Our team will get in touch with you for a free demo

Why is NPHIES important for healthcare providers?

National Platform for Health and Insurance Exchange Services (NPHIES) is a unified electronic services platform launched by the Cooperative Health Insurance Council (CCHI) and the National Center for Health Information (NHIC) and led by the Sehati Company.

NPHIES platform services:

NPHIES Insurance Services:
Aims to connect all stakeholders in healthcare from service providers (government or private), third party administrators, insurance companies and the patients.

NPHIES Clinical Service:
Aims to provide a unified digital health record for patients in the Kingdom of Saudi Arabia, to improve healthcare decision making by improving the efficiency, quality, cost and time of providing these services.

Our team will get in touch with you for a free demo

NPHIES Insurance Services

The healthcare providers have been segregated such that they can be onboarded in a phased manner to adopt only NPHIES Insurance Services as of now.

The type of transactions that NPHIES will support:

  • Eligibility Check Cycle: A transaction allows a provider to request for identifying the patient’s insurance and other insurance details to which the insurance company would respond with errors of the respective insurance details.

  • Pre-Authorization: A transaction which allows a provider to request for prior authorization of products or services.

  • Claim Submission: A transaction where the provider makes a claim request for adjudication of products or services rendered to the beneficiary.

  • Claim Communication: A request from the insurance company for additional supporting documents/information to a claim request.

  • Payment Reconciliation: A transaction which provides the details of payment allocations to the respective claims being settled.

  • Payment Notification: A notification of the current status of claim related payments.

Insta HMS’ readiness for NPHIES Integrations

Insta by Practo will release Phase I of NPHIES compliance in December 2021, where Wave-1 and Wave-2 providers can submit the eligibility check and pre-authorization requests and receive responses.

By February 2022, Insta by Practo will release Phase II of NPHIES compliance, where providers would be able to submit 100% of all transactions to the NPHIES platform.

Why Insta

Insta is your one-stop solution for all hospital management system (HMS) related needs. We are spearheading this initiative by being one of the companies to ready to tie up with NPHIES  to help integrate the system. We will be a completely secure and compliant hospital management software certified for the integrations by NPHIES.

Clients who have trusted Insta

See what our clients have to say about us

Our team will get in touch with you for a free demo