Healspan leverages AI, blockchain to automate insurance claim, improve accuracy, prevent fraud

Healspan is an insurance-technology startup that has innovated a superlative platform for streamlining cashless insurance claims, removing the various difficulties and challenges involved in the process for healthcare institutions such as hospitals. Our advanced tech-enabled platform is designed to make cashless claims management 100 per cent hassle free, and ensure a seamless patient experience, so that healthcare providers can go back to focusing on what matters most –providing quality care, says Vinayaka Naik V, CTO, Healspan

Why India’s 2047 vision of a developed nation is the motivation factor for Healspan?

All developed nations have higher adoption of insurance at every individual level. These individuals can be citizens or travellers. If we look closely why this trend, it is because of higher risks associated with unfortunate events which can happen in life. Many families can get pushed to lower financial sections because of one such unfortunate event. If we look at health insurance coverage in India, it’s around four per cent.

Due to unfortunate events that happened during Covid, many Indian families witnessed the unfortunate situations and financial burdens. Now in my close circle, I observe an increase in health insurance awareness which is aimed at 100 per cent adoption by 2047. At Healspan, we are motivated with this mission and working aggressively towards building simplified solutions to address ground challenges, which we visualise as potential challenges which will also scale with increase in health insurance adoption. We are after neutralising such challenges with the best of our abilities and continue to contribute towards smooth 100 per cent health insurance adoption by 2047.

How is Healspan addressing these challenges?

Our primary factor is our core team. We have different industry veterans leading from front. Domain experts can visualise potential challenges and remediate them at much earlier stages. This helps in building a strong foundation. Second is our intent to ask for help and collaboration. Collectively we all stand a better chance to address challenges which are much bigger than us. Third is continuous investment in technology. I believe technology helps us in automating many processes which can drastically reduce error, turn-around time and we have round the clock availability. We are taking an insight driven approach as insights help us understand the complexity of challenges we are facing in the ecosystem, its impact and possible root causes. These analysis makes way for solutions which can create impact at scale and provide best in class customer experiences.

How does Healspan leverage the latest technologies to innovate within the insurance industry?

I have worked on building multiple marketplaces, complex SaaS products in the past. My key strength during this journey were my mentors who are technology veterans. It’s important to understand what is the right tool to solve any particular problem. However, keeping availability high, cost low, seamless customer experience are key contributors. We use the latest SaaS offerings available in our world which consist of cloud computes, encrypted storages, trusted data transmission protocols, design patterns to build fault tolerant systems, insights and analytics tools. We are now working aggressively on AI/ML models for fast-track claim processing, integration with India health stack systems like ABDM, NHCX, ONDC. We are working on blockchain to block fraudulent intents around insurance data alteration, data manipulation etc. As the claim process becomes more digital, we must put our best efforts to safeguard medical and insurance data. I feel, blockchain can give us a great edge to counter data manipulation with malicious intent.

Can you explain how Healspan’s insurance platform works and its benefits compared to traditional insurance systems?

Both traditional insurance systems and the Healspan platform exist for the same purpose i.e. provide seamless insurance experience to policyholders. Healspan built by first relooking at existing ecosystems, understanding scope of improvements with new generation demands, technology adoption and continuous progress towards integrating India health stack systems. Our primary concerns are about how we can help patients who are admitted at hospital who are waiting for discharge, how we can improvise existing processes so that patients, their family and friends can go home sooner. Second concern is how we can make insurance desk members lives simple at the hospital. I personally witnessed the amount of pressure some insurance desk members go through during peak hour at the hospital. We constantly relook at how we can automate and build solutions to empower insurance desk members. Third, we look at how we can work closely with hospital management and build solutions which gives them an edge to provide best in class patient hospitalisation experience. We are committed to invest continuously all three segments as we move forward.

What specific challenges do you face in ensuring regulatory compliance while operating an insurance platform?

I look at these challenges as our commitment as a nation towards providing protection for citizens of India i.e. our patients, family members, hospital crew, insurance members etc. We exist with a commitment to provide best in class solutions to solve their needs. We work continuously towards medical data security, personal data security, building fault tolerant systems, covering possible paths which a malicious intent person can use to harm, India stack implementations, cashless everywhere initiatives etc. Our domain experts work with the ecosystem to contribute how we all as an ecosystem can improve and address new challenges. We are with our regulators and their decisions.

Can you elaborate on some real-world use cases where Healspan’s technology has streamlined insurance processes or improved customer experiences?

I believe sometimes a small change can create a huge impact in someone’s life. I am a local guardian for a student in Bengaluru. We had to admit her to hospital during an emergency. We visited every 4 hours in person at the hospital front desk to enquire about insurance. This went on for two days. When I joined healspan, I had a discussion with our founders Sabarinath and Abhishek on how we can address these challenges. We built a WhatsApp claim notification feature for the attendant since the patient may be in an unconscious state and we are receiving very positive reviews from the hospital side for this feature. This is one of many reviews we receive for our commitment.

What measures does Healspan take to address scalability concerns, especially as your platform grows?

We work closely with our cloud provider AWS and understand what are the AWS offerings which we can leverage to address scale scenarios at least a couple of years in advance. Since I am a SaaS architect, my profession has helped me visualise possible technical challenges and prepare in stages before they arise. In 2024, cloud offerings are tested for a much higher scale than what exists in the real world. SaaS solutions have greater scalability, availability and flexibility compared to previous approaches.

How does Healspan collaborate with traditional insurance companies or other industry stakeholders to drive adoption and integration of latest technology trends?

Insurance as a domain needs to constantly predict and monitor risks with advancement in trends. So, by default, insurance companies are always exploring the latest technology solutions to analyse risk trends. Since online frauds are increasing, this also becomes a factor for every software company to keep revisiting their system, exploring their own vulnerabilities even before the person with malicious intent gets to know about it. Fraud can be avoided and analysed with latest technologies hence all stakeholders welcome new technologies, do their due diligence and testing internally before accepting software for larger adoption.

What future developments or advancements can we expect from Healspan in the next few years in terms of technology or market expansion?

There are insurance markets around the globe which are similar to the Indian ecosystem. We are exploring and having conversations to get more insights. We are focusing on India and learning about other countries. In terms of technology, in the near term we are focusing on India health stack as we visualise its great success and adoption. We are committed and working continuously to contribute to the Indian health insurance ecosystem. Beyond that, it’s too early to predict something unknown as technology is changing drastically. When we come across a technology which we believe can create a positive impact in India health insurance adoption, patients, their family, hospital crews or healspan representatives, we would definitely pick it up because this is the reason we exist and we will continue our contribution towards a better world.