Digital Tools To Speed Up Health Insurance Claims
Other innovations focused on digitising clinical records such as discharge summaries and diagnostic reports, allowing claims data to be processed without manual entry.
Hyderabad: Digital tools aimed at making health insurance claims faster and more transparent were reviewed at the National Health Claims Exchange (NHCX) Innovation Meet held at the Indian Institute of Technology Hyderabad (IIT H) on Saturday.
Several solutions presented during the NHCX hackathon addressed one of the biggest challenges in the insurance ecosystem: converting hospital records and insurance documents into formats that systems can process automatically. Some teams developed tools to convert legacy hospital software data into standard formats compatible with the NHCX platform, enabling smoother information exchange between hospitals and insurers.
Other innovations focused on digitising clinical records such as discharge summaries and diagnostic reports, allowing claims data to be processed without manual entry. A few teams also demonstrated software that converts insurance policy documents from PDF files into structured digital datasets, making it easier for hospitals to verify coverage and submit claims.
Some proposals used artificial intelligence to analyse claims patterns and detect possible irregular billing or fraud, while others sought to reduce administrative delays by automating parts of the claims submission and verification process.
More than 110 solutions were submitted for the hackathon, conducted between February 22 and 28. Entries were evaluated by an independent jury comprising representatives from IIT Hyderabad, the National Resource Centre for EHR Standards, the General Insurance Council, Google, the India Insurtech Association, NATHealth and the National Health Authority.
The hackathon finale was held as part of the two day NHCX Innovation Meet on March 6 and 7, which brought together regulators, state governments, insurers, hospitals, technology companies and academic institutions to discuss adoption of interoperable health claims systems.
The National Health Claims Exchange is one of the digital gateways created under the Ayushman Bharat Digital Mission to enable standardised exchange of claims information among hospitals, insurance companies and patients.
National Health Authority chief executive officer Sunil Kumar Barnwal said the initiative is aimed at reducing long standing inefficiencies in claims processing. “The National Health Claims Exchange is designed to serve the entire healthcare ecosystem, including patients, providers, insurers and technology innovators,” he said.
Saurabh Gaur, secretary of health, medical and family welfare in Andhra Pradesh, said states were expanding digital health infrastructure through the Ayushman Bharat Digital Mission and increasing the creation of ABHA health identification numbers.
The event also featured recognition programmes such as NHCX Champions, ABDM Ambassadors and NHCX PMJAY Early Integrators to acknowledge organisations helping scale the digital claims platform across the healthcare ecosystem.
