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Connecting Healthcare World
SAUDI ARABIA / GCC
Single Click Solution
www.myhealth.com.ksa
Place
Health TransactionsAccessible all
Myhealth.com
IntroducingE-SOLUTION
One Plate Form
INTERNET TRANSACTION SERVICES
Healthcare Information Technology
• Web Based• Server Based
www.myhealth.com.ksa
Prevailing Healthcare System
• Every healthcare providers have own Information System (HIS), no final destination to merge into.
• Different Database in Insurance Companies & TPA• Different Pricelist Standard & Coding's• Lack of Specific area Reporting's, KPIs, • One patient have several file numbers • No Accuracy• No Caring of patient because of least insurance info • Manually Compiling Monthly Reports by Govt. • And many more….
Healthcare Network
TPAHealthcare Provider
Myhealth.com
www.myhealth.com.ksa
Insurance
Companies & Residents
Over 3 millions InsurerOver 10,000 companies
Myhealth.com
• Staff Insurance• Family Insurance• Call for quotation• No broker required• Direct Dealing
Insurance Broker
Healthcare Provider in KSA
Healthcare Provider in KSA
445262029
605 7180 2249
Others Pharmacies Medical Complex
Insurance CoOptical ShopsHospitals
2259
PHC
Segregations of Roles
Insurance Companies Responsibilities
Awarding contract to providers Renewal or closing Contract Opening all Classes or specific Opening Networks, Services New Products notifications New Policy & Updates Eligibility Pricelist as per Accreditations Preauthorization Approvals E-Claim Checking Rejections Notification for payments
Healthcare Providers
Cash Prices Accepting Contracts Accepting Insurance Pricelist Accepting Classes Accepting new networks Closing Contract Preapprovals Online E-Claiming Rejections Resubmissions Financial Deal/Settlements Acknowledgement of Amount
received
Place
Insurance CardsAccessible all
Expansion Our Offices .....
Myhealth branches will be opened in all the cities for selling all insurance companies products. One place where can get all info.
Third Party Administrator
• Opening new Myhealth Offices for providing Services on behalf Insurance Companies• One place where every one can get complete info,purchase insurance products, • Marketing for insurance companies, healthcare Provider, Pharmaceutical Companies, associated partners
Expansion Our Offices .....
Medical Team Checking E-Claims Insurance Cards Selling Product Marketing,
MarketingTPA Sales
• My Health will work as a implementation agency as well as Third Party Administrator on behalf of all insurance companies. • All insurance products can be obtained on one place according to choice of clientele/employer. • Our Medical Team will work to check E-Claims, Approvals protocols, and recommend for the payment to the provider
Completely Paperless
Hospital
Med
ical
C
ompl
ex
Insurance
Polyclinic
Pharmacy
PatientPlate Form
TPA
Unique Control System
• Unique Patient Number around the country Like IBAN• Drugs Online Controls • Standard Service’s prices as per Protocols• KPIs • Fast Reporting & Checks• Completely Paperless environment• Electronic Records on Single Click around the country
My Health Apps
• Electronic Medical Records• Your Insurance Policy • High Alerts on your medication’s schedules• Appointments • Provider Location Tracer• Emergency & Helps • Information & Services –Healthcare Provider• News & Updates• Complaints
EMR always with you
My Health Community
Social Healthcare Network
Where Patients meet with Doctors
Like facebook, twitter
Government
• Health Policy• Financial & Budgeting Control• Patient Safety• Drug Controls & License• Performance• New Innovations• Announcements• Action to be taken
Monitoring all aspects of health
Ministry of Health
Govt Checks/Control/KPIsSingle click
Insurance Products
Product Information
Network Covering
Product Prices
Price List Comparison
Eligibility Checks
Suggestion Ranks
Cardholders Statistics
# of Patients Visited in MC
Approval
Eclaim
Rejections
Resubmission
Medical Team
HIS
TPA Services
Insurance ERP
Complete InfoSERVICES
Our Center of Attention
26 Insurance Companies Over 3 millions Insurer +5000 Providers
Insurance Insurer HealthcareCompany Centers
Medical Centers+ Hospitals
Integrated Business Growth
EligibilityChecks
E-ClaimManagement
Services
HIS
20%50%
65%90%
ApprovalManagement
Rejection Management
Policy InfoProducts InfoRate ComparisonFor us only
Invoices and Supporting DocApproved CaseRejectionRe-Submission
Consultancy
Medical Team
•Auto•Accidents•Commercial•Property
Medical Team
Integrated HIS
On monthly Installment
Server Based Storage Facilities
OMR 0.010 baisas per case
Original Cost plusMonthly Commission For claim checksEmployer Registration Fee for insurance help
Claim CheckingHIT
Integrated
•1000 OMR Medical Center•3000 OMR Hospital•Maintenance Fee – Yearly15% of total price•Data Storage Fee – to be determined
To be determined after observing the volume of work
Online Support to employer
Services Covered
Healthcare services
Healthcare Information System
TYPE_01 TYPE_02
01Healthcare
CS Support, Policy Info, Eligibility, Updates
02Insurance
Insurance services
Free Support Free Support
65%35%
Approval processing
Claim processing
Medical Claims
BrokersSEASON_002
Product Support, Policy Support, Marketing Ceiling in initial phase, Updates
Elig
ibili
ty
Checking
Policy info
IT Support
Marketing
Produc
t Suppor
t
Policy SupportCS Support
Break the Market by new Invention/Features Sys
VVIP Smart Card
Core Attribute• No deductible applied on Corporate/Govt• Maximum Services covered• Maximum Limit Covered• Zero Wait Policy• Best technique for Advertisement & RetainValued Customer for long run.• VVIP Protocol
Card Issuing Criteria (Just swipe your card, place a finger and process for your treatement)System Integration, Policy and Procedure would be developed after approval from the Employer. The validity of cards & its benefits would be fixed according to awarded policy by company.
