Guide · last reviewed 10 October 2026
What is NHCX, and what does it change for hospitals?
NHCX, the National Health Claims Exchange, is a digital gateway built by India's National Health Authority with IRDAI. It lets hospitals, insurers, TPAs and government schemes exchange claim information in one standard format, instead of each insurer running its own portal. It carries the messages; it does not approve or pay claims. For hospitals it is currently encouraged, not compulsory.
What NHCX is
NHCX stands for the National Health Claims Exchange. It is built by the National Health Authority (NHA), the body that runs Ayushman Bharat PM-JAY and the Ayushman Bharat Digital Mission (ABDM), working with the insurance regulator IRDAI.
“The NHCX will serve as a gateway for exchanging claims-related information among various stakeholders in the healthcare and health insurance ecosystem.”
Press Information Bureau, Ministry of Health and Family Welfare, 14 November 2023
In plain terms, it is a shared switchboard. A hospital sends a claim message once, in a standard format, and the exchange routes it to the right insurer, TPA or government scheme. The reply comes back the same way. NHCX itself does not approve or pay claims.
What it changes for a hospital
| Today | With NHCX |
|---|---|
| A different portal, login and form layout for each insurer and TPA | One standard route to every payer that is on the exchange |
| Documents uploaded as scans; data re-typed at both ends | Structured data in a common format (FHIR) that systems can read |
| Status checked portal by portal, or by phone | Status messages returned through the same exchange |
The government's stated aim is interoperability: the same claim information understood by every participant, with less manual handling on both sides.
What travels over the exchange
The exchange is designed around the stages of a claim: checking the patient's coverage, requesting pre-authorisation, submitting the claim, and receiving payment and status communication. Each is a standard message rather than a portal form.
Is NHCX mandatory?
For hospitals, the texts we have read are advisory, not compulsory.
- In June 2023 IRDAI issued a circular which, in the government's words, "advised all insurers and providers to onboard the NHCX".
- IRDAI's Master Circular of 29 May 2024 says insurers, with the insurance councils, "may endeavor to" onboard hospitals and health care providers on NHCX for faster payment and settlement.
Neither passage orders a hospital to join. The practical pressure comes from payers moving to the exchange and from incentives. This can change; check the current position with IRDAI and NHA.
Who is on it
The most recent official count we could verify is from November 2023. After NHA and IRDAI workshops, the government reported that twelve insurance companies had completed NHCX integration and that ten hospitals had been onboarded to the NHCX provider registry. Adoption has continued since; ask each of your payers whether they accept claims through NHCX today.
What a hospital needs before it can use NHCX
- ABDM integration. The government describes the first ABDM milestone (M1) as an essential step towards NHCX integration. Your HIS or claims software vendor usually does this.
- Registration as a provider on the NHCX provider registry.
- Software that can produce claim messages in the FHIR format the exchange uses, either your HIS, a claims platform, or a product such as Claims Ignite.
- Payers that accept NHCX. The exchange only helps for the insurers and TPAs that are on it.
The incentive, and its fine print
NHA's Digital Health Incentive Scheme (DHIS) has paid hospitals for claims filed through NHCX. The amount and the conditions have changed several times.
| Notice | Incentive to the hospital | Conditions |
|---|---|---|
| As described by the government in November 2023 | Rs 500 per claim, or 10% of the claim amount, whichever is lower | For insurance claim transactions through NHCX |
| DHIS Corrigendum 7, dated 9 April 2026 | Rs 200 per claim, or 10% of the claim amount, whichever is lower | AB PM-JAY claims only, linked to an ABHA address, filed in FHIR format through NHCX; capped at Rs 1 crore per facility; effective April to September 2026 |
Corrigendum 7 covered April to September 2026, which has now passed. Check the DHIS page for the notice in force today before you count on any incentive.
How Claims Ignite handles this
Claims Ignite keeps one complete record of each pre-authorisation, so it can send that record down whichever route a payer accepts: the TPA's portal, the insurer's API, your existing claims platform, or NHCX as a FHIR claim bundle. One adapter per channel covers every insurer behind it.
A hospital does not have to wait for every payer to join NHCX, or run two processes while they do.
Quick questions
What is NHCX?
NHCX, the National Health Claims Exchange, is a digital gateway built by India's National Health Authority with IRDAI. It lets hospitals, insurers, TPAs and government schemes exchange health-claim information in one standard format instead of through separate portals.
Is NHCX mandatory for hospitals?
The texts we have read are advisory. IRDAI's June 2023 circular advised insurers and providers to onboard NHCX, and its May 2024 Master Circular says insurers may endeavour to onboard hospitals. Neither orders hospitals to join. Check the current position with IRDAI and NHA.
Does NHCX approve or pay claims?
No. NHCX carries claim messages between the hospital and the payer. The insurer, TPA or scheme still decides and pays the claim.
What does a hospital need to connect to NHCX?
ABDM integration (the government calls milestone M1 an essential step), registration on the NHCX provider registry, software that can produce claim messages in FHIR format, and payers that accept claims through the exchange.
Is there an incentive for filing claims through NHCX?
The Digital Health Incentive Scheme has paid one. In November 2023 the government described Rs 500 per claim or 10% of the claim, whichever is lower. Corrigendum 7 of April 2026 set Rs 200 or 10%, for AB PM-JAY claims linked to ABHA and filed in FHIR, for April to September 2026. Check NHA's DHIS page for the current terms.
Sources
- Press Information Bureau, Ministry of Health and Family Welfare, 14 November 2023: NHA workshops on ABDM integration and NHCX adoption · definition, IRDAI June 2023 circular, integration counts, original incentive
- IRDAI, Master Circular on Health Insurance Business, 29 May 2024 · insurers may endeavour to onboard hospitals on NHCX
- National Health Authority, Corrigendum 7 to the Digital Health Incentive Scheme, 9 April 2026 · incentive amount, conditions and period
- National Health Authority, Digital Health Incentive Scheme page · current notices
- National Health Claims Exchange · official site
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