Health Insurance Board Directs Claims to Be Processed Through Review Committee

Kathmandu — The Health Insurance Board has instructed that claims under the health insurance program be processed through a claims review committee.

On Monday, the Board’s Senior Medical Superintendent, Dr. Pawan Kumar Shah, directed all service-providing health institutions to mandatorily enter claim details through the real-time system while submitting claims.

According to the “Real-Time Health Insurance Claims Procedure, 2080,” the Board aims to make the claims and evaluation process more efficient and to reduce the rate of claim rejections. 

For this purpose, a committee has been formed at each service-providing health institution, consisting of representatives from the respective institution, to review claims before they are submitted.