Comprehensive health insurance… modernizing service pricing mechanisms to ensure price fairness for its providers
Dr. said. Alaa Abdel Majeed, Chairman of the Chamber of Private Sector Health Care Providers, Member of the Permanent Committee for Pricing Health Services in Comprehensive Health Insurance, provided information about the technical committee concerned with the details of pricing health services, during the third session on the second day of the Media Forum for Comprehensive Health Insurance, that the current health insurance suffers from some Challenges, and citizen dissatisfaction with them, but comprehensive health insurance comes as a symbiotic social project, in which all members of society contribute, without exclusion or discrimination, and seeks patient satisfaction. Egyptian.
The project works on financial sustainability, and there are pricing mechanisms in place within the comprehensive health insurance system, and they are constantly updated to ensure that pricing justice is achieved for service providers within the system.
The technical pricing committee consists of Dr. Mohamed Ayman Saleh, Professor at the Faculty of Medicine, Ain Shams University, and Dr. Alaa Abdel Majeed, Chairman of the Healthcare Providers Chambers, and Dr. Mohsen George Naoum, Advisor to the Comprehensive Health Insurance Authority for Technical Affairs, and Dr. Hazem Khamis, Director of Wadi El Nile Hospital, and Dr. Hisham Steit, Vice Chairman of the Unified Purchasing Authority, and Dr. Ahmed Siam from the Comprehensive Health Insurance Authority, and Dr. Muhammad Hablas, director of a private hospital, and Dr. Omar Sharif Omar, Acting Chairman of the Supreme Council of University Hospitals.
Indicating that the specified price for the medical service is satisfied by the service provider, as it achieves a profit margin of 10%, and the technical committee performs many tasks, including discussing the names of operations and procedures, deleting duplicate ones, deleting operations that were not performed, adding new operations, and dividing the services that were performed. It was based on the same code, based on scientific development in treatment methods, and the proposal of other services to improve medical services.
He said that the total priced services in the fifth edition amounted to 3,451 services, including 1,888 services for the internal department, 554 for the analysis department, 392 for dentistry, 352 for radiology, 177 for external services, 86 for physical therapy, and 2 for examinations.
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