Shafafiya
Reporting of Medical Tourism
In accordance with DOH Circular CEO 52/11 Providers are required to report in electronic claims with ReceiverID=HAAD all transactions not previously submitted through shafafiya. In addition, the DoH Circular US/25/18 requires Providers to distinguish self-pay and medical tourism in their reporting claims.
From 17 October 2022, the DoH Circular number USO/235/2022 established an updated definition of Medical Tourism.
From 3 Jun, 2024, the DoH Circular number USO/96/2024 established updated reporting requirements and definitions for Medical Tourism.
In relation to that, the following definitions and rules apply within the DoH Data Standard:
Definitions
Medical Tourism Services:
The access to either planned or unplanned medical treatment services and non-emergency healthcare services in the Emirate of Abu Dhabi by any tourist traveling from abroad to the UAE for that purpose, excluding patients whose medical care is funded by the Abu Dhabi or federal government or who are insured by health insurance policies issued by the UAE licensed health insurance companies.
Reporting
Patient demographics reported in PersonRegister and encounters in ClaimSubmission transactions in accordance with general requirements of the Data Standard and particularly:
Person Register
-
Header
- ReceiverID=HAAD
- Other elements as per the Data Standard
-
Person
- UnifiedNumber – required if EmiratesIDNumber contains one of the default values as per the definition
- BirthDate
- Gender
- Nationality
- PassportNumber
- EmiratesIDNumber
- MemberID=EncounterFacilityID#EncounterPatientID - as per the definition
- CountryOfResidence=a value from the ‘Country’ column of the list of nationalities
- EmirateOfresidence=a value from the ‘Code’ column of the list of Emirates – only reported if CountryOfResidence=’United Arab Emirates’
Other relevant elements as per the Data Standard
ClaimSubmission
-
Header
- ReceiverID=HAAD
- Other elements as per the Data Standard
-
Claim
- PayerID=MedicalTourismSelfPay or MedicalTourismOther or SelfPay or ProFormaPayer - depending on the patient status as per the definition of ClaimPayerID
- MemberID=EncounterFacilityID#EncounterPatientID - as per the definition
- Gross – as per the definition
- PatientShare=Amount Patient owes to the provider
- Net=0
-
Encounter
- PatientID=Medical record number, as per the definition
- Other relevant elements as per the Data Standard
-
Diagnosis
- all relevant diagnoses as per the Data Standard
-
Activity
- all relevant activities as per the Data Standard
- Other relevant elements as per the Data Standard
Last updated: 21 Nov 2024
For an optimal experience please