To improve transparency in health insurance claims, and reduce consumer grievances, the finance ministry is seeking control of the digital platform National Health Claims Exchange (NHCX) that is currently under the purview of the health ministry.
The department of financial services (DFS), which is under FinMin, is already in touch with the prime minister's office regarding the same, a senior government official said on condition of anonymity.
"The idea is to bring insurance companies, healthcare providers, and insured individuals on a single platform to enhance transparency and ensure better regulation under the Insurance Regulatory and Development Authority of India (Irdai)," the official said.
NHCX connects insurance companies, healthcare service providers, and government insurance scheme administrators to streamline healthcare access and claims.
"We aim to make the health insurance claims process far more transparent and robust. Currently, in several cases, it has been observed from insurers and regulators that hospitals tend to inflate bills for insured individuals," the official said.
Irdai is the apex body responsible for regulating and promoting the insurance and reinsurance industry in India. Irdai also ensures fair treatment of policyholders, maintains financial soundness of the industry, and frames regulations to ensure clarity in operations.
According to government data as on July 21, 2024, 34 insurers and TPAs (third party administrators) are currently live on NHCX, and approximately 300 hospitals are preparing to start sending their claims on the Exchange.
-- Harsh Kumar, Business Standard
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