ClaimOps / Provider economics
Section 05An illustration at 25 seats
Your actual cost base will differ; the structure will not. Built on Chennai and tier-two metro salary bands as at Q3 2026, at an indicative INR 95 to the US dollar. Nothing here is a forecast, a projection or a commitment.
| Line | Monthly (INR) | Note |
|---|---|---|
| Revenue — 25 seats at USD 1,300 | 30,87,500 | USD 32,500 at INR 95 |
| Medical coders — 10 at INR 45,000 | 4,50,000 | Certified; premium band |
| AR analysts — 8 at INR 32,000 | 2,56,000 | Includes overlap-shift allowance |
| Charge entry and posting — 4 at INR 24,000 | 96,000 | Entry-level, trained in-process |
| Eligibility and pre-auth — 3 at INR 26,000 | 78,000 | Overlap shift |
| Management overlay — 6.5 roles | 3,65,000 | Per the seat mix |
| Statutory contributions and benefits at 14% | 1,74,300 | PF, ESI, gratuity provision, insurance |
| Facility and workstation — 25 at INR 6,000 | 1,50,000 | Rent, power, air conditioning, amortisation |
| Secure desktop, licences and endpoint control | 37,500 | INR 1,500 per seat |
| Redundant connectivity and disaster recovery | 45,000 | Two ISPs, failover link |
| Compliance, audit and certification amortised | 40,000 | HIPAA controls, annual audit, background checks |
| Administration and overhead at 8% of people cost | 1,13,500 | Finance, HR, IT support |
| Indicative monthly contribution | 12,82,200 | 41.5% of revenue · USD 13,497 |
- Indicative contribution
- 41.5%At 25 seats and the salary bands shown above.
- Per seat, per month
- ₹51,288Contribution after all direct and allocated cost.
- Indicative break-even
- Month 3On day-zero investment, assuming the agreed ramp holds.
- Contracted term
- 12 mthsAuto-renewing, with 60 days' notice on staffed seats.
Why this process rewards scale
The management overlay is the reason. Between fifteen and sixty seats the productive headcount quadruples while the supervision layer roughly doubles. A fifteen-seat pod is viable; it is not where the money is.
| Seats | Monthly revenue (INR) | Indicative cost (INR) | Contribution (INR) | Margin |
|---|---|---|---|---|
| 15 | 18,52,500 | 12,22,300 | 6,30,200 | 34.0% |
| 25 | 30,87,500 | 18,05,300 | 12,82,200 | 41.5% |
| 40 | 49,40,000 | 27,41,300 | 21,98,700 | 44.5% |
| 60 | 74,10,000 | 38,89,740 | 35,20,260 | 47.5% |
Day-zero investment
| Item | Indicative INR | Recoverable? |
|---|---|---|
| Workstations, thin clients and peripherals — 25 | 8,75,000 | Asset, reusable |
| Bay fit-out, access control and CCTV | 4,00,000 | Asset, reusable |
| HIPAA control implementation and readiness audit | 3,00,000 | Reusable across US healthcare work |
| Coder certification sponsorship and bench training | 2,50,000 | Recovered through retention bonds |
| Total day-zero | 18,25,000 | Approx. USD 19,200 |
What moves the number against you
Certified coder salary inflation
The single largest line and the most volatile. Sponsoring and bonding your own coders is the only durable hedge.
Attrition above plan
Every replacement carries six weeks of ramp at reduced productivity plus the training cost, and it is not separately reimbursed.
Rupee appreciation
Revenue is in dollars and cost is in rupees. A five per cent move in the rate takes roughly five per cent off the top line. There is no indexation clause.
Failing calibration
Two consecutive months below the benchmark triggers a service credit and an allocation review — both of which hit the same line.
Under-staffing supervision
Saving one team leader and one auditor looks like a margin gain for one quarter and costs the account in the second.
Currency basis
The INR 95 basis above is an illustration, not a hedge, a floor or a commitment. Price your own cost sheet at a rate you would still be comfortable with.
Next step
If the rate does not work at your cost base, say so during contracting.
It will not be held against the application. A partner who raises a commercial problem in week one is easier to work with than one who discovers it in month four.
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