🏛️ For PSUs

Health Benefit Automation
for Public Sector Undertakings

Administer employee health benefits with AI multi-tier plan management, automated OPD and IPD claim processing, and full ABDM compliance built for India's public sector scale.

Request Demo → See How It Works
🏛️ Multi-Tier Plans ✅ ABDM Compliant 🤖 AI Adjudication NHCX Connected
Zealthix · PSU Health Scheme Admin
// Multi-tier benefit plan ONGC → zive.configure_plan("ONGC Health Scheme 2026") tiers: Grade A, B, C, D configured employees: 32,800 beneficiaries retirees: 8,200 covered status: scheme live ✓   // Claim submitted Grade B employee → zudy.adjudicate("IPD-PSU-50921") grade: B private ward entitled ✓ approved: ₹82,000 audit_trail: logged ✓
Multi-tierBenefit plans per employee grade
95%Claims auto-adjudicated
ABDMFully compliant platform
100%Audit trail for every decision
What We Solve

Government-grade health benefit
administration, fully automated

🏛️

Multi-Tier Benefit Plan Management

Configure separate benefit entitlements for each employee grade ward type, benefit limits, specialist access, and dependent coverage managed from a single platform with no per-grade manual administration.

👴

Retiree & Dependent Administration

Manage retired employee benefits separately with dedicated entitlement rules, lifetime limits, and dependent coverage the complex eligibility rules that legacy systems can't handle automatically.

🤖

AI OPD & IPD Adjudication

Zudy applies grade-specific benefit rules to every claim ward entitlement, approved specialists, sub-limits, and approved hospital lists enforced automatically. 95% of claims decided without human review.

📋

Complete Audit Trail

Every adjudication decision logged with full reasoning benefit rule applied, amount calculation, supporting documents checked. Audit-ready records available for CAG, IRDAI, and internal compliance teams.

🏛️

ABDM & NHCX Compliant

ABHA-linked beneficiary records, NHCX-connected provider network, and FHIR R4-encoded health data built for India's National Digital Health Mission compliance requirements from the ground up.

📊

Scheme Analytics & Reporting

Real-time cost analytics by grade, department, and location. Utilisation reports for management, budget forecasting tools, and scheme performance dashboards built for PSU governance requirements.

How It Works

Scheme administration
at PSU scale

Zealthix manages your entire employee health scheme from benefit configuration to claim adjudication to provider settlement at the scale PSUs require.

1
Configure Scheme Rules

Upload your health scheme document Zive extracts grade-wise entitlements, approved provider lists, sub-limits, and exclusions. Multi-tier benefit structure configured in under 30 minutes.

2
Beneficiary Roster Sync

Employee and retiree data syncs from your HRMS. Grade, dependent status, and eligibility verified automatically. Joiner/leaver changes reflected without manual intervention.

3
Claims Adjudicated by Grade

Zudy applies the exact entitlement rules for each beneficiary's grade. Private ward, specialist limits, and approved hospital checks enforced automatically with complete audit logs.

4
Settlement & Compliance Reports

Provider settlement automated. Monthly scheme utilisation reports, budget variance analysis, and compliance documentation generated automatically for PSU governance and board review.

Government health scheme administration dashboard
Impact

Transparent, auditable,
and fully automated

95%
Claims processed automatically with grade-specific benefit rules applied
100%
Audit trail for every adjudication decision CAG and compliance ready
ABDM
Fully compliant ABHA-linked, NHCX-connected, FHIR R4 encoded

Modernise your PSU health
scheme without disruption

Book a demo and we'll show you multi-tier plan configuration and automated adjudication tailored to your grade structure.

Book a Demo →