & status tracking
Hospital Claims Portal
-
Verify client eligibility
-
Check available benefits
-
Submit medical claims
-
Upload invoices & documents
-
Track claim status
-
Respond to claim queries
-
View historical claims
Mobile Apps – Android & iOS
-
Real-time benefit information
-
Available & utilized coverage
-
Claim status & history
-
Hospital / provider information
-
Digital medical card
-
Notifications & alerts
-
Member profile & policy info
USSD-Based Healthcare Services
-
Check membership status
-
Verify eligibility
-
Check available benefits
-
Check remaining coverage
-
Track claim status
-
Access basic provider info
-
Access without smartphone / internet
AI-Powered Fraud & Risk Detection
The platform analyzes claim patterns to identify potentially suspicious activity involving clients and providers, assigns a risk / fraud score, and flags claims for investigation. Alerts support human decision-making rather than auto-rejecting authorized teams make the final decision.
Duplicate claims
Abnormal treatment costs
Repeated similar treatments
Duplicate / suspicious invoices
Excessive utilization
Potential benefit misuse
Unusual claim frequency
Suspicious billing patterns
Unusual hospital patterns
Real-time visibility for informed decisions
Total members
Active beneficiaries
Hospitals / providers
Claims received
Pending claims
Approved claims
Rejected claims
Under investigation
Total claim value
Settlement value
Hospital-wise utilization
Client-wise utilization
Treatment-wise analysis
Fraud & risk alerts
Claim turnaround time
