Health Insurance: How can NHCE simplify the claims process for insurers?

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health insurance companies. This single-window interface is expected to replace the current system which traditionally relied on manual paperwork and required a lot of effort from policyholders and the hospital.Under the new system, a common digital standard format will be used to file the claim irrespective of the insurance company. Moreover, NHCX will facilitate the exchange of health claim information between all stakeholders in a completely digital way.

The system will not only be interoperable but also machine-readable and verifiable.The vision behind NHCX is simple, yet pathbreaking. It aims at standardisation and interoperability of health claims through a seamless exchange of data, documents and images between the insurer and the healthcare provider. This is expected to lead to transparent and efficient claims processing, resulting in convenience for the policyholder and reduced operational costs related to claims processing for the insurer.First and foremost, the NHCX will benefit consumers tremendously.

It is expected to drastically reduce the waiting time for claim approvals. In fact, the IRDAI has recently mandated that all cashless claims would need to be cleared within three hours. This would be possible due to automation and standardisation of the claims process.Moreover, by facilitating a seamless and quick exchange of health information between all stakeholders, NHCX would also make it possible to have claims serviced in a cashless manner in non-network hospitals.