Revenue Cycle Management
NPHIES • ZATCA Phase 2 • AI-Powered Denial Appeals
Gross Charges MTD
SAR 2.84M
+12.4% vs last month
Net Collections
SAR 2.31M
81.3% collection rate
Denied Claims
3.2%
↓ 0.8% from last month
Avg Days to Pay
14.7 days
NPHIES electronic claims
AR Aging Analysis
0–30 daysSAR 285K (42 claims)
31–60 daysSAR 138K (21 claims)
61–90 daysSAR 72K (14 claims)
91–120 daysSAR 31K (8 claims)
120+ daysSAR 19K (5 claims)
Total ARSAR 545K
Payer Mix
Bupa Arabia
34%
Tawuniya
28%
MedGulf
16%
AXA Cooperative
12%
Other Insurers
7%
Self-Pay / OSHC
3%
ZATCA Phase 2 Status
e-Invoices Generated1,284
Cryptographic StampActive
CSID StatusValid
QR Code Compliance100%
Pending Clearance12
Last Sync2m ago
Claims Worklist
| Claim ID | Patient | Diagnosis | ICD-10 → ICD-11 | Payer | Amount (SAR) | Status | Actions |
|---|---|---|---|---|---|---|---|
| CLM-2026-001 | Ahmed Al-Rashid MRN-10234 | Type 2 Diabetes CPT 99284 | E11.9→5A11 | Bupa Arabia | 1,850 | Ready to Submit | |
| CLM-2026-002 | Fatima Al-Zahra MRN-10235 | Acute MI (NSTEMI) CPT 93571 | I21.3→BA80 | Tawuniya | 18,500 | Pending Pre-Auth 2d | |
| CLM-2026-003 | Khalid Al-Otaibi MRN-10236 | Upper Respiratory Infection CPT 99213 | J06.9→JA00 | MedGulf | 450 | Submitted 5d | |
| CLM-2026-004 | Sara Al-Ghamdi MRN-10237 | Breast Cancer CPT 19301 | C50.912→CA40 | AXA Cooperative | 32,000 | Denied 14d | |
| CLM-2026-005 | Mohammed Al-Harbi MRN-10238 | Cerebral Infarction CPT 99285 | I63.9→8B20 | Walaa Insurance | 4,200 3,780 paid | Paid 22d | |
| CLM-2026-006 | Noura Al-Shehri MRN-10239 | Hyperlipidemia CPT 99214 | E78.5→5B81 | BUPA Arabia | 620 | Ready to Submit | |
| CLM-2026-007 | Abdullah Al-Dosari MRN-10240 | Chronic Kidney Disease Stg4 CPT 90935 | N18.4→GB04 | Tawuniya | 8,800 | Submitted 8d |