Now, AI will facilitate free medical treatment, offering new features ranging from claims processing to the management of medical records..
Healthcare services under the Ayushman Bharat scheme are set to become more accessible in the near future. The central government is preparing to integrate Artificial Intelligence (AI) into this scheme. This initiative will not only accelerate the settlement of insurance claims but also assist in detecting fraudulent claims and managing patient medical records. In essence, the role of technology will expand, while human intervention in various treatment-related processes will decrease.
This transformation is expected to impact both the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB PM-JAY) and the Ayushman Bharat Digital Mission (ABDM). According to reports, the use of technology and AI will enhance the scheme's overall effectiveness, ensuring better utilization of public funds and strengthening the delivery of healthcare services to patients.
**Faster Insurance Claim Settlements via AI**
Currently, the verification and payment of health insurance claims involve a multi-stage process, which is time-consuming and increases administrative costs. The government now aims to expand the use of 'auto-adjudication'—the automated settlement of claims. Through this technology, AI will evaluate claims based on established rules and medical documentation. Claims that meet the defined criteria will be processed rapidly, while suspicious cases can be flagged for further investigation.
**AI to Monitor Fraudulent Claims**
Preventing fraud within the Ayushman Bharat scheme is a key priority for the government, with the National Anti-Fraud Unit (NAFU) playing a crucial role. AI will help identify suspicious claims, falsified documentation, and irregularities in medical treatment. This will strengthen oversight of those attempting to claim government funds illicitly, while also ensuring that the scheme's resources reach the intended beneficiaries—the patients who truly need them.
Patient Medical Records to be Generated via Doctor’s Voice
A key feature of this development is the 'AI voice scribe,' which was recently demonstrated by the National Health Authority. This technology can generate medical records by listening to the conversation between a doctor and a patient. Notably, it supports multiple Indian languages. This will reduce the need for doctors to repeatedly sit down and manually document patient information and treatment details.
Once the doctor has reviewed and approved the generated record, they can link it to the patient’s Ayushman Bharat Health Account (ABHA). This will help in maintaining the patient’s medical history in a secure, digital format.
What is the Ayushman Bharat Scheme?
The Ayushman Bharat Pradhan Mantri Jan Arogya Yojana is a health insurance scheme launched by the Central Government. Under this scheme, eligible families receive health coverage of up to ₹5 lakh per family annually for hospital-based treatment. The scheme offers cashless treatment facilities at both government and empanelled private hospitals. Its primary objective is to ensure that no family in need is denied medical treatment due to financial constraints.
Disclaimer: This content has been sourced and edited from Dainik Jagran. While we have made modifications for clarity and presentation, the original content belongs to its respective authors and website. We do not claim ownership of the content.
