Ministry of Health introduces eClaims Office service to insurance companies, healthcare service providers

The Ministry of Health and Prevention (MoHAP) held a series of seminars to introduce insurance companies and health care providers to the eClaims Office service which is part of the “Riayati” platform. The new service will be operational as of January 2022.

The eClaims service provides better management and tracking of central information in order to improve the level of treatment services and reduce healthcare 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 oversight of the insurance system to limit misuse of financial resources.

The seminars, held in partnership with “Pure CS”, are considered as a hands-on for insurance companies and health care facilities to register in the “Post Office” initiative (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 “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, while the eClaims service will serve as a central platform to exchange transactions between healthcare facilities and insurance companies.

The eClaims service covers the filing of claims, referral notices, insurance eligibility verifications, and electronic prescriptions. These data be available on the eClaims office service system for authorized 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 “Riayati”, one of the digital transformation initiatives in the healthcare sector launched by the Ministry in partnership with “Pure CS”, as part of the “Riayati” program with the aim to improve the patient experience.

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 authorized 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 “Riayati” program 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.

This comes in line with the Ministry’s strategy to develop health information systems, apply international standards in managing infrastructure in health facilities, and develop appropriate technology for the population health management system.

The “Riayati” platform provides a centralized healthcare data system for insurance companies and healthcare providers alike, which will significantly help improve the patient’s healthcare experience in the UAE. Likewise, the “Post Office” initiative represents an important component of the “Riayati” program, which will serve as a central linking system between health care providers and insurance companies.

The seminars also dealt with other topics, including the introduction of the “Riayati” platform, the eClaims Office service, its transactions and technology structure, and an overview of how to log into the system, the benefits of adopting it, and aspects of cooperation.

The data available at the eClaims Office service is expected to add more value to the smart and integrated health system of the National Unified Medical Record, 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.

About Riayati

Riayati is a national platform for health information exchange (HIE) in the UAE by connecting public and private hospitals and clinics and other healthcare facilities, including clinics, diagnostic centers, dialysis centers, and pharmacies.

The platform is linked to other affiliate medical records (including ‘Nabidh’ and ‘Malaffi’) to form a central database for exchanging public health information in real-time, in order to ensure the completion of a unified, integrated, and digital national medical record for health care in the UAE.

Riayati will also carry out the Ministry’s “Post Office” initiative to enable the smooth exchange of insurance claims between health care facilities and insurance companies.