For VVIP, A+ card holders, Corporate Sectors
Revenue very flexible in first year
Monthly Package (Fee)
Fees includes Free Installation, Annual & Monthly Maintenance, Training & Orientation, Data storage, Quotation assistance for companies, establishment, etc
Monthly Packages (SAR)Description Fees Quantity Total AmountHospitals (Private/MOH/Govt) 3,000 445 1,335,000 Dispansaries (Medical Complex/Polyclinic/PHC) 1,500 4,508 6,762,000 Pharmacies 1,000 7,180 7,180,000 Other Clinic (Lab,Cardiac,Rehibiliation etc) 1,000 797 797,000 Insurance Company Offices 3,000 100 300,000 TPA Offices 3,000 50 150,000 KSA Companies (For employee insurance) 500 10,000 5,000,000 KSA Eastablishment (For employee insurance) 200 5,000 1,000,000
Total Estimated Monthly Revenue 22,524,000
Registration & Software Installation
Revenue very flexible in first year
Awarding Products – TPA•Initially 3% gross Claimed amount from Medical Center or as agreed•Second phase up to 12% from gross claimsApproval via web pages
•10 halalas per document to be received from Medical Centers/Hospitals
E-Claim Web page uses10 halalas per document uploading OR3% gross claimed Amount ORfixed amount to be charged to Medical center and Insurance Companies for using E-claim facilities
Policy UpdatesoFree for first year, or as agreedoCharge Annual Fees to Insurance Companies for using our plate form.
Product InfoUpdates Products, rates, procedures free, package included in the annual fees
E-Claims Checking by our DoctorsActual cost plus commission from insurance companies ORA Fixed amount to be charged to Insurance companies
Second Option Dynamic Charges
Revenue very flexible in first year
Data Storage Fee•Annual Fees from Medical Centers and Hospitals to be charged against Data Storage
Rejections Re-submissionDocuments fee would be charged to Medical centers as per rates.
EmployeroSAR 500 Annual subscription Fee to be charged to Employer those would utilize our online services for Insurance product comparison, obtaining knowledge, price comparison and MIS Reports. The other services will be charged as per standard
Insurance ERP 3000 Monthly ERP Fee But would be decided after completion of HIS
HIS ERPSAR 1000 Monthly Fees from Medical CentersSAR 3000 Monthly Fees from HospitalsSAR 3000 Monthly Fees from InsuranceSAR 2000 Monthly Fees from TPASAR 500 from PharmacyAnnual Maintenance Fees from both Approval Facilities by our Doctors
Actual cost plus commission from insurance companies ORA Fixed amount to be charged to Insurance companies
Revenue with the expansion of Business integration
TPA for checking of Claims
Sales & MarketingFor selling of Insurance Products
Our New BranchesOne place to solve all healthcare issues
Oligopoly
Work as a Implantation agency
No need to open insurance office by every insurance company.
Commission as well as fixed amount will be charged to Insurance companies to provide services
Competitors
Competitors Zero, GCC countries waiting for new invention to save their precious time among the healthcare, Insurer and insurance companies
There is only one web page in KSA launched by waseel.com with limited facility of eligibility & Insurance Approval facility, they are improving their standards as per the Market requirements
Presenting by [email protected]
شروق عيادات مجمعالطبي الهدى
Shrouk Al-Hada Medical Complex
www.shroukalhada.com
