CMA Presents Dhamani Platform to Stakeholders of Health Insurance Scheme

09 November 2020

 

Al  Maamari- Dhamani Platform will contribute to integration with MOH “Shifa” system which will enable  a unified patient record in the future

 

Al Maskari- Dhamani Platform will contribute to quality health insurance services and treatment services in private healthcare institutions

 

The Capital Market Authority held on Monday a virtual  introductory  meeting on Dhamani Platform. The meeting was chaired by the Vice President, Insurance Sector and the participation of the company executing Dhamani Platform and the insurance companies, brokers, agents, third party claim administrators and private hospitals and clinics.

 

Ahmed Ali Al Maamari, Vice President, Insurance Sector said “Dhamani Platform focuses on exchange of health information on the visitors of private health institutions and will contribute in the settlement of insurance claims as well as time saving, funds transfer, requests for approval and  validation of insurance coverage among the parties of the insurance relationship, the regulators and supervisors.”

 

Al Maamari added that “The Dhamani Platform will achieve integration with the Ministry of Health “Shifa” system to link the patients’ medical records with the health insurance records that will eventually enable a unified patients records in the future, beside the link between the companies’ registration databases of the Ministry of  Labour, Ministry of Commerce and Industry and the ID card and immigration system of the Royal Oman Police to enable real-time validation of member eligibility  credentials  during  health insurance transactions as well as the link with payment gateways (through prompt submission, adjudication, conciliation and payment) which will lead to better cash flow between healthcare providers and payers in addition to minimizing unwarranted utilization and fraud.”

 

Engineer Mohamemed Hamed Al Maskari, Chief Executive Officer of Infoline commended the CMA policy in regulating the health insurance market by focusing on creating an electronic platform the  control and quality of health insurance transactions using state of the art technology further to the importance of creating  health records for patients which can be accessed from any health institution linked to the platform which would contribute to quality health insurance and treatment  services in the private healthcare institutions and appropriate medical prescriptions for each patient.

 

He added that CMA’s selection of a consortium of national and international companies, led by Infoline which is an Omani company, was due to the ability of the partnership  that participated in building health insurance claim administration platforms in a number of countries, and due to the transformation  in the health insurance sector in such countries the system contributed in providing  technologies enabling speedy access to approvals for treatment, easy follow-up by the supervisors to limit delays and unsound practices in dealing with insurance policies.

 

Al Maskari said the platform project is a national  project that requires cooperation  to overcome the expected  challenges and all companies are required to improve their internal  systems to ease linking processes to ensure easy flow of data. He pointed out that the company has created suitable  solutions to improve the systems of insurance companies and health institutions that will be linked to the platform.

 

On the technologies used in the platform Al Maskari said the CMA’s selection of the consortium was based on the expertise specially the international partner who introduced  up to date  standards related to information security as CMA attaches great importance to this issue  especially with regard to the network to be used to link all the stakeholders and data centre to be used for data storage.

 

It is noteworthy that Dhamani project is progressing according to clear strategy in line with the Government’s digital transformation initiatives beside engaging the private sector to play an important role in line with 2040 Oman Visions in creating wealth through economic diversification and private sector  partnership  to facilitate decent and sustainable life for all.