NPHIES Integration
Andromeda ITC is a certified NPHIES integration provider. We deliver comprehensive integration solutions that seamlessly connect your healthcare facility to the National Platform for Health Insurance Exchange Services.
What is NPHIES?
NPHIES (National Platform for Health Insurance Exchange Services) is the national system launched by the Council of Health Insurance (CHI) in Saudi Arabia to digitally transform the health insurance industry. The platform serves as a centralized electronic hub connecting healthcare providers and insurance companies, enabling real-time data exchange and transaction processing.
NPHIES aims to automate and streamline all health insurance processes, including patient eligibility verification, pre-authorization requests, claim submission, and payment reconciliation. The system operates on international HL7 FHIR standards to ensure interoperability and seamless integration with various health information systems.
Compliance with NPHIES is mandatory for all healthcare providers and insurance companies operating in Saudi Arabia. This digital transformation contributes to achieving Saudi Vision 2030 goals for a digital, integrated, and efficient healthcare sector. By integrating with NPHIES, healthcare facilities benefit from accelerated revenue cycles, reduced manual errors, and improved transparency in insurance transactions.
National Health Insurance Platform
A centralized platform connecting all stakeholders in Saudi Arabia's health insurance ecosystem
Our NPHIES Capabilities
Comprehensive integration solutions covering all NPHIES services to ensure seamless operations for your healthcare facility
Eligibility Verification
Real-time verification of patient insurance eligibility before providing services, reducing claim rejections and improving revenue cycle.
Pre-Authorization
Submit and track pre-authorization requests electronically, eliminating paperwork and accelerating approval timelines.
Claim Submission
Automated claim generation and submission directly to insurance companies through the NPHIES platform with full compliance.
Claim Status Tracking
Monitor claim processing status in real-time, with instant notifications on approvals, rejections, and pending reviews.
Payment Reconciliation
Automated reconciliation of insurance payments against submitted claims, ensuring accurate financial tracking and reporting.
Prescription Processing
Electronic prescription submission and validation through NPHIES, supporting medication coverage verification and pharmacy claims.
Why Choose Our NPHIES Integration
Certified expertise and proven solutions ensuring seamless and reliable integration with the NPHIES platform
Faster Claim Processing
Reduce claim processing time from days to minutes with real-time electronic submission and automated validation.
Reduced Rejection Rates
Built-in validation rules catch errors before submission, significantly reducing claim rejections and rework.
Real-Time Processing
Instant eligibility checks and authorization responses allow healthcare providers to make immediate informed decisions.
Improved Patient Experience
Seamless insurance verification at the point of care means shorter wait times and transparent billing for patients.
Certified By
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