Name: PROVISION For Inviting partners for conducting POC for auto adjudication of health claims
Start: 2023-08-22
End: 2023-09-12
Location: National Health Authority (NHA)

Organization Details:

Organization Name:

National Health Authority (NHA)

Country:

India

Contact Person:

Address:

Contact Details - Email:

dydirector.admin@nha.gov.in

Phone

Notice Details:

Notice Type

Tender Notice

Bidding Type

Other

Notice No.

70509065

Deadline

2023-09-12

Description

Expression of Interest (EOI)
For
Inviting partners for conducting POC for auto
adjudication of health claims
National Health Authority (NHA)
Page 2 of 24
Fact Sheet
S. No. Reference Description
1. Reference number S-12017/98/2020/NHA
2. Name of purchaser Chief Executive Officer, National Health Authority,
acting on behalf of the President of India
3. Date of publishing 22nd August 2023
4. Title of Services Expression of Interest (EOI) for Inviting partners for
conducting POC for auto adjudication of health claims
5. Availability of Invitation to
POC document
NHA has published this invitation for PoC on the website
of National Health Authority (www.nha.gov.in)
6. Mode and last date of
proposal submission
The proposal is to be submitted through email,
addressed to Dy Director, Administration at
dydirector.admin@nha.gov.in on or before 5 p.m. on
11th September 2023
7. Method of selection The selection process as listed below is expected to be
completed within 2 weeks of last date of submission.
1. Receipt of complete application and documents
on/before last date
2. Technical Presentation and demo by applicant
solution providers (if requested by NHA)
3. Evaluation and selection by NHA based on the
selection process specified in this document
8. Late proposals Late proposals i.e., proposals received after the
specified date and time of receipt will not be considered.
9. Date, Time and Venue for
Technical presentation
19th September 2023 (tentative) at NHA office
Page 3 of 24
Abbreviations
ABDM Ayushman Bharat Digital mission
AB PM-JAY Ayushman Bharat Pradhan Mantri Jan Arogya Yojana
CAPF Central Armed Police Forces
CGHS Central Govt Health Scheme
EHCP Empaneled Health Care Provider
EOI Expression of Interest
HBP Health Benefit Package
HCO Health Care Organization
NHA National Health Authority
NHCX National Health Claims Exchange
SECC Socio-Economic Caste Census
STGs Standard Treatment Guidelines
TMS Transaction Management System
Page 4 of 24
1. Disclaimer
The information contained in this Expression of Interest (EOI) Document is being provided on the
terms and conditions set out in this document. The purpose of this EOI is to provide interested
parties with information that may be useful to them in making their application.
This EOI includes statements, which reflect various assumptions and assessments arrived at by
the NHA (National Health Authority) and other organisations in relation to the Project. Such
assumptions, assessments and statements do not purport to contain all the information that each
Party may require. This EOI may not be appropriate for all persons/organisations, and it is not
possible for the NHA, its employees or advisors to consider the investment objectives, financial
situation and particular needs of each party who reads or uses this EOI. The assumptions,
assessments, statements and information contained in the EOI may not be complete, accurate,
adequate or correct. Each interested Party should, therefore, conduct its own investigations and
analysis and should check the accuracy, adequacy, correctness, reliability and completeness of
the assumptions, assessments, statements and information contained in this EOI and obtain
independent advice from appropriate sources.
Information provided in this EOI is on a wide range of matters, some of which may depend upon
the interpretation of law. The information given is not intended to be an exhaustive account of
statutory requirements and should not be regarded as a complete or authoritative statement of
law. The NHA accepts no responsibility for the accuracy or otherwise of any interpretation or
opinion on law expressed herein. The NHA, its employees and advisors, make no representation
or warranty and shall have no liability to any person/ Party, under any law, statute, rules or
regulations or tort, principles of restitution or unjust enrichment or otherwise for any loss,
damages, costs or expenses which may arise from or be incurred or suffered on account of
anything contained in this EOI or otherwise, including the accuracy, adequacy, correctness,
completeness or reliability of the EOI and any assessment, assumption, statement or information
contained therein or deemed to form part of this EOI Document or arising in any way for
participation in this Pilot Project. The NHA also accepts ‘no liability’ of any nature, whether
resulting from negligence or otherwise howsoever caused, arising from the reliance of any Party
upon the statements contained in this EOI.
The NHA may, at its absolute discretion, but without being under any obligation to do so, update,
amend or supplement the information, assessment or assumptions contained in this EOI. The
issue of this EOI does not imply that the NHA is bound to select or appoint a Party, as the case
may be, for the Project and the NHA reserves the right to reject all or any of the Parties without
assigning any reason whatsoever.
The Parties shall bear all costs associated with or relating to the preparation and submission of
its application including but not limited to preparation, copying, postage, delivery fees, expenses
associated with any demonstrations or presentations which may be required by the NHA or any
other costs incurred in connection with or relating to its application. All such costs and expenses
will remain with such Party and NHA shall not be liable in any manner whatsoever for the same
or for any other costs or other expenses incurred by a Party in preparation or submission of the
Application, regardless of the conduct or outcome of the selection.
Page 5 of 24
2. Introduction:
2.1 About NHA
National Health Authority (NHA) is the apex body responsible for implementing India’s flagship

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