Cashless discharge

Cashless discharge, without the afternoon wait

Insurers now have three hours to authorise a cashless discharge. That clock starts only when your request reaches them, so the summary, the bill and the file are the hospital's part of the race.

Book a demo Discharge time audit sheet

What the rules say, and where the hours go

IRDAI's Master Circular on Health Insurance Business (29 May 2024) requires an insurer to decide on a cashless authorisation request immediately, and within one hour of receiving it. Insurers had until 31 July 2024 to put the systems in place. [1]
Final discharge authorisation must be granted within three hours of the insurer receiving the hospital's request. If it takes longer, any additional amount the hospital charges is borne by the insurer from its shareholders' funds, not by the patient. [1]
The three hours start when the request reaches the insurer — not when the doctor says the patient is fit to go. Finishing the summary, closing the bill and assembling the file before the request goes out is the hospital's time. [1]
NABH's 6th edition standards (effective 1 January 2025) measure time taken for discharge from the consultant's formal approval to the patient leaving the clinical unit, monthly, in minutes. Monitoring it and setting a benchmark is now a commitment element. [2]
An audit at AIIMS Bhubaneswar found a mean discharge time of 195 minutes, with billing clearance taking around half of it. [3]
A 2024 study of 1,000 discharges at a north Indian tertiary hospital found a mean of 329 minutes, with the summary reaching patients 235 minutes after the discharge instruction. After planning a day ahead and adding dedicated counters, the mean fell to 208 minutes. [4]

What MedBrains does about it

One pre-authorisation, every stage

Initial request, enhancement and final discharge authorisation are stages of one pre-authorisation, with the time each was sent and answered, the approved amount and a full status history.

IRDAI clocks on screen

Requests sent to insurers over NHCX are timed against the one-hour and three-hour limits, and the ones that ran over are listed.

A discharge workflow

Discharge ordered, bill closed, medicines dispensed, counselling done, card printed and bed released — step by step, on one screen per admission.

Summaries that are complete

Discharge summary templates and drafting, and a summary can't be finalised until the fields NABH asks for are filled.

Discharge timing per admission

Discharge started, billing, pharmacy, nursing and doctor clearance, and completion are timed for each admission, with a list of expected discharges from the expected date set at admission.

Bills ready on time

Interim bills during the stay, advances adjusted against the final bill, and returns of unused medicines recorded against what was dispensed.

Pre-authorisations and claims over NHCX are built and tested against the NHCX sandbox, not yet certified for production. Requests made through an insurer's portal or email can be recorded on the same pre-authorisation, with their times.

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Discharge time audit sheet

One row per discharge, a timestamp for every hand-off, and a monthly summary by payer — using NABH's definition of time taken for discharge. A4 landscape.

Download PDF Open the printable page

Questions

When does the IRDAI three-hour clock start?

When the insurer receives the hospital's request for final discharge authorisation — not when the doctor declares the patient fit to go (IRDAI Master Circular, 29 May 2024).

What happens if the insurer takes longer than three hours?

Any additional amount the hospital charges because of the delay is to be borne by the insurer from its shareholders' funds, not by the patient.

Does NABH set a fixed time limit for discharge?

The 6th edition asks each hospital to monitor discharge time, set its own benchmark and improve on it. The 180 minutes often quoted is not written into the standard as a national limit.

Where do we start?

Time every step for a month — the audit sheet on this page has a column for each — and work on whichever step is slowest.

Sources

Checked 22 October 2026. Rules change — check the source before you act on any figure here.

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See it run on your departments.

Tell us about your hospital. We'll walk through the screens your teams would use — with your workflows, not a slideshow.

A 30-minute walkthrough, online or at your hospital
Your departments, your tariff, your forms
A clear plan and price for going live

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