Indian pre-authorisation rejections cluster into eight causes: incomplete documentation, missing prior authorisation, identity mismatch, policy not active on the date of admission, condition inside a waiting period, pre-existing disease exclusion, non-network provider, and tariff or package mismatch. Only a minority are genuine clinical disputes.
The eight
Documentation incomplete — a named investigation, consultation note or estimate missing.
Prior authorisation absent where the procedure required it separately from admission approval.
Identity mismatch between the policy, the ID produced and the patient record.
Policy inactive on the admission date, including lapsed premium.
Waiting period, common for specific procedures in the first two to four years of a policy.
Pre-existing disease exclusion, the most contested category.
Non-network provider, where the hospital is outside the payer's panel for that product.
Tariff or package mismatch against the contract on file.
Why sending anyway is expensive
A pre-authorisation that will fail on documentation costs a cycle — usually days — during which the admission is already running and the family is waiting for an answer.
Blocking the send and naming the missing item converts a multi-day round trip into a five-minute correction.
The rule that should never fire
When a fact is unknown, no rule should fire. A missing tariff on file is not evidence of a tariff mismatch, and a system that treats absence as a red flag trains people to ignore it.
Questions we get asked
What is the most common pre-auth rejection reason in India?
Incomplete documentation — a required investigation report, consultation note or cost estimate missing from the submission.
Can a rejected pre-authorisation be resubmitted?
Usually yes, with the deficiency corrected, though the delay can push an admission past its notification window.
Built to international standards. Sold in India only, for now.
Drapto is engineered the way any serious international health platform is — FHIR R4, audit trails, self-hosting — and sold exclusively to Indian clinics and hospitals, so the payer mechanics, scheme rates and clinical vocabulary are modelled rather than approximated.