Universal Sompo Launches First Cashless Claim On NHCX Platform

Universal Sompo General Insurance Company has completed its first cashless claim transaction using the National Health Claims Exchange (NHCX) Platform. 

The company in a press statement on Saturday informed that the NHCX serves as a single-window interface, facilitating the secure and efficient exchange of health insurance claims data. This platform aims to enhance efficiency and transparency in the claims processing system.

Designed to streamline the claims process, the NHCX platform allows seamless interaction among payers, providers, beneficiaries, and other stakeholders. It utilises the Health Claim Exchange Specification, a formal communication protocol that ensures the accurate and reliable exchange of health claim information. This protocol is engineered to be interoperable, machine-readable, auditable, and verifiable.

The primary objectives of the NHCX include establishing uniformity in health claims processes and promoting seamless interaction between different systems, thereby improving overall system coherence and integration. The platform supports fully electronic data transfer between insurance companies or Third-Party Administrators (TPAs) and healthcare providers, eliminating paper-based processes and reducing administrative burdens. Additionally, it simplifies data exchange by transmitting e-claims data via a standardised gateway using established protocols such as Application Programming Interfaces (APIs). This results in improved transparency, faster turnaround times (TAT), and more efficient claims resolution.

Sharad Mathur, MD & CEO of Universal Sompo General Insurance, expressed his satisfaction with this milestone, 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 transactions 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."

Universal Sompo General Insurance is dedicated to leveraging cutting-edge technology to enhance customer experience and streamline operations. The NHCX platform represents a significant step forward in this journey, and the company looks forward to continued success and innovation in the insurance industry.