Indian medical care providers explore HCX platforms to reduce administrative tasks in insurance claims
Posted on May 6, 2024 Updated on May 5, 2024
Indian medical care providers are exploring Health Exchange (HCX) platforms for reducing administrative tasks in insurance claims. It maximises cloud computing, allowing access in real-time, and secure information related to insurance claims. It enables seamless interoperability of health claim data between different systems, whilst safeguarding sensitive medical information at all costs.
Gaurav Gupta, co-founder & CEO, CarePay said, India follows a decentralized approach when it comes to the penetration of health insurance as merely 37% of its population are covered under the present schemes while nearly 400 million have zero access to health insurance.
Amidst the growing discrepancies in the decentralized healthcare insurance industry which is plagued by non-digitised and non-standardised processes, the interlude of the health claims exchange platform represents a revolution in healthcare. Moving beyond merely being another digital lending platform, HCX is a community-driven initiative in alignment with the government’s Ayushman Bharat Digital Mission, aiming to offer universal health coverage via the aid of HCX data exchange, he added.
HCX acts as a platform geared to transform the management of health insurance claims with efficiency.
With digitisation, HCX opens doors to electronic health records, which at the disposal of healthcare professionals enable them to access a patient’s comprehensive information, including insurance coverage and other essential details. Along with a seamless flow of data exchange amongst multiple systems, it improves patient experience, whilst mitigating the possibility of any discrepancies, Gupta a told Pharmabiz in an email.
Further, HCX expedites the settlement process from pre-authorization to discharge which lowers associated expenses. Simultaneously, it enables accessibility as nearly 6 out of 10 patients don’t have enough monetary capacity or insurance coverage.
Being a digital claims platform, it brings together multiple stakeholders under one unified pool, from policyholders to healthcare providers. Primarily, policyholders will get real-time updates of the claim through a simplified flow of information.
Gupta noted that it is already certain an efficient and transparent insurance claim process fosters better decision-making for individuals who pay for that policy. Besides, reduced overhead costs empower healthcare providers to focus from administrative tasks and capitalize on delivering enhanced patient care.
HCX data provides information on the borrower’s spending habits, enabling lenders to have a more holistic view of the person’s financial responsibility. It also helps FinTech and lending startups in making better credit decisions. With assessment algorithms, it opens financial access to the underserved segment of the population, he said.
Individuals can analyze their HCX data and streamline their spending making room for improved budgeting, debt reduction, and get the financial security. It helps them to look for loan options that are tailored best to their financial needs. Therefore, a Health Exchange develops a standardized health insurance framework with refined the settlement process from pre-authorization to discharge. Apart from building an open community amongst policyholders, payers, stakeholders, healthcare providers and other involved entities, the platform is focused on improving the insurance experience with informed decision-making, said Gupta.
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- Source: https://auroushealthcare.wordpress.com/2024/05/06/indian-medical-care-providers-explore-hcx-platforms-to-reduce-administrative-tasks-in-insurance-claims/