Kathmandu. The government is preparing to implement the system of reimbursement as soon as a claim is submitted by a health service provider affiliated with the health insurance program.
The implementation action plan of the report of the Health Insurance Reform Suggestions Task Force, made public by the Ministry of Health and Population today, includes a plan to implement a system of reimbursement (real-time claim and real-time payment) as soon as a claim is submitted by creating a schedule for claim verification and payment. The ministry expects that if this system is implemented, claims management will improve.
The ministry has also mentioned in its action plan that a system will be implemented for all service providers to enter claims through the Application Programming Interface (API) using electronic medical records.
The responsible body for this system will be the Health Insurance Board and the supporting bodies will be the service provider health institutions and the Ministry of Health.