The Digital Transformation In India’s Health Insurance Sector

Digital transformation has revolutionalised each sector in India, and the health insurance sector has not been left far behind. Digital integration for policy comparison, policy issuance, claim management, and renewal processes has streamlined things to ensure seamless customer experience. Health insurance plans for family from ACKO offer seamless digital experience to the policyholders right from issuing the policy, paying premium to renewal processes, it is your one-stop solution for all health insurance requirements.

Factors that Led to Digital Integration in India’s Health Insurance Sector

The traditional paper based health insurance plans and medical records had the following limitations.

1. Inefficient communication:

Endless documentation in case of health conditions has a negative impact on the communication amongst healthcare providers, policyholders, and insurers. Therefore, it affects the quality of care and patient experience due to delays in receiving timely care.

2. Limited security:

Physical documentation of health records lacks robust security. The health records should be kept confidential at all times. The physical documentation of all the records does not ensure privacy. They can be accessed through unaurthorised personnel or are prone to being misplaced as well.

3. Time consuming claim processes:

Traditional paper based claims require an insurance personnel to locate information, verify information, and then process the claim. It is a time consuming process and it leads to delays in processing claims.

The Key Drivers of Digital Transformation

1. Ayushman Bharat Digital Mission (ABDM)

ABDM was launched on 27 September 2021 with an objective to establish robust digital health infrastructure in India. It aims to revolutionalise India's digital healthcare ecosystem to enhance transparency, efficiency, and healthcare accessibility. Below are some impressive numbers which will give you a glimpse into the digital transformation by this initiative.

Over 67 crore Ayushman Bharat Health Accounts (ABHA) have been created and more than 42 crore health records have been linked to ABHA.

2. COVID-19 Pandemic

IRDAI issued a mandate to all the employers to provide health insurance plans to their employees post pandemic. Moreover, the pandemic also saw a surge in teleconsultations, and medicines delivery through e-pharmacies due to movement and travel restrictions. Insurance providers made several services digitally available, which included comparing health plans, issuing health insurance, processing claims, paying premium online, and renewing health insurance plans.

3. Increased consumer expectations

Smartphone and internet penetration has increased significantly over the past few years. It has changed the way consumers interact, access information, and conduct various activities. Ordering groceries, transferring funds, booking maintenance services, and many other services are available at fingertips. Therefore, the consumers’ have similar expectations from the healthcare sector as well, which lead to digital transformation in the health insurance sector.

Important Areas of Digital Transformation

1. Claims processing

Submitting a claim digitally is a fairly easy process as compared to traditional paper based claim submission process. Insurance providers get all the information online and process claims in no-time. Through the digital revolution, the claim process has become efficient. Therefore, patients and their family members do not have to wait for days to receive their money.

2. 24X7 customer service

Virtual assistants and AI powered chatbots provide 24X7 chat support to patients and their family members. They are always available to guide them through their queries and processes.

3. Self-service portals

They help patients access their policy information online, which enables them to check their network hospitals, eligibility in case of various services and add-ons. They can submit the claims online, and view their status if under review or approved. This ensures a seamless and hassle-free user experience.

4. Internet of Things

The apps use data from the wearable devices or any other activity tracking apps to monitor an individual’s health and well-being. The app then prompts personalised care services to these individuals in case of any issue in their activity.

5. Teleconsultations and telemedicine

One can schedule their appointments online and opt for teleconsultations. Therapy sessions can also be conducted online. Moreover, they can get their prescriptions online and medicines can be delivered by e-pharmacies. They can also receive their diagnostic reports.

6. Seamless integration of health records under one digital platform

Individuals are able to store all their health records on a single platform using ABHA ID. These health records include medical history, prescriptions, diagnostic reports, x-ray and radiology reports. As the platform uses robust encryption, it is safe for all the users. The policyholders can access and share the important medical information with their preferred healthcare providers in case of health uncertainties. Therefore, they can receive the treatment promptly.

Conclusion

Smartphone and internet penetration has changed the way we access information, perform daily transactions, and interact with each other online. The government initiatives - mandatory health insurance policies for all employees and ABHA have been instrumental in digital transformation for the health insurance sector in India. Through digital initiatives, individuals can compare health plans online and decide the best plans for themselves. They can store health related data by generating a 14 digit unique identifier - ABHA ID and share them with authorised healthcare providers. They can submit claims and receive their money in almost no time. Therefore, it is clear that digital transformation in the health insurance sector has benefited all the touchpoints - healthcare organisations, insurance providers and customers.

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