NPHIES Integration & Clean Claim Standards

1. Real-Time Pre-Authorization Engine

Direct API interconnectivity with the National Platform for Health and Insurance Exchange Services (NPHIES) validates patient eligibility and insurance benefits within 3.2 seconds.

2. Automated Coding & SBS Mapping

Real-time mapping of clinical consultation terminology to Saudi Billing System (SBS), ACHI, and ICD-10-AM coding standards, reducing first-pass denial rates to under 1.6%.

3. Audit-Proof Claim Packages

Every e-claim includes cryptographically signed physician attestations and encounter time logs, eliminating post-payment reconciliation disputes.