Unified medical justifications to enhance healthcare quality, says council

The Council of Health Insurance has stated that unifying medical justifications will help raise the quality of healthcare and improve the experience of health insurance beneficiaries.

Standardizing medical justifications

In a post on X, the Council explained that medical justifications are approved criteria that determine the necessity and suitability of healthcare services for beneficiaries, based on the latest scientific recommendations, which focus on:

• Preventive care

• Protecting beneficiaries

• Evidence-based practices

• Medical necessity and clinical appropriateness

• Cost efficiency

• Transparency among stakeholders

View the post on X

According to the Council, medical justifications are a set of standards used to determine whether a healthcare service or specific treatment is medically necessary and appropriate for the beneficiary, based on current scientific recommendations. These criteria are used by healthcare providers and insurance companies to ensure that suitable health services are delivered and covered appropriately, with the aim of improving healthcare quality.

Health insurance app

The Council also encouraged everyone to download the Dhaman app to benefit from its services, noting that the app offers a range of features and provides comprehensive data. Through the app, users can submit suggestions, inquiries, reports, and complaints.

The Dhaman app also allows users to view document categories, dependents, approvals, and the medical network.