Dr Azad Moopen, Chairman and Managing Director of healthcare provider Aster DM Healthcare, explained that insurance companies take, on average, three to six months to pay out on claims. “There are companies that pay up within 100 days, which is very rare. Most of the insurance companies take five months on average,” he said.
This puts additional pressure on healthcare institutions who have to borrow from banks in order to continue operations and pay their staff salaries. Dr Moopen noted that, previously, the cash component of the business was 70 to 80 per cent, which made things much smoother.
To make a dire situation worse, many healthcare providers also have to deal with the possibility of rejected claims, and with a first-pass rejection rate as high as 30 per cent for some of the insurance companies, this is an everyday reality for healthcare providers in the region.
But perhaps there is some light at the end of the tunnel. With the implementation of new regulations that have been rolled out by the Dubai Health Authority (DHA), claims payment windows should be reduced.
“These new regulations stipulate both the period within which a provider has to submit a medical insurance claim and the timeframe within which an insurer has to pay the claim,” said Ali Fareed Lutfi, Head of Payer Regulation and Licensing at Dubai Health Insurance Corporation. “The regulations grant the ability to the payer/provider to impose financial penalties on the other party if there is a delay in claim submission or claim payment. With the introduction of the new regulations, the claim cycle is standardised; it will become much more efficient and regulated and thus the duration including resubmissions from providers will become much shorter.”