Service Providers
Healthcare Provider Accreditation Procedures
​• The application and the attached documents shall be reviewed within five working days from the date of submitting the completed application.
The General Secretariat of the Cooperative Health Insurance Council shall have the right for its representatives to visit the health facility applying for accreditation, to review the information you submitted for the purpose of accreditation and to evaluate the health facility to consider the possibility of final accreditation of the health facility.
In case the health facility cannot be accredited, it will be notified of this
In case the service provider's accreditation period expires, it shall be suspended by the Council and the electronic portal directly from the date of the end of the accreditation period.
In case the service provider does not request the renewal of the accreditation after the expiry of the accreditation period and deals with insurance companies / claims management companies, the service provider will be considered in violation of the provisions of the cooperative health insurance system.
In case the health facility, whose ownership has been transferred, retains the previous license number of the GDHA, the health facility maintains the number of its previous accreditation record with the Council.
In case the license number of the GDHA for a health facility whose ownership has been retained has been changed, the health facility shall retain the number of its previous accreditation record with the Council.

In case the license number of the GDHA of a health facility whose ownership has been transferred had been changed, a new accreditation record number will be given to the Council and its previous accreditation record will be cancelled.
The Board may cancel the accreditation of the service provider under a resolution by the Chairman of the Board, in the following cases:

1. Cancelling or withdrawing the license of the Ministry of Health.
2. Evidence of breach of accreditation requirements.
3. Providing the Council with incorrect information or data.
4. Obtaining the council information indicating the inability of the service provider to maintain the health of the beneficiaries.
5. Committing, contributing or facilitating cases of fraud or abuse, or evidence of gross negligence.
6. Failing to provide evidence of the application of quality standards and requirements stipulated in Chapter Nine of these Regulations.
7. Failing to pay the fees to renew the accreditation.
8. Non-compliance with the controls and requirements of E-transactions approved by the Council.
9. The service provider's refusal or obstruction to perform the duties of the supervisory field visits team of the Council when inspecting it.
10. In the event of suspending or canceling the accreditation, the Council shall notify the insurance companies and the Health Insurance Claims Administration companies of that.



Last Update : 13/12/2021 03:22 م

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