The government recently honored the champions of the AB PM-JAY Auto-Adjudication Hackathon Showcase 2026, which aimed to enhance AI-driven solutions for better claims adjudication, transparency, and fraud detection in public health insurance. The hackathon, a collaborative effort by IndiaAI Mission, NHA, and IISc Bengaluru, concentrated on developing advanced technological remedies to expedite claims adjudication processes, ensure transparency, and enhance fraud detection in the healthcare sector. Notable officials like Sunil Kumar Barnwal, Abhishek Singh, Jyoti Yadav, and Shikha Dahiya acknowledged the winners at the event.
The selected solutions from the hackathon have the potential to revolutionize AI-based claims adjudication under AB PM-JAY. Participants were tasked with addressing three key problem statements related to claim processing under the scheme, which manages a significant volume of claims daily across over 1,900 treatment packages. The first challenge revolved around clinical document classification and Standard Treatment Guideline (STG) adherence. Contestants were required to design systems capable of parsing varied healthcare documents, extracting crucial data, recognizing essential visual elements, and ensuring compliance with NHA-issued treatment guidelines.
In the category of clinical document classification and STG compliance, Vinay Babu Ulli emerged as the winner, with Khushi Singh and Vijay Balaji securing the runner-up and second runner-up positions, respectively. The second challenge focused on radiological image-based condition detection and report correlation. Participants were tasked with validating diagnostic tests like X-rays, CT scans, and MRIs submitted as evidence under treatment guidelines and correlating them with medical reports for precise claims adjudication.
Harish Kumar claimed victory in this category, followed by Bharath Varma Sangaraju as the runner-up and Arnold Sachith as the second runner-up. The third problem statement addressed document forgery and deepfake detection. Innovators were required to develop systems capable of identifying forged or artificially generated documents, including altered discharge summaries, manipulated bills, fictitious identities, and AI-generated elements during claim submission. Praveen Sridhar emerged as the winner in this category, with Nikhileswara Rao Sulake and Sumanth Naidu Mathireddy securing the runner-up and second runner-up positions, respectively.
The winning teams were granted cash prizes of Rs 5 lakh, Rs 3 lakh, and Rs 2 lakh.
