NHCX Gains Momentum, More Medical Insurers Joining Platform For Efficient Claim Processing

The National Health Claims Exchange (NHCX) platform, introduced by the National Health Authority, is gaining traction among Indian health insurers for adoption as the platform streamlines the healthcare claims processing, offering various benefits to insurers, healthcare providers and patients.

This digital platform aims to enable patients to access quality healthcare quickly and reduce out-of-pocket expenses.

NHCX connects insurance companies, healthcare service providers, and government insurance scheme administrators to streamline healthcare access and claims.

Officials said that leading insurers like Aditya Birla Health Insurance, Magma HDI General Insurance, Reliance General Insurance, Future Generali India Insurance and HDFC Ergo are joining the NHCX platform in their operations.

By leveraging this technology, insurers can significantly reduce claim processing time, improve operational efficiency, and enhance customer satisfaction, health insurance firms said.

Claim settlement on the exchange has begun with some insurers, albeit on a small scale, which is expected to accelerate in the coming days.

"We have successfully processed its initial health claims via this exchange. This initiative aligns with the industry's broader efforts to leverage technology for enhanced customer service and operational efficiency in healthcare claim processing. It also underscores IRDAI's commitment to expanding insurance coverage and accessibility nationwide," said Mayank Bathwal, CEO of Aditya Birla Health Insurance.

It will enable the company to streamline the claims process, reduce administrative costs, and provide a better experience for the customers, he said.

"I think the National Health Claims Exchange is a fantastic idea by the regulator. IRDAI's primary focus has been affordability, accessibility and customer-centricity. The regulator believes that if the industry has to grow well then it has to create an enabling environment and a regulatory interface where the insurers are able to quickly react to whatever changes are happening in the market," said Anup Rau, MD & CEO of Future Generali India Insurance.

The adoption of NHCX is a positive development for the Indian healthcare industry.

"As more insurers join the platform, we can expect further improvements in the efficiency and transparency of healthcare claims processing," a company official said.

"The NHCX platform, designed to streamline and expedite the claims process, represents a significant advancement in the insurance sector. We believe it will play a significant role in furthering the insurance movement in the country. It testifies to our belief that technology can provide impetus to India's insurance sector," Magma HDI Chief Technical Officer Amit Bhandari said.

Health insurance experts stated that the NHCX platform can also help reduce fraudulent claims in the industry, which may lead to more favourable pricing in the long term. Additionally, having access to a patient's complete medical history online can enable healthcare providers to expedite treatment during emergencies.

To develop the paperless ecosystem of healthcare, the government has introduced a platform called ABHA (Ayushman Bharat Health Account), which maintains the medical history of every registered Indian citizen with an ABHA card.

The card contains a unique 14-digit identification number, known as the ABHA ID, along with the individual's complete medical history, consultation details, and prescriptions. These records can be accessed by the cardholder or other authorized stakeholders.

"ABHA IDs not only serve as a digital identifier for the insured but also help streamline the overall healthcare and insurance experience," an official said.