Latest news with #Dhamani
Times of Oman
a day ago
- Business
- Times of Oman
Oman's 'Dhamani' platform revolutionises health insurance with record activity in 2025
Muscat: The National Health Insurance Platform 'Dhamani' has released its operational report for the first half of 2025, revealing a surge in activity that underscores its growing role in streamlining health insurance services across the Sultanate of Oman. According to the latest figures, the platform processed more than 4.2 million transactions, averaging 40,000 transactions daily. Of these: 2.3 million were eligibility verifications for insured individuals. 1.4 million dealt with medical approvals. 700,000 were claims submitted by hospitals. In a significant milestone, OMR 3.5 million were electronically transferred from insurance companies to hospitals, emphasizing Dhamani's focus on efficiency and transparency in financial settlements. The platform's integrated network now includes: ▪ 33 hospitals ▪ 37 health complexes ▪ 33 specialised health centres ▪ 20 clinics
Times of Oman
a day ago
- Business
- Times of Oman
National Health Insurance platform 'Dhamani' reports strong activity
Muscat: The National Health Insurance Platform 'Dhamani' has released its operational report for the first half of 2025, revealing a surge in activity that underscores its growing role in streamlining health insurance services across the Sultanate of Oman. According to the latest figures, the platform processed more than 4.2 million transactions, averaging 40,000 transactions daily. Of these: 2.3 million were eligibility verifications for insured individuals. 1.4 million dealt with medical approvals. 700,000 were claims submitted by hospitals. In a significant milestone, OMR 3.5 million were electronically transferred from insurance companies to hospitals, emphasizing Dhamani's focus on efficiency and transparency in financial settlements. The platform's integrated network now includes: 33 hospitals 37 health complexes 33 specialized health centers 20 clinics These developments highlight Dhamani's expanding footprint and its strategic contribution to raising service standards, reducing administrative delays, and ensuring seamless communication between healthcare providers and insurers.
Zawya
19-06-2025
- Health
- Zawya
Oman: FSA prepares for second phase of Dhamani platform
Muscat: In preparation for launching the second phase of the National Health Insurance Platform 'Dhamani' scheme, the Financial Services Authority organized a preparatory meeting with insurance companies and representatives of private healthcare institutions to arrange for implementing the second phase of the 'Dhamani' electronic platform. The second phase includes readying the 'Dhamani' electronic platform to exchange medical documents such as x-rays, prescriptions and medical referrals between private healthcare institutions and insurance companies on the one hand and between all hospitals, complexes, clinics and specialized health centers on the other hand. The two-day meeting was organized within the framework of the community participation adopted by the FSA while developing regulatory schemes. The meeting reviewed the nature of the components of the phase with the relevant parties to find out mechanisms for dealing with them, in addition to discussing the key challenges expected in the implementation and how to address them. This phase is considered important within the framework of launching the 'Dhamani' electronic platform as it progresses the platform towards broader services such as building a unified medical record for the insured that allow access to all the details of visits to any health institution linked to the platform. The national health insurance platform 'Dhamani' also adds value in organizing health insurance transactions in the Sultanate of Oman by linking operational and financial transactions between insurance companies, private healthcare institutions; health insurance claims administrators and regulators including government entities supervising the insurance market and private healthcare institutions. It is worth noting that the platform proved its efficiency and digital effectiveness during the operational period, as the number of health insurance transactions concluded through the platform reached more than 4 million transactions until the end of May 2025. All insurance institutions were linked to this platform in addition to the connection of all private hospitals licensed by the Ministry of Health, which are 33 hospitals. While the number of health complexes linked to the platform has reached 37 private health complexes so far, 20 clinics and 44 health centers. The platform also provides its services to more than 650,000 health insurance policyholders with a data and information exchange rate of up to 40,000 transactions per day. 2022 © All right reserved for Oman Establishment for Press, Publication and Advertising (OEPPA) Provided by SyndiGate Media Inc. (
Observer
21-04-2025
- Business
- Observer
Newly launched Dhamani platform to ease insurance claims
