Ayushman Bharat-PM-JAY Hackathon Targets AI-Driven Claims Overhaul

AB PM-JAY currently processes nearly 50,000 claims daily across more than 1,900 treatment packages, making it one of the largest government-funded healthcare assurance programmes globally.

India’s flagship public health insurance scheme, Ayushman Bharat–Pradhan Mantri Jan Arogya Yojana (AB PM-JAY), is accelerating its digital transformation push with a nationwide hackathon aimed at revolutionising claims processing through artificial intelligence and automation.

The National Health Authority (NHA), which implements the scheme under the Ministry of Health and Family Welfare, has launched the AB PM-JAY Auto-Adjudication Hackathon 2026 to develop scalable, technology-driven solutions capable of handling the scheme’s massive claims volume with greater speed, accuracy, and transparency.

Scaling Digital Health at Unprecedented Volume

AB PM-JAY currently processes nearly 50,000 claims daily across more than 1,900 treatment packages, making it one of the largest government-funded healthcare assurance programmes globally. At this scale, efficient claims adjudication—the process of verifying and approving claims—is critical to ensuring timely payments to hospitals and uninterrupted care for beneficiaries.

Despite ongoing digitalisation efforts, only about 15–20% of claims are currently auto-adjudicated, highlighting a major opportunity to expand automation across the system. Officials say the complexity of medical treatments, varied documentation formats, and the need for compliance checks have made full automation a challenging task.

The hackathon seeks to address these gaps by encouraging the development of advanced, package-agnostic systems capable of processing diverse claim types using AI-driven verification, fraud detection, and standardised digital workflows.

Building a Future-Ready Claims Ecosystem

Experts believe that integrating artificial intelligence into claims adjudication could significantly reduce manual intervention, minimise errors, and accelerate processing timelines. Real-time verification and automated decision-making tools are also expected to improve transparency and consistency across the system.

The initiative is aligned with India’s broader digital health strategy, which includes the Ayushman Bharat Digital Mission (ABDM), aimed at creating a unified digital health ecosystem. By modernising claims processing, the NHA hopes to strengthen trust among hospitals, insurers, and beneficiaries while improving operational efficiency.

Strong Nationwide Participation

The hackathon has already attracted significant interest, with more than 2,600 participants registered from across the country. The competition is open to a wide range of stakeholders, including students, researchers, developers, startups, and industry professionals—reflecting a collaborative approach to solving complex public health challenges.

The deadline for registration is 13 April 2026, with applications being accepted through the official NHA portal.

Masterclass Series to Guide Innovators

To support participants, the NHA is organising a three-part Masterclass Series beginning on 13 April 2026. The sessions will provide deep insights into the claims adjudication ecosystem, outline key problem statements, and highlight innovation opportunities in digital health.

Scheduled sessions:

• 13 April 2026 | 2:00 PM – 4:00 PM

• 15 April 2026 | 2:00 PM – 4:00 PM

• 16 April 2026 | 2:00 PM – 4:00 PM

All sessions will be streamed live via the NHA’s official YouTube channel, broadening access to participants nationwide.

Grand Finale at IISc Bengaluru

The hackathon will culminate in a two-day offline finale on 8–9 May 2026 at the Indian Institute of Science (IISc), Bengaluru—one of India’s premier research institutions. Finalists will present their solutions before a distinguished jury comprising experts from healthcare, technology, and public policy.

Winning teams stand to receive cash prizes of ₹5 lakh, ₹3 lakh, and ₹2 lakh for each problem statement, along with opportunities for potential collaboration with the NHA—raising the prospect of real-world implementation of successful solutions.

Driving Innovation in Public Healthcare

Through this initiative, the NHA is reinforcing its commitment to leveraging technology to improve healthcare delivery at scale. By tapping into India’s growing innovation ecosystem, the authority aims to build a robust, future-ready digital infrastructure that enhances efficiency, reduces fraud, and ensures better outcomes for millions of beneficiaries.

As healthcare systems globally grapple with rising demand and operational complexity, India’s approach—combining large-scale public programmes with open innovation platforms—could offer a model for other countries seeking to modernise their health systems.