AndroHealth Achieves NPHIES Certification — Full Insurance Integration for Saudi Healthcare

AndroHealth is Now NPHIES Certified

We are proud to announce that AndroHealth HIS has achieved official certification from NPHIES (National Platform for Health Insurance Exchange Services), Saudi Arabia's national platform for electronic health insurance transactions.

This certification means that healthcare facilities using AndroHealth can now process all insurance operations electronically through NPHIES, eliminating manual paperwork and significantly reducing claim processing times.

What This Means for Healthcare Providers

Real-Time Eligibility Verification

Before providing any service, staff can instantly verify a patient's insurance coverage. The system connects directly to NPHIES and returns eligibility status, benefit limits, copay amounts, and coverage details — all in seconds.

Electronic Pre-Authorization

No more phone calls or faxes to insurance companies. Submit pre-authorization requests digitally through AndroHealth, track their status in real-time, and receive approvals directly in the system. This is particularly valuable for surgical procedures, advanced imaging, and specialty medications that require prior approval.

Automated Claims Submission

After a patient visit, claims are generated automatically from the encounter data — diagnosis codes, procedures, and billing information. Submit them to NPHIES with one click. The system validates all data before submission, catching errors that would cause rejections.

Payment Reconciliation

Track every claim from submission to payment. The system automatically matches insurance payments against submitted claims, highlighting discrepancies and simplifying your accounting workflow.

Compliance Made Simple

NPHIES compliance is mandatory for all healthcare providers operating in Saudi Arabia. With AndroHealth's built-in integration, your facility is automatically compliant. The system handles:

• HL7 FHIR standard messaging format required by NPHIES
• Proper ICD-10 diagnosis coding validation
• Secure certificate-based communication
• Complete audit trail for all transactions

Reducing Claim Rejections

One of the biggest challenges healthcare facilities face is claim rejections. Common causes include invalid diagnosis codes, missing information, and formatting errors. AndroHealth addresses this with:

• Pre-submission validation — The system checks every field before sending to NPHIES
• ICD-10 code verification — Only valid, current codes are accepted
• Required field alerts — Missing information is flagged before submission
• Historical tracking — Learn from past rejections to prevent repeat errors

Getting Started

If you're already using AndroHealth, the NPHIES integration is available in your system. Contact our support team to configure your NPHIES credentials and start processing insurance transactions electronically.

New to AndroHealth? Request a demo to see the full NPHIES integration in action.