Insurance and Revenue Cycle
Protect revenue at every step: check eligibility at registration, request approvals before services, submit clean claims in batches and reconcile payments, all through NPHIES.
Eligibility and approvals
Eligibility checks and prior authorizations sent from the visit.
Claims in batches
Build, submit and track claim batches and pools.
Payment reconciliation
Payment notices matched to claims so nothing is left unpaid.
What's included
- Insurance companies and price lists
- Eligibility verification
- Prior authorization and resubmission
- Claim batches and pools
- Communication with payers
- Polling for responses
- Payment notices and reconciliation
- Claims dashboard
Who uses it
- Insurance officers
- Revenue cycle managers
- Finance teams
Connected integrations
Works together with
Modules share one patient record, so data flows between them without re-entry.
HR, Finance, and Accounting
A full general ledger fed by every clinical and commercial transaction, with ZATCA e-invoicing.
Learn moreHospital Management System
Run every department of a hospital from one system: front desk, wards, clinics, billing and stores.
Learn moreClinic Management System
Fast registration, appointments, consultation notes and billing for clinics and polyclinics.
Learn moreSee Insurance and Revenue Cycle in action
A guided demo for your team, built around your departments and integrations.