The government is expected to launch the National Health Claim Exchange (NHCX) within the next two to three months, a centralized portal designed to streamline the submission and processing of health insurance claims across hospitals nationwide. This move aims to reduce wait times, expedite pre-authorization and discharge approvals, and lower insurance premiums for consumers.
Developed by the National Health Authority (NHA) in collaboration with the Insurance Regulatory and Development Authority of India (IRDAI), the NHCX will enhance interoperability and accelerate health insurance claim processing.
The NHA and IRDAI began working on the NHCX last year, with IRDAI issuing a circular in June 2023 advising insurers and providers to join the platform. Approximately 50 insurance companies, nearly 250 major private hospitals, and other stakeholders have participated in workshops and meetings for full integration with NHCX.
“The portal is ready and expected to launch in the next two-three months,” said a Senior Central Government official, noting it is part of the Ayushman Bharat Digital Mission (ABDM).
The NHCX will serve as a unified platform for health claims processing, promoting efficiency and transparency. Major insurance companies, including Aditya Birla Health Insurance, Star Health and Allied Insurance, Bajaj Allianz, HDFC Ergo, ICICI Lombard General Insurance, New India Assurance, Tata AIG, Paramount TPA, and United India Insurance, have already integrated with NHCX on a pilot basis.
Currently, the claims process lacks standardization, with data exchange often occurring through PDFs or manual methods, leading to high processing costs. The NHCX aims to standardize and digitize these processes.
For hospitals, benefits include a single payer network, universal claims format, faster payments, improved patient experience, and paperless operations. For insurance companies, the portal will reduce operational costs, enable new processes for auto adjudication, fraud control, and improve data quality for the industry and regulators.
“The government is facilitating this platform to simplify the claims process for consumers and stakeholders. Participation by hospitals and insurance providers will be voluntary,” added another Senior Official.
