Unified Portal for Hospital Insurance Claims and Free Healthcare for the Elderly

Unified Portal for Hospital Insurance Claims

The National Health Authority (NHA) is creating a unified portal called the National Health Claims Exchange (NHCX) to allow hospitals across India to submit insurance claims to around 50 different insurance providers through a single platform.

This will streamline the claims process and reduce the administrative burden on hospitals, as they currently have to raise claims on separate portals operated by individual insurance companies.

Key benefits of the NHCX include:

• Decreased need for hospital staff dedicated to processing claims

• Expedited pre-authorization and discharge approval processes

• Potential reduction in insurance premiums

• Provision of public information on claim settlement ratios and turnaround times for insurance companies

• Free Healthcare for the Elderly Above 70 Years

• President Droupadi Murmu announced that all citizens aged above 70 years will now receive free treatment under the Ayushman Bharat health insurance scheme.

• This expansion of coverage aims to provide healthcare access to the elderly population, as a study showed that only 20% of people over 60 years were covered under existing health schemes.

How to Claim Free Treatment Under Ayushman Bharat

1. Visit the official Ayushman Bharat website (mera.pmjay.gov.in) and click on the "Beneficiary Identification" option.

2. Enter your mobile number and the captcha code displayed on the screen. You will receive an OTP on your registered mobile number.

3. Enter the OTP to verify your identity.

4. Your eligibility status will be displayed on the screen. If you are eligible, you can proceed to the next step.

5. Visit any of the empaneled hospitals under the Ayushman Bharat scheme and present your Aadhaar card or any other valid ID proof.

6. The hospital staff will verify your eligibility and provide you with free treatment, including diagnostic tests, medicines, and procedures, up to a limit of ₹5 lakhs per year.

7. In case of any issues, you can contact the Ayushman Bharat helpline at 14555 or visit the nearest Common Service Centre (CSC) for assistance.

Integration of Digital Health Initiatives

The implementation of AB-PMJAY is being supported by various digital health initiatives:

The eVIN portal will be used to enroll children at birth, record their vaccinations, and issue online vaccine certificates. It will be integrated with the digital health account ABHA.

The BHISM cubes - portable medical centers and operation theaters - will be deployed at major government hospitals for use during emergencies and disasters.

These digital initiatives, along with the unified claims portal, aim to create a comprehensive ecosystem for the government's vision of portable digital health records and improved access to healthcare services.

In summary, the key developments in the Indian healthcare landscape include the creation of a unified portal for hospital insurance claims, the expansion of the Ayushman Bharat scheme to provide free treatment for the elderly above 70 years, and the integration of various digital health initiatives. These efforts are part of the government's broader vision to provide universal health coverage and improve the overall healthcare system in the country.

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