Universal Sompo General Insurance completes first cashless claim on NHCX Platform

Universal Sompo General Insurance Company successfully started end-to-end cashless claim transaction on the National Health Claims Exchange (NHCX) Platform. NHCX is a single-window interface that provides a secure platform for the efficient exchange of health insurance claims data. The platform is designed to strengthen efficiency and transparency in claims processing.

The NHCX platform serves as a single-window interface, providing a secure and efficient exchange of health insurance claims data. This platform is designed to streamline the claims process, ensuring that all stakeholders, including payers, providers, beneficiaries, and other pertinent entities, can interact seamlessly and efficiently. The Health Claim Exchange Specification is a formal communication protocol that orchestrates the exchange of health claim information among various stakeholders. Engineered to be interoperable, machine-readable, auditable, and verifiable, this protocol ensures that the information transmitted is both precise and reliable.

The primary goals of the National Health Claim Exchange (NHCX) are to establish uniformity in health claims processes and promote seamless interaction between disparate systems, thereby enhancing overall system coherence and integration. Additionally, the platform supports a fully electronic and streamlined transfer of data, documents, and images between insurance companies or Third-Party Administrators (TPAs) and healthcare providers, eliminating paper-based processes and reducing administrative burdens. The NHCX also facilitates the transmission of e-claims data via a single, standardised gateway using established protocols such as Application Programming Interfaces (APIs), simplifying and unifying the data exchange process. By improving transparency and efficiency in claims processing, the platform accelerates turnaround times (TAT) and ensures more effective and expeditious resolution of claims.

Sharad Mathur, MD & CEO of Universal Sompo General Insurance, expressed his satisfaction with this achievement, stating, “As we work towards IRDAI’s vision of ‘Insurance for All by 2047’, adopting innovative solutions like the NHCX platform is essential. Starting to carry out cashless claim transaction on this platform now demonstrates our focus on improving operational efficiency and enhancing customer service. This initiative sets a new standard for transparency and reliability in the health insurance sector.”