See what every payer and TPA has paid, and what they still owe.
HealthOrbit replaces month-end spreadsheets with one clear view, so your team knows exactly which claims to follow up on first.
For hospitals, clinics, and healthcare finance/RCM teams in the UAE.
Drop the payer remittance. Lines are matched to your submitted claims automatically.
Every file, what it contained, and whether it reached the ledger.
| File | Type | Lines | Status |
|---|---|---|---|
| claims-HO-AE-1042.xml | Claim file | 3 | Committed |
| remittance-HO-AE-1042.xml | Remittance | 3 | Parsing… |
From claimed to paid, in one view. Every step links to the claims behind it.
AED 1,200 open across 2 payers
Every rejected line has an owner, a deadline and a next step.
| Claim · activity | Payer | Denial | Value | Work |
|---|---|---|---|---|
| HO-AE-1044Sample patient · MRN 1044 | Sample insurer | MNEC-004 | AED 400.00 | OPEN |
Each rejection code has a type, a preventable flag and a plain-language description.
By amount. The line is the running share of all rejected value.
UAE payers pay in batches, with partial payments and rejections. Manual matching takes days, and deadlines slip.
Batch payments don’t match individual claims.
Partial payments closed, pending claims ignored.
Rejected claims miss the resubmission deadline.
Days spent compiling claimed vs received.
Claimed vs received for every payer.
Every rejection with the payer’s reason.
Submitted claims still awaiting a remittance.
Unpaid amounts by payer and TPA.
Outstanding amounts grouped by days unpaid.
From eClaimLink, Shafafiya, Riayati, or upload.
Remittances auto-matched to claims, discrepancies shown.
Pending, rejected, and unpaid claims highlighted.
See your claims position in one view
Book a DemoSpot payer patterns before deadlines pass.
Claimed, received, and outstanding figures, auto-compiled.
See where outstanding money is concentrated.
Rejection patterns tracked for each clinician.
Full reconciliation reports in one click.
Use reconciliation alone, or connect it upstream to fix coding and eligibility rejections at the source.
Confirms patient coverage right at registration.
Writes consultation notes as doctors speak.
Generates accurate codes from clinical documentation.
Runs a first-pass check on codes.
Checks claims against eClaimLink and Shafafiya.
Matches remittances to claims, tracks balances.
HealthOrbit AI applies the medical coding and billing rules used by UAE health authorities and insurers.
Claim checks aligned with DHA coding, documentation and XML submission requirements.
CPT modifiers validated against DOH Shafafiya rules, including the three-modifier limit where it applies.
ICD-10 and CPT coding validation for Northern Emirates facilities under MOHAP.
Review eligibility, clinical documentation and payer requirements for claims handled within Sharjah’s healthcare and insurance workflows.
It matches insurer payments to submitted claims, showing what’s paid, pending, underpaid, or rejected.
Payers send remittance advice for each claim. Reconciliation matches it to the original claim and shows any differences.
It groups unpaid balances by how long they’ve been outstanding, so teams know which claims to chase first.
Yes. Pending and rejected claims are tracked separately, and each rejection shows the payer’s denial reason.
Yes. Any claim paid below the claimed amount is flagged with the exact shortfall.
No. It shows exactly what’s owed and why, so your team can resubmit or follow up with the payer.
HealthOrbit pulls claim and remittance data from eClaimLink, Shafafiya, and Riayati, or through file upload.
No. Reconciliation works on its own. Connected to the full suite, it traces rejections back to coding or eligibility.
In a demo, we’ll show remittance matching, pending payment tracking, and insurance ageing on sample UAE claims data.
Talk to our team about your payers, systems, and month-end process.