• Setup sponsor coverage limits by provider network eligibility for copayment/deductibles by types of services offered.
  • Emirates ID Card Integration and dynamic copay feature to update copay and deductible details per patient by insurance card enabling quick registrations.
  • Setup HAAD/DHA based rate/discount factors with automated cash rate determination for exclusions.
  • Auto-determination of insurance limit based billing.
  • FFS/Per Diem and DRG (with high-value consumables) based billing support.
  • Follow-up doctor consultation visit rules determination by the sponsor.
  • Claim Form management.
  • E-Claim submissions, Resubmissions, and Remittance Advice through eClaim Link and Shafafiya.
  • Self Pay and Medical Tourist Submissions.
  • Prescribe by generic names or brand names.
  • E-Prescriptions (ERx), Dubai
  • Pharmacy Business Management, Abu Dhabi
  • E-Authorizations through eClaim Link and Shafafiya.
  • Prior-Authorization status tracking using Pending Prescriptions Dashboard
  • Medical Coding by HAAD/DHA standards and support for ICD, CPT, LOINC, CDT, E&M, DSL, Services Encounter, Drug, HCPCS, etc.
  • Regulatory Reports
  • Malaffi HIE Integration for Abu Dhabi
  • Multi-center support for the usage of a single application across centers in different emirates and health authority standards.
  • Bahrain Government ID Card Integration and Dynamic copay feature to update copay and deductible details per patient by insurance card enabling quick registrations.
  • Policy Holder based search for quick registrations
  • Advanced Insurance Features to define Fee for Service-based co-pay rules by insurance categories for out-patient/in-patient management.
  • Setup price/discount factors with automated cash rate determination.
  • Setup sponsor coverage limits by copayment/deductibles by insurance categories.
  • Auto-determination of insurance limit based billing.
  • FFS based billing support.
  • Claim Form management
  • Medical Coding and support for ICD, CPT, LOINC, CDT, Drug, etc.
  • Prior-Authorization status tracking with Pending Prescriptions Dashboard
  • Consultation EMR with identification of insurance item exclusions.
  • E-Claim submissions to Waseel/DHS.
  • Regulatory Reports
  • Government ID Card Integration with Kuwait Civil ID and Dynamic copay feature to update copay and deductible details per patient by insurance card enabling quick registrations.
  • Advanced Insurance Features to define Fee for Service-based co-pay rules by insurance categories for out-patient/in-patient management.
  • Setup price/discount factors with automated cash rate determination.
  • Setup sponsor coverage limits by copayment/deductibles by insurance categories.
  • Auto-determination of insurance limit based billing.
  • FFS based billing support.
  • Claim Form management
  • Medical Coding and support for ICD, CPT, LOINC, CDT, Drug, etc.
  • Prior-Authorization status tracking with Pending Prescriptions Dashboard
  • Consultation EMR with identification of insurance item exclusions.
  • Regulatory Reports
  • India GST Billing
  • Automated GST/iGST Supplier Taxation support
  • Pre-approved insurance package billing
  • Sponsor Limit based billing for insurance schemes (private/government).
  • Tracking for cash based payments exceeding 2 lakh rupees.
  • Pinelabs EDC machine integration for connecting payments via cards, digital wallets, or UPI.
  • NHIF (National Health Insurance) and HMO-Nigeria (Health Maintenance Organization) sponsor based billing by setting co-pay/per diem IP rules.
  • Claim Form Management
  • Multi-sponsor support