Guidelines for SLAs and ecosystem satisfaction

Key considerations for ecosystem satisfaction with the HCX network

Best practices for service SLAs for high volume transactions already exist as high volume exchanges have been around for many decades, and so has regulation for such exchanges (for example the stock exchanges, depositories and SEBI). It is recommended that the HCX adopts the SLAs currently in operation and publicly available from the likes of National Stock Exchange and NSDL/CSDL.

HCX Operator should provider following SLAs in their agreements with the participants:

• Uptime

• Response times for transactions

• Operation of Sandbox

• Operation of helpdesk

• Upgrade of software as per the latest specifications of HCX.while keeping backward compatibility

• Data protection

An HCX operator may not be able to impose SLAs on participants like payers, providers, or TPAs, as HCX has no control over these players. However, to improve the overall performance of the ecosystem, the HCX Operator could publish the following metrics on a periodic basis:

• Average time for sandbox registration to sandbox certification by participant type

• Average time for claim submission from patient discharge by providers

• Average time for response from payor to providers for each applicabkle cycle (eligibility, predetermination, preauth, claim)

• Average time for claim to cash by payor

• Average time for response from providers for payor queries