UAE launches new service to link insurance companies, health care providers
eClaims service will help improve level of treatment services and reduce health care costs
The Ministry of Health and Prevention (MoHAP) has introduced a new service to link insurance companies and health care providers to help them exchange patient data easily.
Called the eClaims office service, the service will be implemented from January 2022 and is part of MoHAP’s ‘Riayati’ platform, UAE’s national platform for health information exchange that connects public and private hospitals and clinics.
While the Riayati platform aims to provide the highest levels of health care for the UAE community to cover government and private health facilities in the country in 2021, the eClaims service will serve as a central platform to exchange transactions between healthcare facilities and insurance companies. It is an important component of the Riayati programme and will serve as a central linking system between health care providers and insurance companies.
The eClaims service provides better management and tracking of central information in order to improve the level of treatment services and reduce health care costs in the UAE.
The service also aims to achieve a smart and integrated health system that serves those eligible for health services in the country and enhances security of the insurance system to limit misuse of financial resources.
The announcement came after MoHAP held a series of seminars in partnership with IT company Pure CS to encourage insurance companies and health care facilities to register in for the eClaims service and learn about its features and integrated technologies before using the service, which will become mandatory by the beginning of the next year.
The eClaims service covers the filing of claims, referral notices, insurance eligibility verifications, and electronic prescriptions. This data will become available on the eClaims office service system for authorised users in healthcare facilities.
Dr Abdulaziz Al-Zarouni, Acting Assistant Undersecretary for the Support Services Sector, stated that eClaims Office service is one of the main components of the national unified medical record platform ‘Riayati’,
The service is based on a new technology allowing insurance companies and health care providers to exchange accessible data every time a patient needs treatment, he noted.
Al-Zarouni added: "As for authorised healthcare facilities that have access to the eClaims office service, knowledge of insurance coverage status and necessary approvals are a key advantage, which would contribute to saving time by making the entire process electronic, less time-consuming, and more efficient.”
Developing health information systems
Ali Al-Ajmi, Director of the Digital Health Department, MoHAP, said: "The development of the programme is a strategic step aimed at enhancing health information systems, by creating a dynamic and accessible health claims data store, in line with the best global standards in healthcare infrastructure management.
Al-Ajmi noted that the "Riayati" platform is based on advanced technology that supports maintaining the efficiency of the platform, through innovative solutions including automation and data management services.
The data available at the eClaims office service is expected to add more value to Riayati, besides achieving a remarkable improvement in health insurance services across the UAE.
This, in turn, will yield positive impacts such as reducing health care costs, speeding up treatment time, improving the management of the insurance system, and optimizing the use of resources, he said.
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