MoHAP launches ‘Post Office’ initiative to improve health insurance claims process

DUBAI — The Ministry of Health and Prevention (MoHAP) has launched the “Post Office” initiative as part of the National Unified Medical Records “Riayati”, a linkage system between hospitals and clinics and health care providers.

From improving treatment services and reducing healthcare costs in the UAE, to achieving a smart and integrated health system that serves the beneficiaries of health services and strengthening the control over the insurance system to reduce the misuse of financial resources, the new service helps provide better management of the central information related to the electronic insurance claims and their tracking

The post office service is covering the workflow of all claims between healthcare facilities and insurance companies, such as the verification of eligibility and insurance coverage and e-payments, including claims submission and tracking refusals. All the mentioned services are available for use by the authorized users in the healthcare facilities without having to rely on the insurance companies.

Launched at Arab Health 2018 by Sheikh Mohammed Bin Rashid Al Maktoum, vice-president and prime minister of the UAE and ruler of Dubai, Riayati seeks to deliver the best levels of healthcare for the UAE society. The system, which falls under the management of the Ministry of Health in cooperation with Pure CS “healthcare technology company”, is expected to cover public and private health facilities in 2021.

Awad Saghir Al Ketbi, assistant undersecretary of the support services sector, said: “Riayati is a digital health platform that provides an integrated health care system. It showcases updated data of patient records and provides innovative solutions in the automation and management of health data, using the latest technology technologies.”

Further, Riayati, which is based on medical information exchange services, makes use of and disseminates other health initiatives, in line with MoHAP’s strategy aimed at developing health information systems and implementing world-class standards in managing infrastructure in health facilities and developing appropriate technology for the management of population health system.

Al Ketbi underlined the newly launched service will help patients get healthcare services through balanced insurance financial resources.

Digital transformation initiatives

Mubaraka Ibrahim, IT director, MoHAP, explained that the post office initiative is one of the digital transformation initiatives in the healthcare sector in cooperation with Pure CS, adding the service will help improve the patient experience by avoiding the delay due to incorrect insurance claims and by improving claims processing efficiency.

She said: “In comparison to the previous system in which the patient had to wait for longer times to get the insurance, the new system will promptly verify the eligibility and insurance coverage electronically via safe networks. In the meantime, hospitals and clinics will have an opportunity to save additional costs, by developing mechanisms for obtaining prior authorization and submitting electronic claims.”

For his part, Rajesh Dugar, project manager of Riayati Program, Pure CS, said: “The eClaims engine will collect financial and medical information from all healthcare providers in the Northern Emirates in accordance with the international standards. Then, it will work as a third-party between service providers (hospital, clinic, dentist) and insurance companies. The verification of all transactions will be conducted electronically to avoid errors and to ensure that the claim is submitted to the insurance company properly. ” — SG

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