NHA, IRDAI release report on hospital network management

The National Health Authority (NHA) and Insurance Regulatory and Development Authority of India (IRDAI) launched reports focussing on Hospital Network Management, Common IT Infrastructure for Health Insurance Claims Management, Fraud and Abuse Control and Data Standards and Exchange, on Saturday.
NHA, IRDAI release report on hospital network management
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A joint working group of IRDAI and NHA was formed to work on key areas of mutual interest and co-operation. The report is a result of the group that was launched by Dr Indu Bhushan, Chief Executive Officer, National Health Authority, and Subhash Khuntia, chairman, IRDAI.

The recommendations in the report include best practices, common standards, collaborative measures and IT framework, which benefits stakeholders such as beneficiaries, policyholders, insurers, State health agencies, healthcare providers, implementing agencies and intermediaries. “The recommendations in the report are a step forward in enabling quality healthcare and access to the patients. These reports would help further strengthen the transparency, efficiency and effectiveness of AB-PM-JAY, benefiting millions in India directly,” said Indu Bhushan.

The report focused on building a National Repository of Empanelled Hospitals under insurance or government schemes with defined standards for quality and package rates and codes by defining audits on hospital infrastructure and facility. Another section of the report stressed on detecting and deterring frauds through common repository, and capacity building by developing standard reporting formats of such frauds. The report emphasises on increasing service efficiency and transparency for the delivery of health insurance services by automation. The reports of Joint Working Group would be available on IRDAI and NHA websites for comments by industry and public. Subhash Khuntia, chairman of IRDAI said that they were confident that the recommendations would create a positive impact and lead to further growth of health insurance.

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