Revolutionizing health insurance: The potential of claims exchange and ABHA ID
NEW DELHI : Insurance approval delays during hospital admissions and discharges have long been a bane for patients, primarily due to fragmented front-end systems and manual intervention at hospitals. Imagine a unified platform where all hospitals, insurance companies, and stakeholders come together to digitize and streamline this process. Enter the National Health Claims Exchange (NHCX), an initiative developed by the National Health Authority (NHA), the Union health ministry, and the Insurance Regulatory and Development Authority of India (Irdai).
This digital public good promises faster, transparent, and efficient claims processing, enhancing patient experiences while reducing operational costs. What was once a concept was successfully tested last week when HDFC Ergo General Insurance Co. became the first insurer to process a claim through NHCX.
An HDFC Ergo policyholder undergoing a planned medical procedure at Jupiter Hospital in Thane, near Mumbai, had their policy details effortlessly fetched using the ABHA ID (Ayushman Bharat Health Account Identity) after the hospital notified the insurer. "We provided pre-authorisation approval within 39 minutes and the discharge approval was completed in 49 minutes. The auto filling of the patients' policy details in NHCX expedited the entire process, ensuring a swift response and we successfully processed the claim of ₹45,345," says Parthanil Ghosh, president – Retail Business, HDFC Ergo General Insurance.
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