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National Health Claim Exchange
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- Context (TH): India is launching a digital platform called National Health Claim Exchange (NHCX) to improve healthcare access and reduce out-of-pocket expenses for patients.
- NHCX will integrate insurance companies, healthcare providers, and insurance scheme administrators.
- The NHCX will serve as a central hub for health claims data, promoting seamless interoperability among stakeholders. This integration aims to enhance efficiency and transparency in claims processing.
- NHCX aligns with IRDAI’s vision of “Insurance for All by 2047.”
- As a centralised platform for all health claims, NHCX will significantly reduce the administrative burden on hospitals, which currently manage multiple portals for different insurers.
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Digital Health Incentive Scheme (DHIS)
- DHIS, initiated by the National Health Authority (NHA), aims to encourage the adoption of digital health transactions and the digitisation of patient health records across the country.
- Under the DHIS, hospitals receive financial incentives for processing insurance claims through NHCX.
- ₹500 per claim or 10% of the claim amount, whichever is lower.
- The incentives are given directly to the hospitals.
National Health Authority
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Challenges
- Strained relationships between hospitals and insurance companies.
- The IT system and training staff are outdated.
- Discharge delays and miscommunications.
- Data Security.
Facts
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