MUSCAT, APRIL 21 The recently inaugurated Dhamani platform marks a major leap forward in the digital transformation of Oman's healthcare and insurance sectors. Designed as a national digital information exchange, the platform facilitates seamless, real-time communication between healthcare providers and insurance payers. Speaking exclusively to the Observer, Dr Hatim al Lawati, Digital Economy Consultant at the Financial Services Authority (FSA), emphasised that Dhamani is not a standalone system but a comprehensive infrastructure for streamlining claims processing. 'Previously, there was a lot of fluctuation and delay, some claims took up to two years to process,' Dr Al Lawati said. 'Today, with Dhamani, claims can be submitted immediately after treatment, and insurance companies are required to respond within 45 days. The process is faster, more transparent, and significantly reduces administrative hassle.' He also noted that the platform's operational footprint is minimal. 'It is efficient enough to be managed with as few as three workstations,' he added. 'It greatly improves speed and ease for both patients and hospitals.' Through integration with healthcare providers' Health Information Systems (HIS), Dhamani enables instant claim submission by hospitals, polyclinics, clinics, medical centres, and soon, independent pharmacies. Once a patient receives treatment, the system can automatically transmit the claim to Dhamani, which then delivers all relevant data, medical reports, attachments, approvals, diagnoses, costs, and bills, directly to insurance companies. This digital workflow enables payers to act quickly, either approving, rejecting, returning the claim for clarification, or requesting missing information, within a short timeframe. 'Healthcare providers have up to 45 days to submit a claim after the patient receives treatment,' Dr Al Lawati explained. 'If the claim is returned by the insurer, it can be resubmitted within 30 days. Once accepted, the payer is obligated to process payment within another 45 days. This structured timeline ensures swift and smooth claims handling.' Beyond efficiency, Dhamani plays a critical role in combating fraud, waste, and abuse (FWA), common challenges in health insurance systems. 'Fraud involves submitting false claims for treatments that never occurred. Abuse refers to intentionally over-treating patients, for example, prescribing unnecessary medications or requesting unrelated tests. Waste relates to redundant or repeated services, like duplicate lab tests within or across hospitals,' Dr Al Lawati said. To reduce FWA, the platform implements several robust measures. 'First, we are standardising CPT codes, also known as medical protocols, so all providers use consistent procedures for specific illnesses. This allows regulators and insurers to quickly spot irregularities and potential abuse.' 'Second, all transactions on Dhamani are fully digital and transparent, allowing regulators to set automated rules to detect suspicious patterns. For example, if a medicine prescribed only for women is issued to a male patient, the system can flag it immediately.' 'Third, the FSA is deploying business intelligence (BI) and artificial intelligence (AI) tools to analyse data, detect fraud, and manage risk. These technologies empower both payers and the regulator to monitor claims comprehensively and protect system integrity.' In conclusion, Dr Al Lawati affirmed that Dhamani is not only enhancing the speed and transparency of insurance claims but is also serving as a critical infrastructure in safeguarding Oman's healthcare ecosystem from inefficiencies and malpractice.
Yahoo
21-04-2025
- Business
- Yahoo
Oman launches national health insurance platform
The Financial Services Authority (FSA) of Oman has officially launched the National Health Insurance Platform, known as Dhamani, to oversee the operations within the country's health insurance market. The platform is an electronic system aimed at simplifying the exchange of health insurance information and claims processing between insurers and private healthcare providers. At a press conference, the FSA CEO Abdullah Salim Al Salmi detailed the platform's regulatory functions and its anticipated positive impact on the Sultanate's health insurance system. He pointed out that Dhamani is designed to improve the Omani health insurance market and ease citizens' access to health services. Al Salmi confirmed the platform's efficacy, as evidenced by its successful pilot phase. During the first quarter of 2025, Dhamani facilitated around three million health insurance transactions between insurance firms and private healthcare establishments. The platform is now connected to 33 private hospitals and three healthcare complexes. Dhamani aims to address several challenges faced by insurance stakeholders, ensuring the provision of quality health insurance services and the timely settlement of financial obligations to private healthcare providers. The platform will also maintain a database of medical conditions, diagnoses, and treatments, which will enable authorities to conduct research aimed at advancing the health sector. Al Salmi further mentioned that Dhamani currently serves over 650,000 health insurance policyholders and handles up to 40,000 transactions daily. To support the platform's development and offset the costs of its establishment, which totalled OR1.6m, a modest fee will be levied on hospitals utilising the service. "Oman launches national health insurance platform " was originally created and published by Life Insurance International, a GlobalData owned brand. The information on this site has been included in good faith for general informational purposes only. It is not intended to amount to advice on which you should rely, and we give no representation, warranty or guarantee, whether express or implied as to its accuracy or completeness. You must obtain professional or specialist advice before taking, or refraining from, any action on the basis of the content on our site. Sign in to access your portfolio
