Advanced Revenue Cycle Management (RCM) and NPHIES Integration (Hospitals)

(Hospitals) The Kingdom-wide rollout of the National Platform for Health and Insurance Exchange Services (NPHIES) has centralized all healthcare data exchange, making institutional cash flow for corporatized hospitals under the Health Holding Company entirely dependent on a flawless interface with this digital network. This program trains finance directors and frontline RCM specialists to optimize end-to-end billing workflows and eliminate structural claim denials caused by digital friction. Participants map legacy Hospital Information System workflows to NPHIES standards using HL7 FHIR R4 specifications, ensuring patient registration, eligibility, pre-authorization, and back-office billing operate as one synchronized cycle. Within the multi-payer system overseen by the Council of Health Insurance, the course shows how non-compliant claims, pre-authorization delays, and missing demographic data are rejected by NPHIES validation algorithms, and how to prevent these failures. Through applied workshops, leaders learn to design real-time eligibility checks, algorithmic pre-authorizations, and denial-resistant submission practices that prevent revenue leakage and safeguard the financial liquidity required for autonomous regional operations.