“Unified clinical pathways providing minimal guidelines on the best medical practices” is a solution for the current gap between medical necessity and insurance coverage, according to a leading provider of innovative healthcare billing solutions.
A press conference was held on Thursday at the Jumeirah Emirates Towers to explain the current situation in the medical sector where different diagnostic procedures are being performed for similar medical conditions leading to a significant amount of differences in the cost of medical insurance claims.
Pointing to an case study that analyzed different diagnostic procedures used to diagnose or rule out diabetes, hypertension, anaemia, thyroid disorders and Vitamin D deficiency, Dr Ayham Refaat, a leading authority on medical billing, said over 8.6 per cent of claims that were submitted were found to be disputable between the insurance companies and healthcare providers.
