Revolutionizing Health Insurance

Explore how India’s Health Claims Exchange can transform insurance accessibility and streamline claims processing for millions.

Dr. Sabine Kapasi & Dr. Hardik Sankhla

I’m excited to announce that our latest article, Transforming Healthcare: India’s Journey Towards a Functional Health Insurance Claims Exchange has been featured in Elets eHealth. In this piece, I delve into the growing significance of digital solutions in healthcare insurance claims management, exploring how the Health Claims Exchange (HCX) can help address the critical gaps in health insurance coverage.

It’s often said that “standardization promotes efficiency.” But what if leveraging technology through HCX could be the key to overcoming the challenges of fragmented insurance claims? The issue of health insurance accessibility continues to be a significant challenge, impacting over 400 million individuals in India who lack financial protection. However, by leveraging HCX’s digital infrastructure, we can streamline claims processing and enhance transparency.

The article highlights the importance of a regulatory framework for health insurance, drawing lessons from international systems to build a robust ecosystem. It also underscores the necessity of addressing data security, user adoption, and compliance challenges to fully realize HCX’s potential.

Get In Touch

Our consultants are highly capable of strategizing any ad-hoc request, keeping suppliers and customers happy, meeting governance requirements, and project/product development.

Careers

We Are Here To Help You

Contact Us

Copyright © 2024 Enira Consulting Pvt. Ltd. All rights reserved.

Apply Now for Our Exclusive Internship Opportunity!

Take the Next Step in Your Career Journey:

Apply for Our Full-Time Job Opportunities Today!

ShowReels and Enira Consulting

More than 1.5 lakh hirings are done by the government of India every year, The process of recruitment is lengthy and tedious process, after examination screening of candidates takes an average of 3-4 months following interviews and final recruitment. Recruiters face the issue of extensive long interviews with numerous candidates, and further shortlisting a few for final round with senior management/panelists. Even after these lengthy interviews, the aspirants feel that the entire process wasn’t transparent and time consuming. To deal with this problem, showreels with the partnership of Enira consulting intends to provide a free of cost digital tool to screen the candidates based on short videos. Showreels will also fuel entrepreneurship among the candidates by exposing them to the vibrant professional network of mentors and venture capitalists. It will also give INR 1 lakh to 10,000 candidates every year who have game-changing business ideas/ product/ service. Showreels will partner with different central and state governments to optimize the process of recruitment and boost entrepreneurship

Digital Chikitsa: Automated health diagnosis system

Healthcare is very crucial for any nation, we deal with human life, to ensure this we are in dire need of a deeply rooted system to the periphery, which must be accurate and cost-effective, the gaps in the diagnostics can be effectively addressed using technology to create Automated health diagnostic system, such system will be capable to reduce the occurrence of errors to 97%, with use of such system the cost of making a diagnosis will be effectively reduced. The average cost of getting diagnosis comes around 550 INR, this includes the cost of doctor, diagnostic test etc, with the application of automated health diagnostic system the cost can be reduced to 67 INR, this innovation will act as preventive step, as this system is capable of making early diagnosis and the disease can be prevented at very early stage. There are plenty of government initiatives like e-sanjeevni portal, kawach, Arogya sathi which are collecting patient, these applications work on the curative aspect of healthcare while proposed automated healthcare diagnostic system will act as a preventive agent, it will deduct the human factors that are involved making diagnosis, this system will dissolve the dependence on diagnostic test while making diagnosis. To create such a system, historical medical records that are present in the government hospitals across the nation will be utilized as previously, diagnosis entirely depended on the clinical examination and presenting complaints of the patient. With this huge database, a system will be introduced that will effectively reduce the requirement of a diagnostic test, reduce the time taken to make a diagnosis, and accuracy of diagnosis will be improved effectively. This in turn enhances the experience of patients in the hospitals, reduces out-of-pocket expenses, and attracts more people to the government healthcare setup

