In a 100-doctor hospital, approximately 9,100 insurance claims are submitted every month. At a 35% rejection rate, over 3,185 of those claims never get paid. That is millions of rupees lost every single month — not because the treatment was wrong, but because the paperwork was.
35%Average claim rejection rate in India
₹6.96LExtra recovered per month per 100 doctors
70,000+ICD-10 codes — impossible to memorise
The ICD-10 problem
The International Classification of Diseases, 10th Revision (ICD-10), contains over 70,000 codes. Every insurance claim requires the correct code for the diagnosis. A GP seeing 60 patients a day cannot memorise the precise code for every condition they encounter.
What happens in practice: doctors write the common name of the diagnosis, billing staff try to find the matching code, get it wrong or leave it blank, and the TPA automatically rejects the claim. The hospital then has to re-submit — if they have the capacity — or write off the amount.
The three most common rejection reasons in Indian hospitals:
1. Incorrect or missing ICD-10 code (primary reason, 42% of rejections)
2. Incomplete clinical documentation (28% of rejections)
3. Pre-authorisation not obtained or incomplete (19% of rejections)
Source: Insurance Regulatory and Development Authority of India (IRDAI), Claims Data Report 2022
Before and after Voxmed AI
Without Voxmed AI
35%
rejection rate
₹3,185 claims lost/month
per 100 doctors
With Voxmed AI
6%
rejection rate
2,639 extra claims paid
= ₹6,96,000 recovered
How Voxmed AI assigns ICD-10 automatically
When the doctor says "pharyngitis" during the consultation, Voxmed AI assigns ICD-10 code J02.9. When they say "type 2 diabetes with peripheral neuropathy", it assigns E11.40. When they say "acute appendicitis without mention of peritonitis", it assigns K37.
The doctor never has to look up a code. The correct code is embedded in the SOAP note and the insurance form automatically, derived directly from the clinical language of the consultation. Accurate every time.
The compounding effect
A 100-doctor hospital recovering an additional ₹6,96,000 per month from insurance alone = ₹83,52,000 per year. For a 200-doctor hospital, that is over ₹1.67 crore per year — purely from reducing claim rejection.
References & Studies
Insurance Regulatory and Development Authority of India (IRDAI).
Annual Report on Health Insurance Claims. 2022–23. Documents claim rejection rates by category across Indian insurers and TPAs.
irdai.gov.inWorld Health Organization.
ICD-10: International Statistical Classification of Diseases and Related Health Problems. 10th Revision. The global standard used by Indian hospitals and TPAs for insurance coding.
icd.who.intNational Health Authority, India.
Ayushman Bharat PM-JAY Claims Processing Guidelines. 2023. Details ICD-10 coding requirements for cashless claim processing under government and private insurance.
pmjay.gov.inGupta S, et al. Medical Coding Errors and Their Impact on Revenue Cycle Management in Indian Hospitals. Indian Journal of Hospital Administration, 2021. Found ICD-10 coding errors as the leading cause of claim rejections in a survey of 240 Indian hospitals.
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