The ISAHD System in Dubai
Insurance System for Advancing Healthcare in Dubai (ISAHD) is a patient classification system introduced by the Dubai Health Authority (DHA) and Dubai Health Insurance Corporation (DHIC) to improve transparency and quality of healthcare services in Dubai and enhance the claims payment process.
The DHA has been working to simplify the payment process for hospitals and insurance companies. The ISAHD system, known in many countries as International Refined Diagnostics-Related Group (IR-DRG), has been optimizing treatment for patients since 2020.
The name ISAHD in Arabic means “bringing happiness,” signifying the UAE’s dedication to offering its people peace of mind when using and paying for healthcare services in the emirates with two main pillars: providing coverage for everyone in Dubai and promoting sustainable quality healthcare systems.
In this Pacific Prime Dubai article, we’ll discuss the concept of shadow billing and the IR-DRG system as well as how they contribute to the way hospitals set the prices for treatments.
What is the IR-DRG Payment System?
International Refined Diagnostics-Related Group (IR-DRG) is an international payment standard that hospitals employ to bill patients. The main concept behind this reimbursement system is to group similar medical procedures with other historical data to set up standardized prices for the treatments.
Focusing on quality of service rather than cost, the IR-DRG system takes into account the nature of the patient’s illness along with other variables, such as age, diagnostic, comorbidities, and so forth, to determine the overall bill to be paid by the insurer.
What is Shadow Billing?
Shadow billing is a reporting technique whereby physicians submit information relating to health services performed for administrative, tracking, or cost analysis purposes. It was a crucial step in the transition from the previous fee-for-service (FFS) payment system to the IR-DRG system.
The shadow billing process forms part of the IR-DRG that many hospitals in Dubai adhere to, allowing hospitals, insurance companies, and other stakeholders to understand the detailed requirements of the ISAHD payment system and the impact the system has on them.
Benefits of the ISAHD System
The ISAHD system allows patients in Dubai’s hospitals to pay in bundles rather than paying separately for each service and medication. Before the implementation of the new system, the costs of the same treatments varied from hospital to hospital, resulting in high medical expenses and long wait times.
With the IR-DRG payment system, patients admitted to hospitals can expect to be billed for a fixed price for a treatment, which won’t vary regardless of whether the patient is admitted for one or 10 nights. They won’t have to pay extra for hospital stays, and the final bill will be fairer.
Simplifying Reimbursements and Administrative Work
The ISAHD system streamlines the process of billing for reimbursement, making it more efficient and reducing the time and labor to settle payments to health care providers for their services.
Improved Quality and Efficiency
Hospitals in Dubai will also be rated for their efficiency and quality based on factors like readmission rates and failures. Healthcare providers will be competing with each other for quality and efficiency status to attract patients.
For instance, if a hospital falls below the standard, 10% of their treatment fees will be subtracted. On the other hand, a hospital with higher quality services will receive a 10% increase. Such practice will encourage healthcare providers to offer the most appropriate treatments to their patients.
Healthcare providers will also be less inclined to give patients expensive medication or services if not needed. This reduces the time patients are in the hospital and helps save resources. As a result, beds in the wards are freed up for those who require necessary medical attention.ฃ
Do You Need Health Insurance in Dubai?
While the ISAHD system provides convenient access to healthcare services and streamlines the billing process in hospitals across Dubai, your experience with the emirates’ healthcare system will be even more favorable with private medical insurance.
As health insurance is mandatory for expats in the UAE, there’s no better time for expats to get coverage for inpatient and outpatient admissions as well as medication and treatment costs than now since the ISAHD system will create a seamless healthcare experience in the UAE for you.
Pacific Prime Dubai offers a wide range of comprehensive medical insurance plans from reputable insurance companies in the emirates. Our consultants will assist you in sourcing the plan that best fits your needs and budget with impartial advice and more than 20 years of experience in the industry.
Contact us for a no-obligation quote and plan comparison today!
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