This Indian Tech Disruptor Is Changing India’s Health Insurance Claims System
Posted: August 11, 2016 Filed under: Cashless Health Insurance, Health Insurance, Health Insurance Companies, State Government Schemes | Tags: Cashless Health Insurance, claim settlement, Government Scheme, Health Insurance, Remedinet, Technology in health insurance
This articles was first published on Forbes Asia Online.
If you suffer the misfortune of being an inpatient in the Indian medical system, you may find your time spent trying to file health insurance claims ends up being longer than your time as a patient, because it’s all being filed by hand. One company set out to be the first to solve this, finding an unusual new problem ahead.
After hearing about an inpatient insurance claims experience, Remedinet CEO Munish Daga says he realized that the process was unnecessarily painful, taking between four and six hours to complete in many cases.
“The adoption of technology was very minimal,” says Daga discussing how this particular segment remains stuck in a 1980s India before liberalization caught on. “This is a sector that was ripe for something new and innovative.”
Based out of Bangalore, Daga and his team set out to cut down the amount of time that manually entered information and reams of paperwork take to process for each health insurance claim, by automating it instead.
Enabling the exchange of structured data between hospitals and insurers through their platform, Remedinet has managed to entirely automate the checkout and claims procedure, eliminating manual filing and phone calling from the inpatient transaction.
Since setting up shop in 2012 they’ve taken 10% of India’s market share of cashless claims; reducing discharge times to under an hour.
Daga believes that the health services sector can be further automated to the extent that the financial services sector is through online banking. He’s got plans to launch a Remedinet drugs database (India currently has no standard, government approved version), which will help turn the process into a swifter version of itself, he says, “eligibility [for insurance], room rent, it should all be automated.”
But as it turned out, the problem wasn’t getting the segment automated. It was the acceptance of its use in the mainstream context. While up to 30% of the insurance space in India is private sector, the remaining bulk is all part of the public sector.
“The reaction in the private space has been great,” says Daga, “but the public sector sees it as a threat – the challenge we’re facing today is typical of the public sector.”
The public medical insurance space is government territory, running at low costs, and peppered with large doses of human inaccuracy. If technology automates the space, the fear is that jobs will disappear.
“The same thing happened in the banking sector a decade ago when ATMs came in,” says Daga.
He wants to create efficiency within the segment, building profitability onto that. Large Indian private insurers including Max Bupa and Bajaj Alliance are on board with that. As are Indian billionaire Rakesh Jhunjhunwala, often referred to as India’s Warren Buffet, along with venture capitalists Bessemer Venture Partners and Nirvana Venture Advisors, who have backed Remedinet.
The cashless health insurance platform is being used in 240 private hospitals across Bangalore, New Delhi, and Mumbai to date. They’re also operating in rural districts through the states of Karnataka and Tamil Nadu, providing cashless health insurance to families below the poverty line.
Here they’re trying to work with government on certain schemes that will enable the old bureaucracy to go paperless. In Maharashtra they’ve rolled this plan out for state police employees.
Comparing Remedinet to US based insurance claims management solutions providers such as Change Healthcare’s Emdeon product, Daga says he wants to create the gold standard for cashless claims across India.
“In a market like the US, standards preceded technology,” Daga says, “India is far away from the adoption of any standards, the good part is that if we do succeed, we do become a standard.”