UAE Healthcare Claims Management Market Report 2022 to 2030

UAE Healthcare Claims Management Market Analysis

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The UAE healthcare claims management market is projected to grow from $133.5 Mn in 2022 to $765.67 Mn by 2030, registering a CAGR of 24.4% during the forecast period of 2022 - 2030. The main factors driving the growth would be mandatory health insurance, emphasis on quality healthcare and technological advancements. The market is segmented by component, type, delivery mode and by end-user. Some of the major players include NAS Neuron Health Services, Nextcare, Aafiya, Optum, GE Healthcare and Cognizant.

ID: IN10AEHS006 CATEGORY: Healthcare Services GEOGRAPHY: UAE AUTHOR: Neha Davda

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UAE Healthcare Claims Management Market Executive Summary

The UAE healthcare claims management market is projected to grow from $133.5 Mn in 2022 to $765.67 Mn by 2030, registering a CAGR of 24.4% during the forecast period of 2022 - 2030. As a percentage of GDP, national healthcare spending in the UAE grew from 4.15% in 2018 to 4.28% in 2019. The UAE government has prioritised creating a cutting-edge healthcare infrastructure, and as a result, during the past few years, the industry has greatly expanded and flourished.

Processing and managing claims that healthcare providers submit to insurance companies or other payers for reimbursement is healthcare claims management. Healthcare claims management is gaining importance in the UAE as the healthcare sector develops and becomes more complex. The number of medical claims submitted to insurance firms has dramatically grown since Dubai made health insurance mandatory in 2014; Abu Dhabi and other emirates followed suit.

The need for healthcare claims management services has increased as a result, and various businesses now provide these services to healthcare providers and insurance companies in the UAE. These businesses offer a variety of services, including processing claims, adjudicating claims, managing denials, processing payments, and providing analytics and reporting.

UAE Healthcare Claims Management Market

Market Dynamics

Market Growth Drivers

The UAE healthcare claims management market is expected to be driven by factors such as:

Mandatory health insurance- The number of medical claims submitted to insurance firms has dramatically increased in the UAE since the introduction of mandatory health insurance. As a result, there is an increasing demand for efficient and effective claims
Emphasis on quality healthcare- The UAE government has gone to great lengths to raise the standard of healthcare in the nation. As a result, numerous quality improvement programs have been put into place, which in turn necessitate efficient claims administration to guarantee that providers are paid accurately and promptly for high-quality healthcare services
Technological advancements- The UAE has made significant investments in innovation and technology, particularly in the healthcare industry. As a result, cutting-edge healthcare information systems and digital health solutions have been created, which call for efficient claims administration services to guarantee correct and prompt compensation

Market Restraints

The following factors are expected to limit the growth of the healthcare claims management market in the UAE:

Regulatory challenges- Healthcare claims management organisations may face difficulties in the UAE due to its complex regulatory framework. Regulations governing insurance, for instance, may have an impact on how sensitive healthcare data is handled, as well as how claims are processed and decided
Dependence on oil- The UAE's economy is very reliant on oil, which can lead to market turbulence and unpredictability. Healthcare claims volume and spending can be affected by economic downturns or changes in oil prices, which could have an effect on the market's expansion for healthcare claims management
Limited insurance penetration- Even though the UAE has made health insurance mandatory, the country's insurance penetration is still very low when compared to several other nations. As a result, the market for healthcare claims management may not grow as quickly as it might otherwise

Competitive Landscape

Key Players

NAS Neuron Health Services (ARE)- based in Abu Dhabi, provides its clients with a complete claims management solution encompassing the whole claim cycle. Using tried-and-true rule engines, NAS, a pioneer in the use of complex automation techniques, has made it possible to increase efficiency in terms of performance and cost containment
Nextcare (ARE)- in the GCC and MENA region, Nextcare is the top Third-Party Administrator (TPA) for the insurance sector. The business specialises in offering insurers and other healthcare payers full-service health insurance management and administration services that strike the ideal balance between the best possible customer service and the greatest possible cost optimization, in addition to regulatory compliance. Health insurance management programs for customer service, risk assessment solutions, managed care services, software solutions, and added services are developed and customised by Nextcare
Aafiya (ARE)- is among the best TPA Claims Management firm in Dubai. Healthcare management is a speciality of Aafiya, an integrated service provider. Founded with the goal of providing high-quality, comprehensive health insurance services to all facets of the population. Aafiya serves as a nexus for insurance companies, policyholders, and healthcare providers
Optum- is committed to making healthcare delivery better, creating opportunities for clients to have better experiences, better health, and lower costs
GE Healthcare- offers healthcare claim management services as a component of its revenue cycle management systems. These systems help healthcare organisations manage their financial billing, coding, and claim-filing processes
Cognizant- a multinational corporation with its main office in the US, provides tools for handling medical claims along with consulting, operational, and digital services. The cloud, IoT, AI, and software engineering are the main technological topics that are revolutionising business

Notable Developments

December 2022: The UAE Ministry of Health and Prevention (MoHAP) reported that more than 4.9 pre-approval requests have been made since the platform's introduction on April 1, 2022, an average of 26,000 requests per day. More than 6,000 physicians, 40 paying agents, and 1,000 healthcare facilities, including hospitals, clinics, pharmacies, and healthcare centres, have access to the e-claims post office. The National Unified Medical Record (NUMR) program's digital healthcare platform for the UAE has advanced significantly, processing more than 4 Mn insurance claims over the course of the previous eight months through the portal "Riayati".

