Providers Affairs and Quality Assurance Directorate
Providers Affairs and Quality Assurance Directorate
Services delivered by Providers’ Affairs and Quality Assurance Directorate
- Ensure availability of implementation manuals for the sections within the directorate, and follow up amendment as deemed necessary
- Follow up preparations of selection criteria for providers, and ensure incorporation of the necessary criteria
- Follow up preparations of documents for contract agreement with providers, and ensure that the documents are prepared as per the required standard
- Establish a medical audit system that controls cost escalation and enables provision of quality & proper health care services for beneficiaries; provide support for branch offices on issues related with medical audit
- Conduct studies and propose solutions for issues and problems raised with regards to prices and payment mechanisms, make studies on introduction of new payment mechanisms and commend on their implementations
- Work in collaboration with stakeholders on provision of quality health services
- Follow up and monitor the availability of adequate contracted health care providers by the branch and follow up if provision of health services are at the required level of quality
- Follow up and control the screening and registration of health facilities and monitor if quality assurance activities are done properly
- Follow up and control that reimbursements are made as per the prices and payment mechanisms approved by the Agency
- Conduct studies on health facility standards and propose amendments as deemed necessary
- Conduct studies regularly on timeliness of prices approved for providers under each branch of the Agency and propose amendments as deemed necessary
- Assign and notify beneficiaries the health facilities contracted with the health insurance
- Compile and analyze information on health services utilization of beneficiaries and epidemiological changes, reimbursements made, issues arising with regard to provision of health services and propose solutions as deemed necessary