‘Claims exchange will end insurer-hospital friction’

The National Health Claims Exchange (NHCX) brings the entire health insurance ecosystem onto one structured digital platform.

- SAIKAT NEOGI

Tapan Singhel, MD & CEO, Bajaj General Insurance and chairman of General Insurance Council, tells Saikat Neogi while all insurers are already on NHCX, hospital participation has been slow. Once hospitals join, real-time digital exchange will make claims faster, simpler, and more transparent. Edited excerpts:How can the growing friction between health insurers and hospitals over claim settlements be resolved?

To address this issue, we must go back to what is already mandated by law and by the regulator. The first step is the common empanelment framework created by the General Insurance Council, which ensures that customers get cashless treatment irrespective of which insurer’s policy they hold. We have been requesting hospitals to join this, and while there was initial resistance, close to a thousand hospitals have come on board, and over 6,000 have registered, which is a very positive shift.

The second requirement is the adoption of the NHCX. All insurers are already on NHCX, but hospital participation has been slow. Once hospitals join, real-time digital exchange will make claims faster, simpler, and more transparent. Third, as per Supreme Court directions and provisions of some state governments, all hospitals are required to display their charges transparently. The recent Kerala judgment also reinforces this. If these three elements move together, customers will get seamless cashless access, more transparent pricing, and quicker payments.

How can the NHCX help in streamlining and digitising health insurance claims?