1. Executive Summary
1.1 Service Overview
1.2 Global Scenario
1.3 Country Overview
1.4 Healthcare Scenario in Country
1.5 Healthcare Services Market in Country
1.6 Recent Developments in the Country

2. Market Size and Forecasting
2.1 Market Size (With Excel and Methodology)
2.2 Market Segmentation (Check all Segments in Segmentation Section)

3. Market Dynamics
3.1 Market Drivers
3.2 Market Restraints

4. Competitive Landscape
4.1 Major Market Share

4.2 Key Company Profile (Check all Companies in the Summary Section)

4.2.1 Company
4.2.1.1 Overview
4.2.1.2 Product Applications and Services
4.2.1.3 Recent Developments
4.2.1.4 Partnerships Ecosystem
4.2.1.5 Financials (Based on Availability)

5. Reimbursement Scenario
5.1 Reimbursement Regulation
5.2 Reimbursement Process for Services
5.3 Reimbursement Process for Treatment

6. Methodology and Scope

Healthcare Claims Management Market Segmentation

By Component (Revenue, USD Billion):

Further breakdown of the software and services segment of the healthcare claims management market

Software
Services

By Type (Revenue, USD Billion):

Although they have nothing to do with it, skills unrelated to patient care are equally crucial for any healthcare organization that wants to stay in business. Among these are managing intricate insurance regulations, comprehending best practices for data collection, and analyzing data to identify areas for development. For the above reasons, providers are constantly looking for methods to improve claim administration and medical billing systems. Setting up an integrated billing and claims processing system is one approach to accomplish this, which has a number of benefits.

Integrated Solutions
Standalone Solutions

By Delivery Mode (Revenue, USD Billion):

On-Premise
Cloud-Based

By End User (Revenue, USD Billion):

Healthcare Payers
Healthcare Providers
Other End Users

Healthcare payers in this market are anticipated to rise quickly over the course of the projection period because of the installation of strict regulatory requirements, a lack of experienced personnel internally for claims processing, rising healthcare expenditures, and fraud associated with those charges. Payers have also assisted healthcare providers by creating a web-based and cloud-based interface that helps them manage medical billing and associated claims and offers accurate and timely information about the epidemic.

Methodology for Database Creation

Our database offers a comprehensive list of healthcare centers, meticulously curated to provide detailed information on a wide range of specialties and services. It includes top-tier hospitals, clinics, and diagnostic facilities across 30 countries and 24 specialties, ensuring users can find the healthcare services they need.

Additionally, we provide a comprehensive list of Key Opinion Leaders (KOLs) based on your requirements. Our curated list captures various crucial aspects of the KOLs, offering more than just general information. Whether you're looking to boost brand awareness, drive engagement, or launch a new product, our extensive list of KOLs ensures you have the right experts by your side. Covering 30 countries and 36 specialties, our database guarantees access to the best KOLs in the healthcare industry, supporting strategic decisions and enhancing your initiatives.

How Do We Get It?

Our database is created and maintained through a combination of secondary and primary research methodologies.

1. Secondary Research

With many years of experience in the healthcare field, we have our own rich proprietary data from various past projects. This historical data serves as the foundation for our database. Our continuous process of gathering data involves:

Analyzing historical proprietary data collected from multiple projects.
Regularly updating our existing data sets with new findings and trends.
Ensuring data consistency and accuracy through rigorous validation processes.

With extensive experience in the field, we have developed a proprietary GenAI-based technology that is uniquely tailored to our organization. This advanced technology enables us to scan a wide array of relevant information sources across the internet. Our data-gathering process includes:

Searching through academic conferences, published research, citations, and social media platforms
Collecting and compiling diverse data to build a comprehensive and detailed database
Continuously updating our database with new information to ensure its relevance and accuracy

2. Primary Research

To complement and validate our secondary data, we engage in primary research through local tie-ups and partnerships. This process involves:

Collaborating with local healthcare providers, hospitals, and clinics to gather real-time data.
Conducting surveys, interviews, and field studies to collect fresh data directly from the source.
Continuously refreshing our database to ensure that the information remains current and reliable.
Validating secondary data through cross-referencing with primary data to ensure accuracy and relevance.

Combining Secondary and Primary Research

By integrating both secondary and primary research methodologies, we ensure that our database is comprehensive, accurate, and up-to-date. The combined process involves:

Merging historical data from secondary research with real-time data from primary research.
Conducting thorough data validation and cleansing to remove inconsistencies and errors.
Organizing data into a structured format that is easily accessible and usable for various applications.
Continuously monitoring and updating the database to reflect the latest developments and trends in the healthcare field.

Through this meticulous process, we create a final database tailored to each region and domain within the healthcare industry. This approach ensures that our clients receive reliable and relevant data, empowering them to make informed decisions and drive innovation in their respective fields.