This section presents key health claims use cases that have been thoroughly analyzed by HCX community work streams for feasibility and implementation within the HCX protocol. These use cases are invaluable for the ecosystem as they provide a clear understanding and visualisation of the diverse health claims transactions that can be facilitated through HCX.
Health claims are primarily categorised into the following groups:
OPD (Cashless & Reimbursement)
IPD (Cashless & Reimbursement)
These use cases represent real-world scenarios and serve as essential reference points for stakeholders looking to leverage the HCX protocol effectively within their healthcare processes.
Following subsections provide details about the typical workflows, reimagined workflows using HCX, & key considerations/challenges while implementing these use cases.