oeHealth Insurance & Claims Management - HCFA-1500, EDI 837P, Pre-Auth, Eligibility, Packages, Fraud Detection
by Braincrew Apps https://www.oehealth.in$ 649.72
| Availability |
Odoo Online
Odoo.sh
On Premise
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| Odoo Apps Dependencies |
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Discuss (mail)
• Invoicing (account) • Employees (hr) • Inventory (stock) • Website (website) |
| Community Apps Dependencies |
Show
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oeHealth - Laboratory Information System (LIS) | Pathology Lab, Sample Tracking, Test Templates & Patient Portal Reports
• oeHealth - Radiology Information System (RIS) | X-Ray, CT, MRI, Ultrasound, PET, Mammography, DICOM-Ready • oeHealth - Surgery Management | OT Scheduling, Pre-op Checklist, ASA / Mallampati / RCRI Scoring & Surgical Team • oeHealth Core: Clinic & Hospital Management Software • oeHealth Inpatient (IPD) Management — Admissions, Beds, MAR, Vitals, Discharge & Billing • oeHealth: Patient Portal Management • oeHealth - Medical Certificate | Sick Leave, Fitness & Doctor Certificate Generator • oeHealth - Patient Evaluation | Clinical Assessment & EMR Vitals |
| Lines of code | 105597 |
| Technical Name |
oehealth_insurance |
| License | OPL-1 |
| Website | https://www.oehealth.in |
| Availability |
Odoo Online
Odoo.sh
On Premise
|
| Odoo Apps Dependencies |
•
Discuss (mail)
• Invoicing (account) • Employees (hr) • Inventory (stock) • Website (website) |
| Community Apps Dependencies |
Show
•
oeHealth - Laboratory Information System (LIS) | Pathology Lab, Sample Tracking, Test Templates & Patient Portal Reports
• oeHealth - Radiology Information System (RIS) | X-Ray, CT, MRI, Ultrasound, PET, Mammography, DICOM-Ready • oeHealth - Surgery Management | OT Scheduling, Pre-op Checklist, ASA / Mallampati / RCRI Scoring & Surgical Team • oeHealth Core: Clinic & Hospital Management Software • oeHealth Inpatient (IPD) Management — Admissions, Beds, MAR, Vitals, Discharge & Billing • oeHealth: Patient Portal Management • oeHealth - Medical Certificate | Sick Leave, Fitness & Doctor Certificate Generator • oeHealth - Patient Evaluation | Clinical Assessment & EMR Vitals |
| Lines of code | 105597 |
| Technical Name |
oehealth_insurance |
| License | OPL-1 |
| Website | https://www.oehealth.in |
oeHealth: Insurance & Claims Management
Run your hospital's insurance operation end-to-end — payer master, per-patient policies, eligibility checks, prior authorisation, claim lifecycle, HCFA-1500 forms, EDI 837P electronic submission, hospitalisation packages, fraud detection and patient-portal access — all natively integrated into oeHealth and Odoo.
Scan to view demo
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Important Notice
Limited Description & Screenshots on the App StoreoeHealth was the first Odoo-based Hospital Management application launched in the marketplace. Unfortunately, several developers and authors have engaged in dishonest practices by replicating our application and re-publishing it on the store under different names. To protect the integrity of our work, we have chosen to publish only a limited description and minimal screenshots on the Odoo App Store, rather than disclosing the full scope of features and UI. Feel free to contact us and our team will walk you through all the exciting features of our app. |
Live Demo
https://www.oehealth.in/demo
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Email
sales@oehealth.in
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WhatsApp
+91 63588 27230
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Works with All Odoo Environments
oeHealth Insurance & Claims Management is fully compatible and optimized to work seamlessly across all Odoo deployment options.
Comprehensive Insurance & Claims Features
Cover the entire payer workflow — verify, authorise, claim, submit and follow up — with bedside-ready integration into every clinical service.
