Dr Sherbaz Bichu, CEO of Aster Hospitals, asserted that the majority of the healthcare visits are to see GPs or internal medicine, so the per-visit claims generated are not on the high side – typically, they range between AED400 (US$109) to AED500 ($136). It is, however, the volume of claims being incurred that has affected the cash flow.
Another clinic owner in Abu Dhabi points out that since February, most healthcare facilities in the UAE would have seen a drop in the number of in-patient claims for orthopaedic issues, general surgery, etc. In addition, the note that the bulk of the claims now being generated are for health scans or paediatrics, and average out at about AED300 to AED500 (around $130) – these do not require intensive processing by insurers, the clinic owner argues.
In the last two years, the repayment period has been stretched to 120+ days, and allegedly claims rejection rates have also increased.
However, insurance officials insist that there is no need to speed things up on the payments side as healthcare providers should have the funds to manage such increase and not be dependent on claims payouts.
Dr Bichu reasoned: “The healthcare industry needs medical insurers to speed up claims processing and free up cash. For most healthcare facilities in the country, what insurers pay represents 80 to 90 per cent of their cashflow.”