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DHPO and eClaimLink e-claims integration for Dubai facilities

eClaimLink is the Dubai Health Authority e-claims programme, and the DHPO is the gateway its transactions pass through. This is what it asks of a hospital system, and how Ventrecs scopes an adapter.

What DHPO and eClaimLink are

eClaimLink is the Dubai Health Authority's electronic claims programme. The DHPO is the gateway through which the transactions pass, and its XML schema documents the transaction types, including prior authorisation.

Providers reach the system through a portal and through web services. The electronic prescription initiative has run through the same programme since 2013.

At a glance
Where
Dubai
Operated by
Dubai Health Authority
Carries
Claims, prior authorisation, remittance and electronic prescriptions
Format
XML transactions with a published schema
Access
A portal and web services
Code lists
ICD-10-CM, CPT, CDT, IR-DRG and the Dubai Drug Code
DHPO and eClaimLink

Who needs to connect

Healthcare facilities in Dubai that submit claims or prior authorisation requests to insurers.
Insurers and third-party administrators that receive and answer them.
Groups that also operate in Abu Dhabi, where claims run on Shafafiya.
DHPO and eClaimLink

What data is exchanged

ClaimsClaim transactions with coded diagnoses, procedures and medicines.
Prior authorisationRequests and approvals through the published schema.
RemittanceRemittance advice applied to each claim line.
Electronic prescriptionsThe electronic prescription initiative that runs through the same programme.
DHPO and eClaimLink

What the exchange involves

Transactions

The programme covers the claim lifecycle and electronic prescriptions.

  • Claims and prior authorisation
  • Remittance advice
  • Electronic prescriptions

Schema and rules

The schema and circulars define the rules.

  • XML schema published for each transaction
  • Rules and code lists published in circulars
  • Schema versions that change, so each file records its version

Shared code lists

The same lists are reused by NABIDH, so a facility that bills electronically already holds most mappings.

  • ICD-10-CM for diagnoses
  • CPT for procedures and CDT for dental, with IR-DRG
  • The Dubai Drug Code for medicines
DHPO and eClaimLink

How Ventrecs handles it

One claim modelA single internal claim record with a lifecycle, from which each platform's output is generated, so a group does not keep two versions of the truth.
Pre-authorisationRequested from the clinical workflow, with the approval stored against the service.
RemittanceThe payer response applied to each claim line, with the denial reason stored.
Durable outboxMessages leave through an outbox with retry, a transaction log and a reconciliation queue, so a deferred, rejected or missing response is a visible state with an owner.
How the connection is delivered

Each connection is delivered as a project: scoped with your facility and DHPO or eClaimLink, built as an interface adapter on the Ventrecs integration layer, tested in the operator's environment and signed off before go-live. Where the operator requires approval or certification, it is part of the project plan. The DHPO claim format is delivered as an adapter for the jurisdiction, on top of the insurance module.

Messages are carried by Ventrecs Connect. See how an integration is delivered, from scoping to monitoring. Ventrecs Connect · The integration lifecycle

DHPO and eClaimLink

Typical rollout steps

The same eight stages as every Ventrecs deployment, applied to this connection. How we deliver

  1. 1
    DiscoverConfirm with the Dubai Health Authority which of your facility types must connect, and which messages or transactions apply.
  2. 2
    DesignAgree the message set, identifiers and code mappings, and name an owner for each interface.
  3. 3
    ConfigureSet up facilities, users, catalogues and the integration layer, with credentials held outside the clinical records.
  4. 4
    MigrateLoad the master data the exchange needs, such as facilities, clinicians and patient identifiers, and reconcile it.
  5. 5
    TestTest in the environment the Dubai Health Authority provides, with synthetic data, including rejected and duplicate messages.
  6. 6
    TrainTrain the teams who watch the interface and fix the rejections.
  7. 7
    Go-liveCut over in phases with on-site support, and with sign-off from the Dubai Health Authority where the operator requires it.
  8. 8
    HypercareClose monitoring in the first weeks, then hand-over to the agreed support process.
DHPO and eClaimLink

Sources

Operator and standards documents these statements rest on. Standards change, so work from the current version.

DHPO and eClaimLink

Questions we are asked

What is the difference between eClaimLink and DHPO?

eClaimLink is the Dubai Health Authority's electronic claims programme. The DHPO is the gateway and XML schema through which its transactions pass.

Do Abu Dhabi and Dubai share a platform?

No. Abu Dhabi uses Shafafiya and Dubai uses eClaimLink with DHPO. A group with facilities in both builds and operates two integrations.

Which code lists apply?

ICD-10-CM for diagnoses, CPT for procedures and CDT for dental, IR-DRG, and the Dubai Drug Code for medicines.

Can Ventrecs submit claims in the DHPO format?

Yes, through a DHPO adapter on the integration layer, delivered on top of the insurance module. We scope it with you, build it and test it in the operator's environment before go-live.

Talk to us about your setup

Tell us about your facility and current systems. We will reply within one working day.