eClaims - Payer eObjects
This document presents the design specifications for electronic claim objects and associated standard processes for their exchange between Payers and Providers, through a Health Claim Platform that was recommended in the report “Common IT Infrastructure for Health Insurance Claims management” by IRDA-NHA joint working group. The health claim platform is intended to improve current claim processes, enforce transparency and facilitate on time provider payments for Health insurance Claims in India. Usage of Standard Electronic Claim related objects will facilitate auto adjudication of claims by both Public and Private Health Insurance Payers with reduced operational costs. eClaims Objects - Health Claims Platform Payer eObjects Specifications: eClaims Object, Claims Response etc. eDischarge Summary Object : Pick the eDischarge Object from Provider eObjects v2 Standard Value Sets for eClaims Objects Standard Value Sets for eDischarge Objects Summary of Insurance eObjects The eOb
