Star Health Expects Most Cashless Claims to Be Settled by AI Within 2 Years

Star Health Insurance, the largest health insurer in India, plans a transformative shift towards artificial intelligence (AI) for settling cashless claims.  

Currently, 20% of claims are processed via AI, with Star Health aiming to push this beyond 50% in 2 years. 

Increased Efficiency through AI Implementation 

The use of AI technology by Star Health aims to streamline the settlement of cashless hospitalisation claims significantly. At present, AI handles 20% of the claims, ensuring compliance with timelines for pre-admission and post-discharge authorisations.  

The adherence to regulatory requirements—1-hour completion for pre-admission and 3-hour post-discharge authorisations—demonstrates the urgency for efficiency improvements in the claims process. 

Current and Future AI Handling Projections 

Given that 85% of Star Health's claim value is cashless, it's imperative for the company to enhance operational efficiencies.  

The plan to raise the AI processing of claims to over 50% within the next 2 years underscores their commitment to innovation. Human intervention will mainly focus on exceptions, high-value claims, and fraud detection. 

Empanelment and Regulatory Partnerships 

The General Insurance Council collaborates with hospitals to create a standardised schedule of rates.  

Efforts are in place to empanel at least 10,000 hospitals, aiming at transparent billing, standardisation, and digital integration through initiatives like NHCX and ABHA.  

Read More: Newgen Technologies Share Price in Focus After US$1.49 Million Digital Transformation Deal with Caribbean Insurer! 

Conclusion 

Star Health's strategic move to enhance AI deployment for cashless claims signifies a key innovation in the insurance industry, striving for greater efficiency and customer satisfaction. The transition allows for a faster, more streamlined service, transforming how claims are processed and settled. 

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