Standardized medical procedure codes support golf health insurance

The magnitude of the demand for healthcare in the Gulf region has increased dramatically over the past decade. Annual health insurance Expectations in the Emirate of Abu Dhabi show that healthcare utilization increased by 99.3% between 2011 and 2020 – and that was before the COVID-19 pandemic accelerated demand even further.

To successfully manage this continued surge in demand, governments across the Region are striving to implement innovative, resilient and sustainable public health and medicine practices. To achieve this, several governments have standardized Current Procedural Terminology (CPT®) content from the American Medical Association (AMA) to unlock more efficiencies for local health insurance programs.

In 2022, the Capital Markets Authority (CMA) in the Sultanate of Oman selected the CPT code set to support the newly launched electronic platform that automates the administration of Dhamani, a new compulsory national health insurance scheme. Similarly, since 2011, the Department of Health – Abu Dhabi (DOH-AD) and the Dubai Health Authority (DHA) in the United Arab Emirates have used standardized CPT codes to streamline communication and report analysis across their healthcare ecosystems. CPT serves as a common language that uses consistent and standardized procedural codes to enable communication between patients, healthcare providers, and private and public insurers to support each country’s reimbursement network and its regulatory role by the government.

Additionally, the use of standardized CPT codes in the Gulf has increased automation and efficiency through integrated digital systems such as eClaimLink founded by the Dubai Health Authority, Shaafafiya from the Ministry of Health – Abu Dhabi and the warranty Platform to support the people of the Sultanate of Oman. Insurers, health authorities and physicians in this region have a structured reimbursement system in place that allows for more efficient pre-approval of treatment for patients and promotes better access to treatment as the demand for more care continues to grow.

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The implementation of integrated systems and CPT codes allows health ministries to manage and monitor the localized payment rates for each medical procedure, regardless of the care environment. Most CPT procedure codes are linked to Relative Value Unit (RVU) data, which provides an objective measurement of the resources required to perform a medical procedure. Based on the principle that payments for medical services should be directly correlated to the resource costs of delivering those services, the RVUs for CPT codes are regularly updated to help modernize medicine. The RVUs associated with CPT procedures allow healthcare professionals to combine the time, intensity, and cost of care into a single relative ranking scale for payment. These relative values ​​are then converted locally by health ministries to support their goal of sustainable health care cost management. To learn more about how RVUs add value to healthcare systems, please Watch this short two minute video.

Governments throughout the Gulf region rely on a globally recognized, evidence-based CPT code set that keeps pace with modern medicine. The CPT code set continues to meet the evolving needs of Gulf region data-driven healthcare systems, which aim to innovate while controlling costs, improving quality and increasing access to care. CPT content helps maintain the affordability of health services as governments expand and adopt innovative public health and medical practices, and support their vision of building sustainable, resilient health systems. The implementation of CPT code sets has helped the Abu Dhabi Ministry of Health to drive innovative healthcare solutions such as: B. Supporting the Malaffi platform in delivering COVID-19 tests and vaccine codes to enable medical and government agility during Abu Dhabi’s COVID-19 pandemic response.

About the American Medical Association

That American Medical Association (AMA) is the physician’s strong ally in patient care. The AMA uses its strength by removing the barriers that hold back patient care, advancing the initiative to prevent chronic diseases and address public health crises, and driving the future of medicine to address the biggest challenges in healthcare.

Current procedural terminology

The Current Procedural Terminology (CPT®) code set streamlines communications throughout healthcare and informs advanced analytics about medical procedures and services. Governments, healthcare providers, technology providers and payers use the CPT code set in their healthcare management systems. CPT coding is trusted to support payment processes and inform public health planning and research. As a standardized, comprehensive language, it reduces reporting challenges, allowing providers to unleash administrative efficiencies and productivity while focusing on their patients.

Learn how CPT content can support your initiatives. The CPT code set is the language of medicine today and the code for its future.

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