Timely dose for medical insurance firms: Consider request approved if reply takes more than an hour

Applications for medical treatment are automatically approved if insurance firms fail to respond within 60 minutes, according to the Council of Cooperative Health Insurance (CCHI).
Naif Al-Reefi, spokesman of the CCHI, said in a statement that the law states that a firm must provide approval for treatment an hour after receiving a faxed request.
Al-Reefi said that the CCHI shut down three insurance companies last year for failing to provide their clients with access to medical treatment.
Al-Reefi said the secretariat of the council supervises and monitors all insurance companies to ensure their compliance with the law. This includes regular inspections, and resolving disputes as they arise.
Al-Reefi said the CCHI has amended its regulations to assist the public to get access to quick health care. The secretariat has made it mandatory for insurance companies to print their phone number on their health insurance cards to facilitate the submission of complaints.
Pharmacist Ahmed Al-Issa, director of private sector management at the Riyadh health department, said the regulations for private health-care institutions and practitioners stipulate severe sanctions on doctors and health facilities that refuse to treat medical-insurance patients or charge extra fees. The fines are between SR80,000 and SR100,000.
Al-Issa said that the regulations also ban government doctors from working in the private sector.
He urged medical-insurance patients to post complaints on the Health Ministry's website if they are denied treatment. The inspectors would investigate complaints.