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AI tools to help centre catch fake Ayushman claims

AI tools to help centre catch fake Ayushman claims

NEW DELHI: The Centre on Friday showcased new AI-based systems that can help detect fake hospital bills, forged medical papers and fraud under the Ayushman Bharat health insurance scheme.The tools were presented during the AB PM-JAY Auto-Adjudication Hackathon Showcase 2026 organised by the Union health ministry, National Health Authority (NHA), IndiaAI Mission and IISc Bengaluru.Officials said the AI systems are aimed at reducing fraud, speeding up insurance claim settlements and improving transparency under Ayushman Bharat PM-JAY.The showcased technologies included multilingual OCR systems that can scan and classify medical documents, extract data from low-quality records and verify compliance with standard treatment guidelines.Another set of AI tools demonstrated the ability to analyse X-rays, CT scans and MRIs to help verify diagnoses and treatment claims submitted by hospitals.Teams also presented AI models capable of identifying forged discharge summaries, manipulated billing records, ghost beneficiaries and deepfake-generated medical documents used in fraudulent claims.NHA CEO Dr. Sunil Kumar Barnwal said India was among the first countries in the Global South to develop a health AI benchmarking platform using India-specific datasets.Officials said the initiative aims to build a faster and more transparent digital claims system while reducing manual workload in the government’s flagship health insurance programme.

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