Friday 26 / April / 2024
Muscat: An electronic platform agreement for compulsory health insurance system for private sector has been signed on Wednesday.
The Capital Market Authority (CMA) has concluded Dhamani Platform contract with Info Line in collaboration with its strategic partner IQVA.
According to Dhamani, the platform will link a database of more than 3.5 million visitors and 2.5 million workers with different health institutions.
“It is a platform that links regulatory and supervisory authorities, insurance companies and health institutions with a unified database,” Dhamani said.
The platform aims to connect all relevant parties, facilitate the exchange of information, raise the level of transparency and trust, settle claims and transfer funds, provide indicators about the health insurance status and use an unified coding system.
The tender documents were prepared after studying the needs of the local market through meetings with the stakeholders such as insurance companies, health service providers, Ministry of Health, Ministry of Labor and Public Authority for Social Security as well as consideration of the regional and global experiences.
Dhamani scheme is considered one of five key steps designed by the CMA in collaboration with the entities concerned in the preparatory stage for implementation of health insurance scheme for the employees of the private sector, residents and visitors (Dhamani) to set out legislations, set up a database for health insurance sector, organize awareness campaign on the implementation mechanisms and how to deal with health insurance products beside conducting actuarial study on the prices.
The platform will contribute to the quality of insurance services and upgrading the level of transparency and precision of all transactions as well as providing timely and accurate data on the market conditions and to reduce insurance fraud to maintain market stability and insurance companies. It will also boost confidence in the health insurance market whether for patients or other participants due to the electronic link showing the history of the patient, medicines and description of the cases which would reflect positively on the sector as a whole.
It is noteworthy that implementation of Dhamani platform will be in phases due to the size of technical and operational requirements. The first phase will commence after signing the contract and will continue for 9 months.
This phase includes building the platform and linking to the government entities concerned with health insurance schemes, insurance companies and health services providers for online exchange of health insurance transactions.
Then, the second phase which will take 8 months and includes electronic payment features, verification of insurance coverage and data storage.
Finally, the third phase will continue for 8 months and is related to training of the parties of the insurance relationship and government entities on the system components and work methods. This means that the platform will take 25 months for full implementation.
