CCHI Approves the First 3 Companies for Revenue Cycle Management (RCM)


The Council of Cooperative Health Insurance (CCHI) has approved the first three (3) companies specialized in the works of revenue cycle management (RCM), to initiate their activity in the field of organizing document cycles for healthcare service providers, providing medical coding services, increasing revenues and developing technical, financial and consulting services.


The Secretary-General of the CCHI, Dr. Shabab bin Saad Al-Ghamdi, described the step as significant progress in the health insurance market industry that would achieve important objectives, foremost of which are raising the level of claims quality, reducing costs, increasing revenues for service providers, reducing financial disputes between insurance companies and service providers and limiting imposed claims.


He emphasized that such activity achieves the highest objective sought by the CCHI, which is the satisfaction of the insured, as it contributes to organizing the work procedures of service providers and their financial stability, ensuring the conformity of medical bills, ensuring the knowledge of (ICD10) codes, and improving and simplifying the operational procedures.


He pointed out that all of this lies at the core of the CCHI's mission and endeavors to promote the health of beneficiaries through an organizational environment, which focuses on prevention, empowering stakeholders and achieving transparency, justice, quality and efficiency.


Al-Ghamdi referred to the joint collaboration and complementary efforts with the General Authority for Statistics (GASTAT), Ministry of Investment, Ministry of Commerce, and Small and Medium Enterprises General Authority (SMEA), where the RCM activity was added within the activities included in the National Classification for the Economic Activities "Get ISIC Activities", and the E-Government Program (Yesser).


The activity of RCM focuses on carrying out the tasks of verifying the patient's identity and eligibility for the service, converting medical services to billable fees, working on processing rejected approvals and claims and identifying the source of problems and solving them.


The CCHI had previously announced its approval for the RCM activity, and invited all fully qualified companies to apply for the accreditation to practice such activity through visiting the CCHI's website: ww.cchi.gov.sa, calling the Customer Service Center: 920001177 or via social media platforms: "Twitter, Facebook, LinkedIn" on the official pages: cchiksa and via the CCHI's App for smartphones.


It is worth mentioning that the activity licensing process starts with issuing the commercial registry from the Ministry of Commerce under the name of "Revenue Cycle Management", registering the same at the Ministry of Human Resources and Social Development, issuing the Zakat Certificate, Municipal License and Australian Medical Coding License (ICD10 - AM) to be accredited by the CCHI.​

Last Update : 13/07/2020 02:32 م