NHA and IRDAI jointly organized a workshop for Insurance Companies and TPAs

The National Health Authority (NHA) and IRDAI (Insurance Regulatory and Development Authority of India) jointly organized an exclusive three-day Accelerator Workshop to help insurance companies complete their ABDM integration and to facilitate adoption of Health Claims Exchange (HCX) specifications and e-Claim standards for insurance companies and Third-Party Administrators (TPAs). The workshop was organized from 10th to 12th August 2023 in New Delhi and saw participation from over 150 professionals representing 29 insurance companies and 16 TPAs.

The IRDAI had issued a circular in June 2023 advising all insurance companies to start capturing ABHA (Ayushman Bharat Health Account) number of all of the persons seeking insurance cover and also to obtain their consent for sharing medical records with insurers/TPAs through АВНА. The ABHA number would help identify the insured in a digital environment and facilitate seamless healthcare and insurance service delivery. It would give insurers easy and timely access to a person’s medical information in a safe and paperless manner and help the insured with a transparent and speedy process of claims servicing.

Further, the IRDAI also issued a circular advising the insurers and providers get on-boarded to the National Health Claims Exchange (NHCX). The NHCX will serve as a gateway for exchanging claims-related information among stakeholders present in the healthcare and health insurance ecosystem including insurers, TPAs, claimants, beneficiaries, healthcare providers etc. The integration with NHCX will enable seamless interoperability of health claims processing. More information on the NHCX is available here: https://sbxhcx.abdm.gov.in/

The combined efforts from the teams resulted in 29 entities, including 23 insurance companies and 6 TPAs completing their first level (M1) of ABDM integration, which enables them to create and verify ABHA. Further, 20 insurance companies were also able to successfully complete Level 1.2 of their NHCX integration which would enable them to link or delink ABHA with an insurance policy.

Speaking about the outcomes from this workshop, CEO, NHA said – “This Accelerator Workshop was a first-of-its-kind focused initiative for ABDM adoption in the insurance sector. The large number of entities who got successfully integrated demonstrate the power of collaborative working to achieve a larger goal. This has definitely encouraged us to organize more such workshops to strengthen the digital health ecosystem.”

NHA and CDAC, Pune provided technical support to the representatives from insurance companies and TPAs and helped them complete the respective integrations. The General Insurance Council (GIC) helped in bringing the concerned teams from leading insurers and providers for the workshop.

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