Muscat: As the Sultanate gears up for the launch of the Unified Health Insurance Policy, Oman-based IRIS Health Services is preparing the ground by implementing future-tech solutions to ensure faster and more efficient diagnostic procedures and claims settlements, higher levels of customer satisfaction, and better protection from fraud, waste, and abuse.
In the last six months IRIS, a health insurance third party administrator, has integrated its proprietary and custom-built digital solutions across more than 100 medical services providers in Oman and trained more than 300 hospital, clinic and pharmacy staff to use the e-services, many of which use future technologies such as blockchain, artificial intelligence and machine learning.
The digital solutions include electronic health cards, real-time eligibility checks, e-pharmacy lists and a Physicians Support Tool, benefiting everyone involved in the health insurance ecosystem from consumers to insurance companies to regulators and providers.
Mr. K. O. Devassy, Chief Marketing Officer at the Badr Al Samaa Group of Hospitals and Polyclinics, the largest private healthcare provider in Oman, said the IRIS systems are making a considerable difference to its operations.
“IRIS’ digital solutions have given a user-friendly experience and their easy access tools including patient eligibility check and registration process are boosting our efficiency and effectiveness, customer service levels and resource utilisation, as well as building our capacity in healthcare technology integration,” Mr. Devassy added. “Adopting future technologies like these aligns with our goals of improving access to care, ensuring patient confidentiality and boosting treatment effectiveness and prevention.”
“Insurance technologies are where the present meets the future,” said Anil Nair, CEO of IRIS Health Services. “At the micro-level, the best insuretech solutions improve access to care and ensure quality, value-based care and wellbeing for Omani residents; at the macro-level, these advances and the associated benefits will boost confidence in and strengthen the nation’s health insurance sector.”
The best insuretech tools are also intuitive, intelligent and easy to integrate and operate, Nair added. IRIS’ real-time eligibility check is one such tool; Nair added IRIS has many more it intends to roll out for Oman.
“With the real-time eligibility check, the front office team at a hospital, clinic or other medical service provider can instantly validate an insured member’s eligibility,” Nair explained. “This is a crucial step as it ensures only eligible members have access to services, thereby reducing fraud and contention between health providers and insurers and saving time and resources for clinics, hospitals and pharmacies.”
The IRIS solution also generates instant insurance e-cards with benefit information such as deductible and co-payment details clearly visible, as well as standardized claim forms – together, these two processes alone increases efficiencies for the health ecosystem.
As a goodwill gesture, IRIS is currently providing its Physician Support Tool and related training for free to all the medical service providers in its network in Oman. The Support Tool allows physicians to code diagnoses according to World Health Organization and other international standards at the touch of a button without the need for specialist coders or knowledge.
About IRIS Health Services
IRIS Health Services is an award-winning third-party administrator (TPA) providing professional medical benefit and claims administration services in the UAE and Oman. As a TPA, IRIS manages health insurance policies on behalf of insurance companies and businesses, liaising with health providers and policyholders to provide better access to medical care and better health outcomes.
IRIS began operations in Oman in late 2018 with a commitment to extend best practices in adjudication by integrating the latest technologies like AI and blockchain with experience and expertise. IRIS has helped save more than USD 10 million in healthcare fraud in the UAE, Oman and other Middle East markets through these solutions.
IRIS maintains a 24-hour, multilingual call centre and an in-house team of doctors for its insured members. IRIS also provides solutions for specialized insurance needs for reinsurers, regulators and self-insured companies.
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