The Ministry and IRDAI are launching the National Health Claim Exchange (NHCX), a digital platform which will bring together insurance companies, healthcare sector service providers and government insurance scheme administrators.
The Health Claim Exchange Specification is a communication protocol that facilitates the seamless exchange of health claim information between payers (insurance companies, TPAs, government scheme administrators), providers (hospitals, labs, polyclinics), beneficiaries, and other entities. It is designed to be interoperable, machine-readable, auditable, and verifiable, ensuring accurate and trustworthy information exchange.
Health insurance contributes to approximately 29% of the total general insurance premium income in India. The primary hurdle in health insurance today lies in improving the relationship between hospitals and insurance companies, said Dr. Prakash, adding that the push towards digitisation requires active involvement from both parties, necessitating upgrades to current IT systems and enhanced workforce training. “Issues such as discharge delays and miscommunication between hospitals and insurers further complicate matters. Building trust among policyholders hinges on delivering efficient services.
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