Why health insurance claims are rejected in Saudi Arabia
The two kinds of claim rejection, technical and medical, where each starts in the clinic, and what to check before a claim is submitted.
By the Nabdah team ·
Blog
Notes from the Nabdah team on claim rejections, clinical documentation and coding in Saudi health insurance.
What a clinical note has to show to support medical necessity
An insurance reviewer judges medical necessity from the note alone. How to write the chief complaint, findings, diagnosis and plan so that every order has its reason.
By the Nabdah team ·
Coding diagnoses to the detail the note supports
Saudi claims code diagnoses in ICD-10-AM. When an unspecified code is right, when it is wrong, and why every service needs a diagnosis that explains it.
By the Nabdah team ·
Writing prior authorization requests that hold up at the claim stage
What a prior authorization request needs to show, how to handle a partial approval, and why a claim for an approved service can still be rejected.
By the Nabdah team ·