Transition From 6th edition to 10th Edition - ICD-10-AM, ACHI and ACS - KSA

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Stand out with internationally recognized knowledge

Developed by RCM experts
in the UAE

Complete understanding of Revenue Cycle Management (RCM)

Compliant with the UAE’s Department of Health (DOH) & Dubai Health Authority (DHA)

Course Summary

Strategic Revenue Cycle Management In The UAE course offers a complete understanding of the UAE healthcare insurance concepts, the coding and billing regulations of UAE’s Department of Health (DOH) & Dubai Health Authority (DHA), coding concepts, claim submissions, insurance denials, resubmissions, reconciliation and billing compliance. 

The core objective is to provide you with the knowledge on the Revenue Cycle Management (RCM) model, work flows, various departments involved and their roles in collecting all payments that are due towards the medical billing services that have been delivered. This course will offer a comprehensive knowledge in handling the denials and the process of resubmissions or reconciliation and the effective ways of managing the information and data security.

This course helps the learner understand the cycle of a claim generated after a patient’s visit and the following steps and is based on the information the claim carries and whether it reaches the physicians account as a reimbursement or gets rejected or denied midway due to lack of critical or wrong information.

By the end of this course, you will be able to:

  • Be proficient with the various insurance programs offered by each Emirate with respect to Emiratis, government employees, expatriates.
  • Understand the coding and billing adjudication rules as per DHA and DOH
  • Identify the different methods of billing medical and dental procedures practiced in Dubai
  • Know the role of DRG in billing and its importance in current billing
  • Be well versed with the compliance standards for Outpatient and Inpatient records.

MODULES

Insurance protocols module is a guide to understand the basic terminologies used in medical billing, the steps involved in a claim cycle, and all the steps involved to submit a claim. It also educates on the various teams involved and their roles within RCM. It will offer a thorough understanding of the differences between the processes as handled in Abu Dhabi and Dubai in a claim cycle.

DHA billing rules explains the various billing adjudication and coding rules followed in the Emirate of Dubai. This module will explain the various methods of insurance payment both medical and dental in relation to Dubai.

In this module, you would be able to understand the billing standards for Abu Dhabi. The chapter explains in detail the various billing adjudication rules of each section of CPT as per the regulator (DOH). It educates you on the various methods of insurance payment both for the medical and dental in relation to Abu Dhabi.

Coding concepts module will introduce you to the world of codes used and to interpret the various diseases and the procedures. It discusses the different chapters/sections of ICD 10 CM / CPT/ HCPCS.

It will help you address and decide on what could be a principal diagnosis or secondary diagnosis? Plus, it will offer you the guidelines for accurate coding and how to report uncertain and unconfirmed diagnosis.

Claim Submissions module explains the different methods of submissions in Abu Dhabi (Shafafiya) and Dubai (eClaim). Knowledge on claim form submission portal and its various components are explained in detail. 

You will also identify what an ideal prescription looks like. Plus, information on causes of claim denials, common denial codes will also be explained.

Insurance denials explains about the various denial codes for DOH and DHA supported with effective examples.  You will learn about the methods to identify the reason for denials and the possibilities of resubmission. It will greatly help you to observe and analyze the situations for reconciliation.
Compliance rule is the most important module – as “best saved for last” of the whole RCM course. This module discusses and makes you understand the violations, standards of DHA and DOH to make your practice regulatory compliant, plus the application of compliance rules to different specialties.