An e-platform currently under development to support the roll-out of the Unified Health Insurance Scheme (Dhamani) for private-sector employees and their dependents, as well as visitors and tourists, will eventually link up an estimated 1,700 health care service providers in the Sultanate when it is fully deployed. A contract for the establishment and operation of the e-Health System, which will integrate all of the stakeholders playing a role in the effective implementation of this mandatory health care insurance scheme, was signed by the Capital Market Authority (CMA) last week.
The platform will be developed and rolled out over a two-year timeframe with the first phase set to be fully operational in the second half of 2021.
According to the CMA, which regulates the insurance sector alongside the capital market in the Sultanate, the Dhamani platform represents the core of a comprehensive medical insurance system catering to an estimated 2.5 million insured people in addition to 3.5 million visitors and tourists annually.
All seven of the country’s seven licensed health care insurance services providers will be connected to the network, in addition to a number of Third Party Administrations and related service providers. Also due to be integrated with the platform are a number of government regulatory agencies and stakeholder institutions, including the CMA, Ministry of Health, Ministry of Labour, Royal Oman Police, and Ministry of Transport, Communications and Information Technology.
More importantly, all of the estimated 1,700 businesses that form part of the health care ecosystem in the Sultanate will be connected to the e-platform. They include hospitals, polyclinics, diagnostic centres and labs, optometrists and opticians, optical labs, radiology labs, pharmacies, medical equipment vendors, occupational therapy centres, hearing aid dispensaries, and other related service providers.
In a tweet, the CMA – which has been spearheading the implementation of the Dhamani scheme – said a proposed mobile app will make it possible for insured customers to access a range of services and facilities via the platform.
Besides gaining full access to their coverage details and benefits, individuals can also pinpoint their nearest service provider using GPS, request quotes, make appointments via service provider networks, and request ambulance services. Further, they can submit claims, lodge complaints and seek medical reports. While private data will remain essentially confidential, the e-platform will help in, among other things, the accurate collation of health information, studying mortality trends and causes, prioritising health care investment and resource allocation, and evaluating the overall performance of the sector, it added.
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