33 Major Health Insurance Companies Boarded NHA’s NHCX Platform

Other major players already available in the NHCX platform include Aditya Birla Health Insurance, Star Health and Allied Insurance, Bajaj Allianz Insurance, among others.

In a significant development, 33 leading health insurance companies in India have joined the Government’s National Health Claims Exchange (NHCX), a centralized platform to streamline insurance claims processing.

The NHCX, developed by the National Health Authority (NHA) in partnership with the Insurance Regulatory Development Authority of India (IRDAI), aims to expedite the insurance claims process and provide real-time access to claim status.

This platform will allow citizens to track their insurance claims through mobile devices, thereby increasing transparency and accountability.

As of now, the specific names of the insurance companies that have joined the NHCX have not been publicly disclosed.

Several insurance companies have already started trialing the NHCX for claims processing, with a full-scale launch expected soon. A senior official from the NHA commented, "Citizens will also be able to see the status of their insurance claim through their mobile devices."

Recently, HDFC Ergo, a significant player in the health insurance sector, successfully processed its first claim through the NHCX.

Other major players previously onboarded the NHCX platform include Aditya Birla Health Insurance, Star Health and Allied Insurance, Bajaj Allianz Insurance, ICICI Lombard General Insurance, The New India Assurance Company, Tata AIG General Insurance, and United India Insurance.

How Does NHCX Work?

Currently, the insurance claims process is fragmented across multiple platforms, resulting in significant delays.

The current process requires patients to provide their insurance policy details or a card issued by their Third-Party Administrator (TPA) or insurance company when they seek treatment at a hospital.

The hospital then accesses the insurer's claim processing portal and uploads the necessary documents for pre-authorization or claim approval. Once received, the insurance company or TPA digitizes and authenticates the claim form, which is then adjudicated by the relevant team.

Highlighting the inefficiencies of the existing system, a senior doctor noted, "Often, patients keep waiting throughout the day for this process to be completed, leading to delay in discharge from hospital and additional room rent charges. With NHCX, they can monitor the progress of claim settlement. It is a major relief."

The NHCX addresses this issue by offering a unified digital platform for all stakeholders, including insurers, third-party administrators, hospitals, laboratories, and beneficiaries.

This integration is expected to significantly reduce processing times and improve the overall efficiency of claims settlements.

Sources familiar with the matter have indicated that while the NHCX is not intended to regulate business practices, the data generated from this digital platform could be instrumental in developing future measures to prevent malpractices, such as unjust claim rejections.

As the NHCX prepares for its official launch, it aims to bring substantial improvements to the health insurance sector in India. The platform seeks to reduce processing times and enhance transparency in claims settlements, addressing longstanding challenges faced by both patients and insurers.

In November, last year, ten hospitals including Jupiter Hospital (Thane), Kauvery Hospitals (Chennai), A J Hospital Research and Research Centre (Bengaluru), Sarvodaya Hospital (Faridabad), Fortis Hospital (Gurugram and Noida), Shri Balaji Action Hospital (Delhi), Sanar International Hospital (Gurugram), Centre for Sight (Dwarka, Delhi), and Narayana Hrudayalaya (Delhi) joined the NHCX platform.