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📚 Knowledge Hub

NPHIES — Hospital & Clinic Integration

Your comprehensive guide to NPHIES integration in Saudi Arabia. FHIR R4, eligibility, claims, code samples, and Odoo Healthcare solutions from certified experts.

The Concept

What is NPHIES?

NPHIES (National Platform for Health Information Exchange Services) is a unified Saudi platform for health information exchange between 3 parties:

  • Providers: hospitals, clinics, pharmacies, labs
  • Payers: health insurers (Bupa, Tawuniya, MedGulf, etc.)
  • Regulators: CCHI, MoH, CHI

Before NPHIES, each hospital dealt with each insurer through a different system. Now everything is FHIR R4 standard unified — one XML/JSON, one endpoint, one protocol. Result: vendor-neutral, scalable, compliant.

The 4 core transactions: Eligibility Check (seconds), Pre-authorization (1-3 days), Claim Submission (real-time), Payment Reconciliation (auto).

❓ Common Questions

NPHIES FAQ

What is NPHIES?

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NPHIES is the National Platform for Health Information Exchange Services, a unified Saudi platform for health info exchange between providers, payers, and regulators.

What are NPHIES core transactions?

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4 transactions: Eligibility Check, Pre-authorization, Claim Submission, Payment Reconciliation.

Is NPHIES mandatory?

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Yes, NPHIES is mandatory for every healthcare provider in Saudi Arabia (hospitals, clinics, pharmacies, labs) per CCHI regulations.

How much does NPHIES integration with Odoo cost?

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Cost and timeline depend on the integration scope (eligibility + pre-auth + claims + reconciliation) and the number of facilities; we set both in the proposal after a discovery session.

Have a hospital or clinic needing NPHIES?

Softloomer delivers NPHIES integration with Odoo: eligibility, pre-authorization and claims. Book a free scoping call.

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