Health insurance

Zyntra OS + NPHIES

The patient's eligibility, prior authorizations and the visit's claim sent through NPHIES, Saudi Arabia's health insurance platform — the insurer's answers and payments come back to the claim.

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What is NPHIES?

NPHIES is Saudi Arabia's national platform for health insurance, run for the Council of Health Insurance: providers and insurers exchange eligibility checks, prior authorizations, claims and payments through it.

What you gain when you connect it

Eligibility at check-in. The patient's coverage is checked for the day, and the answer — covered or not, with the benefits allowed and used — is kept on the patient's file.
Prior authorization. The visit's procedures are sent with their codes and diagnosis; the answer and its reference are kept, and the reference goes with the claim.
The claim walks by the answer. Approved, approved with changes, rejected with NPHIES's reasons, or under review — and the insurer's and the patient's invoices are split by what was approved.
The payment comes back. The insurer's payment is kept on the claim, and the claim is marked paid once the insurer's invoice owes nothing.

Who it suits

A clinic in Saudi Arabia on Zyntra Clinic whose patients are insured by insurers on NPHIES.

How to switch it on

Open Clinic › Settings › NPHIESAn administrator who may change settings opens it in Zyntra OS.
Enter your own accountEnter your provider licence, facility licence and the certificate NPHIES issued to your clinic — for a company with an address in Saudi Arabia — from your own account with the provider. Secret keys are kept sealed and never shown again.
Try it in test modeIt starts in test mode: you try it, and nothing real is sent, charged or recorded.
Switch it onTurn test mode off and switch it on — from then on it works by itself.

Every connection is free

We take no setup fee for anything our customers need that improves their work: enter your own account and key, and it works. You pay your subscription to the service provider only, not to us; the connection with Zyntra is free.

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See them working

Ask for a demo and our team shows you the connections your company needs.

Talk to us +962 795 900 124 [email protected]