Embracing Technology For Expansion of HealthCare Insurance
Health is a basic human requirement and right and therefore its accessibility and affordability has to be ensured. The soaring medical treatment cost is beyond the reach of common man and in particular where a substantial chunk of population belongs to poor segment of society. To make matter worse Government control over expenditure for spend on social cause to keep physical deficit under control has added to the woes in the health care sector. Healthcare in India is in a state of enormous transitions though it remains highly under developed and less significant for masses. Health insurance is more complex than other segments of insurance business because of unavailability of data, Lack of information and moral hazards. Health sector policy formulation, assessment and implementation are an extremely complex phenomenon due to changing epidemicological, institutional and technological scenario.
Various challenges Indian healthcare sector faces can be summed up as under.
- Soaring cost in healthcare sector
- High financial burden on poor eroding their hard earned income
- Need for long term nursing care for senior citizens
- Increasing burden of new diseases and health risks
- Under funding of government healthcare preventive and primary care
- Beneficiary Management Module
- Diseases/ Benefit Package Module
- Provider Management Module
- Enrollment Module
- Pre-Authorization Module
- Claims Management Module
- Utilization Management Module
- Provider quality Management Module
- Grievance Committee Module
- Audit/Fraud detection Module
Prepared by Mr. Bhavin H.Shah Director – Anmol Technomart Pvt. Ltd.
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