Medicines have a legal ceiling
Scheduled formulations under DPCO 2013 cannot be priced above NPPA's notified ceiling — hospital pharmacies included. Even a ₹10/unit breach across thirty days adds up.
Free · No login · India
Hospital bill audit
against Indian government rates
Upload an itemised hospital bill. We check every line against three public Indian datasets — the NPPA ceiling price list for medicines, CGHS rates for procedures, and the IRDAI non-payable list for insurance disputes — and explain every flag in plain English.
Why an Indian hospital bill needs an audit
Procedures have a benchmark
CGHS publishes procedure-level rates negotiated between the government and empanelled hospitals. Private hospitals are not bound, but 3× CGHS is a strong negotiating signal.
Insurance has a no-pay list
The IRDAI Master Circular spells out items insurers do not have to reimburse — registration, admin charges, gloves. If you have insurance, knowing these saves the dispute.
What we check on every bill
Thirteen deterministic rules. Every flag cites the underlying notification verbatim. No “AI judgment” decides whether something is flagged.
- HIGH
NPPA ceiling breaches
Scheduled drugs priced above the legally notified ceiling under DPCO 2013. We compare per-unit pricing, not per-strip, and apply the ±30% tolerance NPPA itself recognises.
NPPA_CEILING_BREACH · DPCO 2013 · NPPA Statutory Orders
- MEDIUM
CGHS rate comparison
Procedures benchmarked against CGHS NABH rates. CGHS rates are a recognised reference, not a cap — we frame these as benchmark, not violation.
CGHS_PREMIUM_3X · CGHS rate schedule (latest revision)
- HIGH
IRDAI non-payable items
Items insurance does not have to reimburse — gloves, gowns, administrative charges, registration fees. Flagged only when you indicate you have a policy.
IRDAI_NON_PAYABLE · IRDAI Master Circular — non-payable items
- HIGH
Consumable overuse
Gloves over 20/day or syringes over 15/day outside ICU, normalised against ward type and length of stay.
GLOVES_EXCESS · SYRINGE_EXCESS · IRDAI guidance · clinical norms
- HIGH
Duplicate lines
Same item billed twice with the same date and unit price. Cross-unit check, looks across the whole bill at once.
DUPLICATE_LINE · Internal consistency rule
- HIGH
Room-rent vs stay length
Billed room-days that exceed the admission-to-discharge window from the bill context. Flags overlapping or invented days.
ROOM_RENT_DAYS_MISMATCH · Internal consistency rule
- MEDIUM
Arithmetic anomalies
Line totals that don't equal quantity × unit price (±₹1 tolerance). Small lines add up across an entire hospital stay.
ROUNDING_ANOMALY · Internal consistency rule
- MEDIUM
Investigation duplicates
Same investigation (CBC, X-ray, ECG) billed twice on the same day. Cross-unit check.
INVESTIGATION_DUPLICATE · Internal consistency rule
What to do if a flag stands
- Step 1
Take the report to the hospital billing desk
The citation is in the report. NPPA ceiling breaches are usually resolved on first request when the S.O. number is shown.
- Step 2
Escalate to the hospital grievance officer
Every hospital has one under the Clinical Establishments Act. Submit the dispute in writing — Jaanch generates a template.
- Step 3
File with NPPA, IRDAI, or the consumer forum
NPPA's public grievance portal for ceiling breaches. IRDAI's IGMS portal for insurance issues. State Consumer Forum for excessive charges. Each routes to the right body.
Hospital bill audit — frequently asked
Is this free to use?+
Yes. The full audit, the flag report, and the plain-English narrative are free for individual patients. We rate-limit to ten audits per day per visitor to keep the service available; B2B users (TPAs, insurer claims teams) are charged for batch processing.
What kinds of bills can I upload?+
Itemised hospital bills — PDFs from hospital portals, photos of printed discharge summaries, or page-by-page phone photographs of long bills. We stitch multi-page photos into a single PDF before processing. Summary bills (one line: 'Total ₹X') cannot be audited; we need line items.
What if my hospital is not in CGHS?+
Private hospitals are typically not CGHS-empanelled, so we frame CGHS as a *benchmark* rate (CGHS NABH x3 is our threshold) rather than as a cap. NPPA ceilings, on the other hand, apply to every retailer in India including private-hospital pharmacies — those flags are based on a legal ceiling, not a benchmark.
How do I dispute a flagged charge?+
Each flag includes a verbatim citation (DPCO 2013, NPPA Statutory Order number, IRDAI Master Circular reference). Start at the hospital billing desk with the citation in hand. If unresolved within 48 hours, escalate to the hospital grievance officer, then NPPA / IRDAI / consumer forum depending on the flag type. The paid tier generates a dispute letter for you.
Will the hospital actually correct the bill?+
For NPPA ceiling breaches, hospital pharmacies are legally bound and most correct on first request when shown the notification. CGHS benchmark flags depend on the hospital's discretion. IRDAI non-payable items typically need to go through your TPA or insurance grievance route rather than the hospital.
What about generic drugs and brand names?+
We maintain a brand → generic alias map (Augmentin → Amoxicillin + Clavulanate, Crocin → Paracetamol, Pan → Pantoprazole, etc.) so branded line items still match the underlying NPPA ceiling. If we cannot map a brand, the line is left unflagged rather than guessed at.
How fresh is your reference data?+
Every report shows the 'rates verified as of' date. CGHS and NPPA notifications are refreshed quarterly; a scheduled job alerts us when source URLs change. We never auto-ingest to production — every update is reviewed manually.