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The unified electronic services platform is National Platform for Health and Insurance Exchange Services launched by the Cooperative Health Insurance Council (CCHI) and the National Center for Health Information (NHIC) and led by the Sehati Company
Transforming the health care sector in the Kingdom of Saudi Arabia by using the latest technologies to enhance the level and quality of health services
Consolidated, accurate and comprehensive data; supporting the achievement of Value Based Healthcare (VBHC ) and Diagnosis Related Group (DRG)
Digital Standard insurance Services aims to govern health insurance services by connecting all stakeholders in health insurance (health service providers, health insurance companies).
Unified digital health services (unified health record) for patients in the Kingdom of Saudi Arabia aims to improve the efficiency and quality of health care services provided, and also reduces the cost and time of providing health care services, which is a basis for improving healthcare decision-making
Insurance Component
NPHIES Clinical Services
General overview of NPHIES
Mandatory participation in market assessment, awareness and training events
Portal participation: hardware and software requirements
Types of NPHIES Financial Services transactions
Roles and responsibilities
monitoring and compliance
NPHIES fees
Billing code sets
The Rollout plan of nphies platform
Service Codes List Validation
The rollout plan of gradual adoption and compliance phase of nphies platform
Inpatient: CCHI Billing System (CCHI-BS)
Outpatient: The Australian Schedule of Dental Services and Glossary (ADA)
قائمة الترميز للتنويم والعمليات لخدمات طب الأسنان
الترميز للعيادات الخارجية: جدول خدمات طب الأسنان الأسترالي
For more information about medical standards please refer to the NHIC website
( please click here)
SNOMED CT
Encode Allergies
نظام الترميز والمصطلحات الطبية
ترميز الحساسية
ICD-10-AM/ACHI/ACS Tenth Edition
MDC and URG
Inpatient: ICD 10 AM + ACHI
الترميز للتنويم والعمليات: نظام الترميز الأسترالي
“NPHIES Champions (SPoC)” In line with the Kingdom's Vision 2030, and to create synergies within the Healthcare Ecosystem (Healthcare Providers and Health Insurance Co.), we are delighted to announce the launch of NPHIES champion initiative. Please provide information as detailed and accurate as possible to ease the communication and the onboarding process. For more information Click here
In order to become one of nphies certified vendors, kindly see below the requirements to get the certificate and have the ability to link nphies to the health care providers and the health care insurance:
System suppliers approved for Nphies so far
The accredited system vendors that successfully complete most of nphies integration requirements so far, if you are a healthcare provider you can link to nphies platform through the following systems.
Implementation guide will be used by Insurance (including TPAs) and providers to integrate with nphies. The guide describes the information exchange construction and flow between different healthcare stakeholders and the solution, use cases, defines the message structure of profiles for FHIR implementation, and specifies the links to relevant FHIR artifacts and documentation.
The documents are now available on nphies Community Portal website using the following link: Link Documents can be found using the following pathway after logging into nphies Community Portal: Health Dictionary HD > Documentations > Technical Standards
If your entity is not part of wave 1 of nphies onboarding and you require access, please contact Link
In the process of transitioning in NPHIES project from inception phase to activation phase, we are introducing series of training courses, to enable the market and provide them with the essential skills to implement the change and to develop a more detailed understanding of NPHIES and to ease the adaptation of the platform.
Note: All provided training sessions are considered mandatory for any entity to be certified to use NPHIES platform.
Standard Coding Training Courses focus on developing a high-level understanding of standard code sets in order to use them within the working environment. These codes are very important to simplify the processes and decrease the costs associated with every health care transaction.
2. Business/Operational training:
Business and Operational Training Courses will focus more on specific areas of the implementation process, it is anticipated that the onboarding orientation sessions will encompass all generic project overviews regarding objectives, approach, and desired outcomes.
3. Technical Training:
Technical Training Courses will be conducted using the integration tool kit (Material, guidelines, sample data, and web services) provided by NPHIES insurance core vendor. The course will provide details about NPHIES solution, registration, configuring, and utilization to perform the transaction, mapping, and communication.
Training sessions are held weekly for those who have been invited from healthcare providers and health insurance companies.
KFSH&RC - Riyadh
Dr. Hassan Ghazzawi Hospital-(30) Beds
Al Lulu Medical Complex
King Abdulaziz Medical City in Jeddah
Dr. Sameer Abbas Medical Group
Al Maghlouth Medical Complex
Royal Commission Hospital in Jubail
Edwani National Hospital
Al Mostaqbal Medical Hospital
Medical Center of the Royal Commission in Yanbu industrial
Family Care Hospital
Al Nakhba Hospital
King Saud Medical City - Riyadh
First Modern Clinics Complex
Al Qassim National Hospital
King Fahad Hospital - Jeddah
Future Care
Al Sadiq Hospital
King Fahad Medical City - Riyadh
Green Crescent Hospital
Al Saedy General General Complex
King Khaled Eye Spelcity Hospital
Halla Isa Bin Laden Hospital
Al Salam Health Medical Hospital
Abdullatif Jameel Hospital for Medical Rehabilitation
Hussain Ali Medical Group
Al Salama Hospital
Adwaa Al Alamy Medical Complex
International Extended Care Center
Al Taawun Al Ahli Complex
Al Ahli Hospital
Jeddah National Hospital
Al Wattan Medical
Al Amal Medical Complex
Al Yousif Hospital
Madina National Hospital
Al Zafer Hospital
Al Ameen National Hospital
Mecca Medical Center Hospital
Al Zahra General Hospital in Kateef
Al Ansari Specialist Hospital is owned, Mahmoud Abdullah Ansari Almenzlawi / Yanbu. Of the Royal Commission
Mohammed Suleiman Alkhnena Medical Complex
Al Zahra Hospital Group
Al Emies Hospital
Muhammad Saleh Basharahil Hospital
Al Falah Hospital
Nahdha National Hospital
Al-Ahsa Medical Group
Al Hamra Hospital
Olaya Medical Complex
Alwrood Medical Polyclinics
Al Jadani Hospital Group
Rabia Hospital
Araya Altakhasusiya Hospital in Al Khubar
Safa Makka Group
Arrawdha General Hospital
Al Jazirah Clinic
Salamat Medical Complex
Al Jazirah Hospita/Riyadh
Bugshan Hospital
Al Kahhal Medical Center
Yanbu National Hospital for medical services
Center of Ophthalmology Consultants
Dar Al Sihha Medical Center
Consultative Medical Clinics
Clinics Al-Rayan International / District of Al-sharafiyah/Jeddah
Dar Al-Shifa National Hospital
Danat Al Sahraa Medical Complex
Dr. Abdulrahman Almashari Hospital
Dr. Hamid Suliman Al-Ahmadi Hospital
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