DHA to regulate services provided through health insurance | Dubai ...

This will be done through the implementation of a regulatory framework as well as electronic insurance claims, aiming to further improve the quality of services provided in Dubai and insure that nationals and residents are protected in a sustainable health system.

Registration of insurance providers:
Dr Haidar Al Yousuf, Director of Health Funding for the DHA, said, "This means that all insurance companies will be registered by the authority and that the authority will take on an inspectional role to ensure all providers are following protocols to provide best insurance services to their customers."

Insurance policy holders' will have a channel to lodge their feedback, suggestions and complaints. Regulating health insurance policies also means that the DHA will ensure that the policy holder's are getting insurance for all the services they are entitled to as per their policy.

E-claims system to lodge all health claims electronically:
Moreover, every health insurance claim in the Emirate of Dubai, will be lodged online through the e-claims portal which is already in place. The portal will provide a complete break-down of the insurance claims which is a significant leap for the health sector in Dubai.

This means that, we will be able to get a detailed range of gold-standard data such as break-up of claims according to health specialties in the Emirate of Dubai. E.g: No of people who visited the practitioner for cardiac problems, diabetes etc in 2013.

This information will help the DHA study healthcare pattern which in the long run, is a process that will substantially aid in setting public health policies and strategies to ensure better health for the population of Dubai."

Regulating the services provided by insurance companies is an essential stage within the universal coverage mandate as highlighted by the Dubai Strategic Plan 2015, as envisioned by His Highness Sheikh Mohammad Bin Rashid Al Maktoum, Vice-President and Prime Minister of UAE and Ruler of Dubai.

The authority will also regulate price increases by private providers as well as insurance premiums based on inflation parameters and best practice models in health insurance, the authority's role will ensure establishing the correct balance to drive further investment to the health sector and the ensure long-term sustainability of health services without any parties making exaggerated profits that could be damaging to beneficiaries, employers and the economy.

Dr Al Yousuf elaborated that health insurance is a dynamic growing sector with close to 40 insurance companies and many self insured schemes providing health insurance coverage to around one million members in Dubai and that regulating and monitoring this sector is fundamental to protect members, limit attempts of abuse and further enhance the quality and sustainability of health services in the Emirate.

He announced that the DHA Director-General has instructed to expedite the role out of the framework to be functional within the first quarter of 2013.

Source: http://www.ameinfo.com/dha-regulate-services-provided-health-insurance-324148

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