Because of the strategic objectives of the Council of Health Insurance, and to enable health insurance companies and health care service providers in the private sector accredited by the Council to raise the level of their services, the unified contract was implemented starting from the date of 2/1/2021.

It aims to regulate the contractual relationship between insurance companies and service providers and protect their rights in accordance with the Council's regulations.


The importance of the unified contract
•  Providing an ideal environment governing the contractual relationship between the parties, to encourage stakeholders to invest in the health insurance sector
• Enhancing the health of beneficiaries through a regulatory environment that focuses on prevention, empowers stakeholders, and achieves justice, transparency, quality and efficiency.
•  Enabling insurance companies and service providers to raise the level of their services to beneficiaries in the presence of advanced regulations and policies
•Activating the reconciliation and settlement center in the Council in order to end disputes between insurance companies and health service providers to preserve the rights of the parties to the contractual relationship
•Unifying and updating the documentary cycle of financial obligations between the parties in line with the requirements of the General Authority for Zakat and Income, and introducing the role of revenue cycle management companies
•Using of the Council approved medical coding and classification standards in claims pre-approval processes and submitting the final settlement claims and denial reason codes
•Enabling the parties to the contractual relationship to use the platform for regulating the online exchange of health insurance information and transactions “Nphies”​

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Last Update : 13/01/2022 08:01 م