Switching Solutions

Eligibility 

  • Mem  bership status validation (MSV)

This allows the HEALTHCARE provider staff to check whether or not the patient is a valid member of the mentioned medical insurance company.

 

  • Provider status validation (PSV)

This allows the healthcare professional to check whether the provider is an adequate healthcare provider as per the contractual agreement with the PAYER. 

 

Approvals

The healthcare professional is required to get an approval from the PAYERS before providing the care or service. The absence of this approval means that the insurance companies may not provide coverage or pay for the services requiring you to cover some or all of the costs personally.

 

Electronic Claims Submission 

  • DHS Arabia provides the healthcare professionals, clinics managers, hospital administration staff, and pharmacists to submit a claim electronically for the patient to the appropriate the Insurance Companies / Third Party Administrators – TPA’ s (both known as PAYERS). The submission of the claim can be made through DHS Arabia and the process for the submission can vary, based on the method implemented by the software vendor at the healthcare service provider’s site.

 

  • DHS Arabia MTS SYSTEM support REALTIME submission of single claims and the traditional Monthly Batch submission process depending on the contractual agreement of the payer with the providers

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