Govt to launch a national portal to reduce delays in health insurance claim settlements

The government has already linked about 50 insurance companies and 250 hospitals to begin with, and gradually more hospitals and insurance providers will come onboard

In what could be a game-changer in the health insurance sector, the Union Health Ministry is soon likely to launch a National Claim Exchange Portal.

According to sources, the portal is believed to "provide a single-window interface between health insurance companies, hospitals, and insurance policyholders, with the aim of facilitating easier and faster health insurance claim settlements."

The portal is likely to be accessible across India from the time of launch. The government has already linked about 50 insurance companies and 250 hospitals to begin with, and gradually more hospitals and insurance providers will come onboard, sources added.

"The portal is ready for launch and will be part of efforts undertaken by the government under the National Digital Health Mission," sources said.

It remains to be seen whether this portal helps in reducing the number of complaints the government has been receiving through several quarters, including at the Ministry of Consumer Affairs, at various consumer courts, and at other levels of the judiciary.

The National Health Claim Exchange (NHCX) portal is set to debut within the next two to three months, promising to simplify the health insurance claims process significantly. It will serve as a unified platform facilitating communication between insurance policyholders and service providers.

Developed by the National Health Authority (NHA), the platform is designed to expedite insurance claim processing and ensure interoperability, according to insiders.

Notably, the Insurance Regulatory and Development Authority of India (IRDAI) has advised all insurers and service providers to integrate with the NHCX, anticipating its imminent launch.

"The National Health Claim Exchange portal is almost ready and likely to be launched in the next two-three months. This portal has been developed as part of Ayushman Bharat Digital Mission (ABDM)," said sources.

Functioning as a singular gateway for exchanging claims-related information between payers and service providers, the NHCX is expected to revolutionise health claims processing, fostering efficiency and transparency within the insurance industry for the benefit of policyholders and patients alike.

Several prominent companies such as Tata AIG General Insurance, Paramount TPA, and Bajaj Allianz Insurance have already completed their integration with the portal, as per sources.

Presently, the health insurance claims settlement process in the country predominantly relies on manual procedures, resulting in significant time consumption.

"Hospitals have different claim portals and on each portal beneficiaries asks different questions that makes it more complicated, but this is going to be a single portal. The claim processing will be fastened," sources highlighted.

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Source