Non-Fungible Tokens for GI Tagged Artist and Artisans of India

Handicraft is a family activity their craft runs through generations. Statistics and study by the UN stated that over the past 30 years, the total number of Indian artisans has decreased by 30%. An understanding of Indian craft entails insight into the current scenario marked by a loss of demand, dwindling skills, difficulty in catering to new markets, and rural artisans increasingly moving to urban areas looking for often low, unskilled unemployment. The average income of Indian artisans is 2000 INR for a family of five, it is a matter of serious concern, artisans are exploited and underpaid workers of rural India. The handicraft industry is one of the worst-hit industries of India during the pandemic, most of the heads of artisan families don’t see a future in their work, so they are encouraging their offspring to discontinue their work, they have stopped training their children. India is on the verge of losing its rich cultural heritage. To solve this problem, An End-To-End, B2B solution based on Blockchain financial Technology that allows GI tagged Artists to allow Businesses to procure and use their IP as a product or create new products by using their IP. The ‘Global Artisans’ platform will allow GI Artists to declare availability of their unique IP art/designs via creating a Non-Transferable-NFT or a Creator-NFT. This will permanently tag the NFT Creator and proprietary owner as the respective GI Artist. Businesses can ‘mint’ (buy) copy of an IP in form of a License-NFT which allows the Businesses to utilize these NFTs and produce products using one or more such NFT designs on their Physical products. The license to use the Creator-NFT (Artist’s IP) can only be ‘minted’ (bought) using a Crypto ‘Heritage’ coin. Businesses must pre-pay a fee to govt as well as to the Artist IP for minting ‘License-NFT’. Then after once the Businesses export or sell the goods, they must scan the QR code to Artist’s crypto account and pay the remaining amount owed to the Creator-NFT. The Heritage coin going back to creator Artist is then burned/destroyed automatically and Artist’s linked Bank Account is credited with Indian Rupee Currency as payment for their NFT being licensed. The Creator Artist can view the Audit trail of who used their NFTs and who it was sold to, making the supply chain transparent. The key features of this technology are that Artisans will be paid on each sale and re-sale, they will get global recognition, and this solution will enable tracking of the original artwork. Along with artisan’s revenue, streams will open for the government.

T-CAM Insurance and Enira Consulting

The Traditional medicine industry is one of the oldest practiced systems of medicine of great importance. The most commonly administered and popular complementary therapies include the Alexander technique, acupuncture, herbal medicine, homeopathy, aromatherapy, reiki, naturopathy, and yoga. With the increasing burden of non-communicable diseases and excessive dependence on allopathic medicines, there has been a global shift of people towards the traditional medicine systems due to fewer or no side effects and lower cost of care via the traditional medical system. The global market size for complementary and alternative medicine is expected to reach around USD 404.66 billion by the year 2028. It is expected to expand at a CAGR of 22.03% from 2021 to 2028. Enira consulting in partnership with Arogya Sanjeevani Healthcare services is working on T-CAM Insurance Model, which will offer value-based insurance services in India and South-East Asia. For this a standalone health insurance company for T-CAM industry is registered, This company aims to concentrate on the value-based insurance with wellness as the focus. This will insure the people for the defined and standardized treatment protocols of TCAM in the identified TCAM clinics, hospitals, and tertiary care facilities. Company aims to collaborate with the AYUSH Ministry, QCI and other authorities of respective systems of medicine to identify, document and standardize the treatment protocols available in these systems. The idea is to standardize the treatment protocols, to identify and calculate the risk precisely. All the products will be values-based health insurance, aiming the preventive aspect of healthcare. Every customer is encouraged to achieve continuous improvement in the health status by rewarding them through less premiums in the upcoming year.

Gau - tech Incubator - Animal Husbandry & Fishery and Enira Consulting

India accounts 33 percent cattle population across the globe. In India, of the total 3,030 gaushalas in the country, 1,325 are run by various animal husbandry departments. These gaushalas are home of non-productive cattle are they largely depends on donations and government grants. Gaushala incubator will work in hub and spoke model, Network of leading; pharmaceutical companies, agricultural colleges, veterinary colleges, ayurvedic colleges, and rural development studies’ colleges will be empaneled with a selected gaushala. The Gaushala will collect raw materials (cow dung and cow urine) and Industry leaders will incubate new technology along with empanelled academic and research institutions under the umbrella of the Gau-tech incubator. Further contract will be signed between the government and concerned industry participant, that IP of developed products will be sole property of participant and it will be mandated that private parties will purchase raw material from the hub and spokes of empanelled gaushalas. This project aims to develop sustainable Gaushala economy.