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Insurance Companies & Policies |
| ✓ | Payer master with payment terms, processing days and pre-auth threshold |
| ✓ | Network type tracking (HMO, PPO, EPO, POS) |
| ✓ | Per-patient policies with policy / group / member numbers and validity |
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Coverage Options & Eligibility |
| ✓ | Re-usable coverage templates with per-service percentages and limits |
| ✓ | Eligibility verification with active / inactive / pending state |
| ✓ | Inpatient / Surgery / Lab / Imaging coverage configured per policy |
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Prior Authorization (Pre-Auth) |
| ✓ | Authorisation requests with diagnosis, procedure and service date |
| ✓ | Approval workflow: draft, submitted, approved, denied, expired |
| ✓ | Direct link from pre-auth to the resulting insurance claim |
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Claim Lifecycle & Tracking |
| ✓ | Full claim lifecycle: draft, submitted, under review, approved, paid |
| ✓ | Linked to consultation, surgery, lab, imaging or inpatient records |
| ✓ | Document attachment, chatter timeline and notes per claim |
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HCFA-1500 (CMS-1500) Generator |
| ✓ | Standard US paper claim form with all 33 boxes pre-filled |
| ✓ | Box 24 service lines, one per CPT / HCPCS code with diagnosis pointers |
| ✓ | Place-of-service codes and rendering provider info captured |
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EDI 837P Electronic Claims |
| ✓ | Standards-compliant EDI 837P file generation |
| ✓ | Direct-to-payer electronic submission readiness |
| ✓ | Batch claim sheet management for grouped submission |
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Packages, TPA & Fraud Detection |
| ✓ | Hospitalisation packages (cardiac, maternity, ortho) with templates |
| ✓ | TPA management with associated payer relationships |
| ✓ | Automated fraud alert generation with rule-based anomaly detection |
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Patient Portal & Service Integration |
| ✓ | Patients view policies, submit claims and request pre-auths from the portal |
| ✓ | Insurance fields surfaced on Inpatient, Surgery, Lab and Imaging forms |
| ✓ | One-click claim creation from each clinical service form |
Scan to view demo
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Ready to Run Your Insurance Operation?Transform your hospital's payer workflow with the oeHealth Insurance & Claims module. From eligibility checks and pre-auths to HCFA-1500, EDI 837P and fraud detection — every step covered. Contact our team for a personalised demo and discover how a complete insurance workflow lifts approval rates, shortens AR days and reduces denied claims.
sales@oehealth.in
Run a complete insurance & claims workflow on Odoo with oeHealth Insurance Management. |
Odoo Proprietary License v1.0 This software and associated files (the "Software") may only be used (executed, modified, executed after modifications) if you have purchased a valid license from the authors, typically via Odoo Apps, or if you have received a written agreement from the authors of the Software (see the COPYRIGHT file). You may develop Odoo modules that use the Software as a library (typically by depending on it, importing it and using its resources), but without copying any source code or material from the Software. You may distribute those modules under the license of your choice, provided that this license is compatible with the terms of the Odoo Proprietary License (For example: LGPL, MIT, or proprietary licenses similar to this one). It is forbidden to publish, distribute, sublicense, or sell copies of the Software or modified copies of the Software. The above copyright notice and this permission notice must be included in all copies or substantial portions of the Software. THE SOFTWARE IS PROVIDED "AS IS", WITHOUT WARRANTY OF ANY KIND, EXPRESS OR IMPLIED, INCLUDING BUT NOT LIMITED TO THE WARRANTIES OF MERCHANTABILITY, FITNESS FOR A PARTICULAR PURPOSE AND NONINFRINGEMENT. IN NO EVENT SHALL THE AUTHORS OR COPYRIGHT HOLDERS BE LIABLE FOR ANY CLAIM, DAMAGES OR OTHER LIABILITY, WHETHER IN AN ACTION OF CONTRACT, TORT OR OTHERWISE, ARISING FROM, OUT OF OR IN CONNECTION WITH THE SOFTWARE OR THE USE OR OTHER DEALINGS IN THE SOFTWARE.
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