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Collect data of health professionals from repository: IRDAI to insurers


The Insurance Regulatory and Development Authority of India (IRDAI) has advised insurance companies to capture the identity (ID) of medical practitioners from a repository for verification while issuing or renewing health policies. The new system is expected to enable seamless, cashless functioning of outpatient treatment (OPD) across the country.

According to IRDAI, insurers can validate their ID from the Healthcare Professional Registry (HPR), a comprehensive repository of registered and verified practitioners of healthcare professionals delivering modern as well as traditional healthcare services across India. “This will enable digitization and ease the process of buying and selling the Professional Indemnity policies and push for HPR registration among the healthcare professionals,” the regulator said.

This will also help in avoiding medical malpractices under professional indemnity cover.

General and health insurers offering health insurance policies can also consider leveraging on the Health Professional Registry for building up the network of doctors, physicians or other healthcare professionals for providing OPD or other healthcare services, IRDAI said.

As part of Ayushman Bharat Digital Mission, the National Health Authority (NHA) has incorporated a Healthcare Professional Registry (HPR). Under HPR, a healthcare professional ID (HPID) will be created via Aadhaar or other KYC, along with the medical qualifications of the medical professional which is verified by their respective State Medical Councils.

This HPID serves as a unique ID to the medical practitioners to enable connection with all stakeholders of the healthcare ecosystem. “The potential of the mandate is immense. I see three major benefits from this.  First, the availability of a country-wide vetted repository of healthcare practitioners for insurers and TPAs to leverage and build on their network strength.  Second, the enormous reach of Ayushman Bharat Digital Mission,” said Dr Vijay Sankaran, SVP and Chief Medical Officer at MediAssist.

As Ayushman Bharat Digital Mission manages to reach every nook and corner of the country, insurers and TPAs would now be able to empanel verified doctors from far reaching places, he said. “This brings me to the third and foremost benefit. We will now be able to have our cashless OPD network seamlessly spread across both metropolitans and small towns. This is a welcome move and will result in better access to healthcare in the country,” Sankaran said. Health insurance is now the largest segment in the non-life insurance sector with gross premium collection touching Rs 51,361 crore during the seven-month period ended October 2022, a growth of 21 per cent when compared to the previous year.

The Healthcare Professionals Registry will not replace existing registration issued by respective councils. It will, however, bring together data of those professionals from all States participating in ABDM on a digital platform. It will provide additional digital services to the enrolled professionals and will be their primary identifier under the Ayushman Bharat Digital Mission. If professionals wish to avail of these services, they may do so by enrolling in HPR. Further, the processes for registration vary greatly by state, hence a separate enrollment in the Healthcare Professionals Registry is required to capture a standard set of attributes, NHA said.





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