The Ayushman Bharat-Pradhan Mantri Jan Arogya Yojana (AB PM-JAY), the flagship health assurance scheme implemented by the National Health Authority (NHA) under the Ministry of Health and Family Welfare, Government of India, is driving digital health transformation in India, processing nearly 50,000 claims daily across 1,900+ treatment packages. At this scale, speed, accuracy and compliance in claims adjudication are critical. While 15–20% of claims are currently auto-adjudicated, the need for a scalable, package-agnostic solution remains significant.
Given the volume and complexity of claims, there is a growing need for an advanced auto-adjudication system capable of handling diverse treatments and document formats. Leveraging automation, AI-based fraud detection, standardised documentation and real-time verification can help fully digitise claims processing while delivering faster, more consistent and transparent outcomes.
The AB PM-JAY Auto-Adjudication Hackathon aims to catalyse innovative digital solutions that seamlessly integrate with the existing AB PM-JAY infrastructure, reduce manual effort, accelerate processing timelines, and build a scalable, future-ready adjudication framework for the entire ecosystem.
The National Health Authority (NHA) has received an enthusiastic response to the AB PM-JAY Auto-Adjudication Hackathon 2026, with 2,600+ participants registered so far from across the country.
