False
Download Learnerz IAS app from the Play Store now! Download

$show=search/label/May%202022

 


National Health Claim Exchange UPSC NOTE

 

  • The Health Claim Exchange Specification is a communication protocol that facilitates the exchange of health claim information between payers, providers, beneficiaries, and other relevant entities. 

  • It is designed to be an interoperable, machine-readable, auditable, verifiable, which helps ensure that the information being exchanged is accurate and trustworthy. 

  • It is an open standard based communication.

Challenges of the Current Process

  • The current process of exchanging claims lacks standardization across the ecosystem.

  • With most data exchange occurring through PDF/manual methods.

  • Additionally, there are no established health standards.

  • Processes vary significantly among insurers, TPAs, and providers.

  • In India, a significant portion of the adjudication process is presently manual, whereas in many developed markets, over 90% of claims are auto adjudicate

  • To address these challenges, NHA along with industry experts have made standard domain specification and NHCX protocal and published for feedback from industry participants such as insurance companies, TPAs, and state health agencies. 

  • This collaborative and transparent effort aims to create an open, widely agreed Health Claims data Exchange Specifications that can be adopted as a public good.

How is the NHCX expected to work?

  • The NHCX will serve as a gateway for exchanging claims-related information among various stakeholders in the healthcare and health insurance ecosystem. 

  • The integration with NHCX is expected to enable seamless interoperability of health claims processing, enhancing efficiency and transparency in the insurance industry, benefiting policyholders and patients

Challenges:

  • Building trust: Requires efficient service delivery and addressing issues like discharge delays and miscommunication.

  • Digitalization: Both hospitals and insurance companies need to upgrade IT systems and train staff.

  • Data security: Addressing concerns about data breaches.

Overall NHCX is a digital initiative with the potential to improve healthcare access and affordability for all stakeholders in India's healthcare system.


COMMENTS

Name

Amritsar,1,April 2024,301,Art & Culture,1,August 2023,251,Courses,7,Daily Current Affairs,48,December 2023,189,Disaster Management,2,Environment and Ecology,148,February 2024,228,Foundation Course,1,GDP,1,GEMS Club,1,GEMS Plus,1,Geography,154,Govt Schemes,2,GS 2,1,GS1,6,GS2,36,GS3,15,GST,1,History,9,Home,3,IAS Booklist,1,Important News,71,Indian Economy,118,Indian History,2,Indian Polity,135,International Organisation,12,International Relations,97,Invasive Plant,1,January 2024,240,July 2023,281,June 2022,6,June 2023,268,June 2024,173,March 2024,238,May 2022,17,May 2024,330,Mentorship,2,November 2023,169,October 2023,203,Places in News,2,Science & Technology,66,Science and Technology,90,September 2023,205,UPSC CSE,111,
ltr
item
Learnerz IAS | Concept oriented UPSC Classes in Malayalam: National Health Claim Exchange UPSC NOTE
National Health Claim Exchange UPSC NOTE
Learnerz IAS | Concept oriented UPSC Classes in Malayalam
https://www.learnerz.in/2024/06/national-health-claim-exchange-upsc-note.html
https://www.learnerz.in/
https://www.learnerz.in/
https://www.learnerz.in/2024/06/national-health-claim-exchange-upsc-note.html
true
4761292069385420868
UTF-8
Loaded All Posts Not found any posts VIEW ALL Readmore Reply Cancel reply Delete By Home PAGES POSTS View All RECOMMENDED FOR YOU LABEL ARCHIVE SEARCH ALL POSTS Not found any post match with your request Back Home Sunday Monday Tuesday Wednesday Thursday Friday Saturday Sun Mon Tue Wed Thu Fri Sat January February March April May June July August September October November December Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec just now 1 minute ago $$1$$ minutes ago 1 hour ago $$1$$ hours ago Yesterday $$1$$ days ago $$1$$ weeks ago more than 5 weeks ago Followers Follow THIS PREMIUM CONTENT IS LOCKED STEP 1: Share to a social network STEP 2: Click the link on your social network Copy All Code Select All Code All codes were copied to your clipboard Can not copy the codes / texts, please press [CTRL]+[C] (or CMD+C with Mac) to copy Table of Content