People will no longer have to wait long for health insurance claims. The Central Government has created a single portal to speed up the process of health insurance claims of patients and ensure transparency in it. 50 insurance companies and 250 hospitals of the country are likely to join it.
Health Insurance Claims: With the aim of expediting the process of health insurance claims of patients and ensuring transparency, the Central Government has created a single portal. Patients, insurance companies and hospitals will benefit from this. Keeping in mind the long wait for settlement of insurance claims and the speedy approval of claims of patients discharged from hospital by the company, the government has prepared the National Health Claims Exchange Platform. About 50 big insurance companies and 250 big hospitals of the country are also preparing to connect with this one portal. It is often seen that the patient is discharged from the hospital in the morning but it is late at night before the green signal for settlement of the claim is received from the insurance companies. In this way the patient has to stay in the hospital for one more day. Before preparing this portal, the National Health Authority held workshops and meetings with representatives of various insurance companies and hospitals. After this the portal has been prepared.
How will this portal bring changes in the system?
If this effort of the government is successful, there will be a big change in the health insurance ecosystem of the country. Currently a hospital has to prepare and process claims from more than 50 insurance companies on its websites. Patients admitted to the hospital are linked to different insurance companies and the claims of each patient are processed on the websites of those companies. An insurance company has to process claims coming from different hospitals and has to remain connected to the websites of all the hospitals. When this platform of the government is launched, claims will be processed through a single platform. Hospitals and insurance companies will check on a single platform and this will speed up the process. The claim will also be settled soon. Currently, the government will remain in the role of coordinator regarding this portal, but in the coming time, the monitoring process will be speeded up.
Why is the government doing this?
Sources in the Health Ministry say that only insurance companies and hospitals want a single platform. Insurance Regulatory and Development Authority of India (IRDAI) has taken this initiative forward. This is a digital health claims platform, which will give insurance companies an opportunity to reduce their costs. Also, policy holders will be able to get their claims as soon as possible. This will help in preventing claim fraud. It will also be known which company is clearing the claims quickly and which company delays. The status of the claim can also be seen easily. Policy holders will be able to track their claim status online. The workshops held so far have been attended by professionals representing insurance companies, TPAs and hospitals. This will prove to be an important step to promote the adoption of digital health transactions and digitization of patient health records in the country. This will also make it easier to keep digital records of the patient’s treatment.
