NHA and IRDAI collaborate to boost digital health integration in insurance sector

The National Health Authority (NHA) and the Insurance Regulatory and Development Authority of India (IRDAI) recently concluded a groundbreaking three-day Accelerator Workshop aimed at facilitating the seamless integration of digital health systems within the insurance sector. The workshop, which took place from August 10th to 12th in New Delhi, witnessed active participation from over 150 professionals representing 29 insurance companies and 16 Third-Party Administrators (TPAs).

In line with its commitment to advancing digital health initiatives, the IRDAI issued a pivotal circular in June 2023, urging insurance companies to collect the Ayushman Bharat Health Account (ABHA) number from all individuals seeking insurance coverage. The directive also emphasized obtaining consent from these individuals for sharing their medical records with insurers and TPAs through the ABHA platform. The integration of ABHA aims to streamline healthcare and insurance services by enabling insurers to access medical information efficiently and securely, ultimately expediting the claims process and fostering transparency.

Moreover, the IRDAI issued another circular, encouraging insurers and providers to embrace the National Health Claims Exchange (NHCX). This platform serves as a hub for the exchange of claims-related information among key stakeholders in the healthcare and health insurance ecosystem, encompassing insurers, TPAs, claimants, beneficiaries, and healthcare providers. The seamless interoperability offered by the NHCX is set to revolutionise health claims processing.

The collaborative efforts of the participating entities yielded impressive results, with 29 organisations, including 23 insurance companies and 6 TPAs, successfully completing the initial level (M1) of ABHA integration. This achievement empowers them to generate and validate ABHA numbers. Additionally, 20 insurance companies achieved Level 1.2 of their NHCX integration, enabling them to associate or disassociate ABHA numbers with insurance policies.

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