NHCX, a single portal for all health insurance claims soon: what is the claims process, benefits to policyholders
What is NHCX platform?
NHCX is a digital platform developed by the National Health Authority (NHA) and Union Ministry of Health and Family Welfare as part of the Ayushman Bharat Digital Mission. It is being created on the recommendation of the joint working group of the Insurance Regulatory and Development Authority of India (Irdai) and NHA.
The portal will bring all the players involved in the claim process, including ‘payers’ (insurer, third-party administrator, government scheme administrator) and ‘providers’ (hospital, laboratories, polyclinics) at one place. Irdai has urged all the players to onboard the platform, and many have already done so.
How will it function?
The portal will simplify, speed up and standardise the claim settlement process through seamless exchange of information and documents between payers and providers. This will be done through a single gateway using standard protocols, and the medical information and data will be well encrypted and secure..
Currently, at the time of discharge, hospitals manually fill up claim forms, scan documents and upload these to individual insurer portals to seek approval. At the insurer’s end, the data is digitised, manually authenticated and adjudicated. It is then sent back to the hospital and discharge is processed. With NHCX, most of the process will be digitised and automated. The claim format will be standardised and the insured’s digitised details accessed via his Ayushman Bharat Health Account (ABHA) number. The NHCX portal will automatically validate
