International Council for Education, Research and Training

Technology And Innovation In HR

Varma, C. Bhaskar

Research Scholar, Jain University, Bangalore

Abstract

In India, the high cost of medical education, particularly for an MBBS degree, poses significant challenges for new doctors, who often find that their qualifications do not justify the Expenses incurred. This financial strain is exacerbated when these highly trained professionals are employed for routine tasks such as insurance treatment and billing verification, roles that are not commercially viable given their level of education and potential. As a cost-effective measure, many insurance companies and third-party administrators (TPAs) opt to employ doctors with BHMS or BMS degrees for these tasks. However, these professionals are often underqualified for the complexities of medical verification, leading to inefficiencies and errors in treatment validation and anomaly detection. The situation also adversely affects programs like the Ex-Servicemen Contributory Health Scheme (ECHS), where the need for accurate and efficient cashless medical services is critical. Delays and inaccuracies in medical verification can complicate the provision of timely healthcare to veterans and their families, underscoring the need for improvement in these processes. This paper proposes the implementation of an Artificial Intelligence (AI) ecosystem designed to function as highly qualified medical agents. This AI system will be capable of independently verifying diagnoses, treatment plans, and medical reports for accuracy while also identifying procedural anomalies. The primary objective is to augment the capabilities of the current workforce, enhancing overall efficiency and effectiveness in medical management. By deploying AI medical agents, the project aims to not only address the gap in qualification and task complexity but also improve the accuracy and reliability of medical administrative processes. This initiative promises to revolutionize the way medical verifications are handled, providing a sustainable, scalable solution to a pressing healthcare management issue in India.

Keywords: Technology, Innovation, financial strain, artificial intelligence, challenges 

Impact statement

The current research proposes the implementation of an Artificial Intelligence (AI) ecosystem designed to function as highly qualified medical agents. This AI system will be capable of independently verifying diagnoses, treatment plans, and medical reports for accuracy while also identifying procedural anomalies. With the objective to augment the capabilities of the current workforce, the research focus on enhancing overall efficiency and effectiveness in medical management. By deploying AI medical agents, the project aims to not only address the gap in qualification and task complexity but also improve the accuracy and reliability of medical administrative processes. 

About The Author

With over 30 years of professional experience spanning aviation, human resources, and healthcare, C. Bhaskar Varma has built a diverse skill set that allows him to navigate and succeed in complex industries. His began in aviation, where he oversaw operations that demanded precision, safety, and adaptability. This role sharpened his leadership abilities and gave him an in-depth understanding of managing large-scale, high-stakes environments. Transitioning into human resources, He gained valuable experience in people management, recruitment, employee development, and organizational efficiency. He became adept at creating cohesive, high-performing teams and optimizing workflows to meet business objectives. Currently, he apply his skills to the healthcare sector, focusing on hospital insurance services for retired personnel. He is particularly passionate about delivering ethical, affordable medical services to those most in need, ensuring that quality healthcare is accessible and sustainable. A key strength is his ability to set up and launch new ventures or operations, leveraging his experience to establish efficient, effective systems from the ground up. He approach each challenge with a commitment to ethical practices, cost-effectiveness, and long-term success, making a tangible difference in the industries that he serve.

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