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Critical and Opportunity Analysis of Automation and IT in Health Insurance in India

Critical and Opportunity Analysis of Automation and IT in Health Insurance in India

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Published by: anuiscool on Dec 09, 2009
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PROJECT REPORT Critical/Opportunity analysis of automation and IT in HealthInsurance in India
SUBMITTED BY: ANURAG SINGH ROLL NO. 06 XPGDM 2007-2008 INTERNATIONAL MANGEMENT INSTITUTE 
 
2
AKNOWLEDGEMENTS
I would like to thank Prof.
Abhijeet Roy
, Faculty “B&I,” INTERNATIONAL MANAGEMENTINSTITUTE, New Delhi, for giving me his invaluable guidance and blessings to completethis project.My sincere thanks to Mr.
Ashvini Srivastava
(CEO, Apollo HealthHiway), Ms.
MeghaMalagatti
, (Consultant Health Care Solutions - HealthHiway), Mr.
A.V. Rajan
(GeneralManager- Insurance and Claims Solutions) for spending their valuable time and givingme invaluable insights on Health Insurance IT and automation.
 
3
TABLE OF CONTENTS1.
 
Introduction – Page 4.2.
 
Health Care In India – Page 5.3.
 
Overview of Health Insurance In India – Page 10.4.
 
Special Role of TPA s in the health insurance sector – Page 15.5.
 
Need for a national health data repository under the auspices of IRDA – Page 19.6.
 
Prerequisites for proper implementation – Page 21.7.
 
Proposed business model for data repository and costing – Page 23.8.
 
Role of smart cards in health insurance and opportunities – Page 26.9.
 
Types of smart cards – Page 27.10.
 
Use of smart cards in healthcare – Page 29.11.
 
Present use of smart cards in India in health insurance – Page 31.12.
 
Outpatient Claims concept using smart cards – Page 35.13.
 
Claims process automation and opportunities – Page 37.14.
 
Gap analysis of manual resources for the TPA industry – Page 42.15.
 
References – Page 44.

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