Hospital Revenue Leakage: A Real PMJAY Claim Reconciliation Case Study
Case Study: How a 100+ Bedded Hospital Discovered ₹2.66 Lakh Monthly Revenue Leakage Through Payment Reconciliation
Introduction: The Hidden Reality of Hospital Revenue Leakage
In today’s healthcare ecosystem, hospitals across India are increasingly dependent on PMJAY (Ayushman Bharat) and cashless insurance schemes for patient inflow and revenue stability. While these schemes ensure accessibility and affordability for patients, they also introduce complex billing, settlement, and reconciliation challenges for hospitals.
Many hospital management teams believe that having a dedicated PMJAY or TPA desk is enough to ensure smooth operations and accurate payments. However, this case study reveals a different reality.
This is the real story of how a 100+ bedded multi-speciality hospital in Vadodara, Gujarat unknowingly lost ₹2.66 lakh every single month, amounting to ₹31.92 lakh annually, due to unnoticed revenue leakage—until Oasis Hospital Solutions stepped in.
Management Reaction
When the findings were presented, the Hospital Director was extremely surprised and concerned.
“Despite having a good PMJAY team, we never imagined that such a significant amount was being lost every month without our knowledge.”
The management immediately realized that:
- Strong teams still need specialized financial audits
- Revenue leakage is often invisible without expert reconciliation
Payment reconciliation is critical for hospital financial health
Outcome & Impact
- Complete visibility of actual monthly revenue leakage
- Immediate corrective and recovery actions initiated
- Improved control over PMJAY and cashless settlements
High satisfaction and confidence in Oasis Hospital Solutions
Key Insight
