Around 3.79 crore claims were submitted under the Ayushman Bharat insurance scheme for secondary care hospitalisation between 2020-21 and 2022-23, of which 3.54 crore claims have been paid and 12.04 lakh are pending as on November 30, the Rajya Sabha was informed on Tuesday.
Under the Ayushman Bharat-Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) claims are settled by health agencies under state governments, Union Health Minister Mansukh Mandaviya said.
Timely settlement of claims is one the key parameters against which scheme performance is measured, he told the Upper House of Parliament. The National Health Authority (NHA) monitors the status of claim settlement under the scheme.
Regular review meetings are organised to take stock of progress with regard to the claim settlements. Further, capacity building activities are organised for efficient claim settlements, the minister said.
The NHA has launched another initiative called the Green Channel Payments (GCP) with the objective to ensure timely payment to hospitals, he said.
Under the GCP, partial payment of 50 per cent of a claim amount is automatically released to hospitals at the time of claim submission, while the balance is released after the normal claim adjudication process, Mandaviya said. Many states have initiated the implementation of the GCP, he added.
