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Daman Carries Out Diagnosis Related Groups Program

This year in 31st of October, The National Health Insurance Company, ,  the former health premium organization in has managed to perform the recent billing program named that is established to aid in increasing efforts  and better control for the quality of medical services by dividing hospitals ‘s allegation for inpatient services.

The move came following the Health Authority –Abu Dhabi’s circular mandating the payment of the Basic Abu Dhabi allegation beginning from August 1st depended on DRGs. Daman is the former health insurance organization in Abu Dhabi to adopt this program. Before the end of 2011, all inpatient allegations for Daman’s developed plans will also follow the recent DRG program. Daman has already successfully processed inpatient allegations depended on DRG that have been received from healthcare providers in Abu Dhabi. According to healthcare providers e.g. (consultation, medical laboratory tests, drugs hospitalization days etc) healthcare providers’ inpatient bills were detailed.

Diagnosis Related Groups, or DRGs, are depending on a simple concept of averages. DRGs identify patients with similar clinical profiles and costs of cure and pay the hospital the average amount, regardless of what it costs to cure an individual patient. This will consequently limit healthcare providers from adding unnecessary services in trying to boost their revenues. Dr. Jad Aoun, Chief Medical Officer of Daman reported that “At Daman we strive to position ourselves as a pioneer in the UAE’s health insurance industry. We have implemented the DRG system as a sign of commitment to HAAD’s vision , one that guarantees more transparency in the health insurance process and enhances the way medical care is delivered to all inpatients at Abu Dhabi’s hospitals,”

The DRG program has been applied in many countries in the world such as: the United States, Germany, Australia and Singapore. This program will aid in increasing efficiencies and decreases difficulty in the billing procedure between healthcare providers and health premium organizations. Simplifying billing will ultimately aid in preventing fraud, transparency in cost negotiation and eventually protecting members from unnecessary rise of insurance.

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