Add or find patient's name or ID…Sample patient · MRN 1042from Your HIS system
Out-patient
00:00
TranscriptClinical Notes
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DoctorGood morning. What brings you in today?
PatientI have had a fever and a dry cough for about three days.
DoctorAny shortness of breath, chest pain or vomiting?
PatientNo, just a mild sore throat and body aches.
DoctorTemperature is 38.4, oxygen 98 percent. Chest is clear.
DoctorI will order a blood count and start paracetamol and fluids.
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NOVODOC FINALIZEDCodes 4Short ⌄
Temp38.4 °CSpO₂98%Heart rate92 bpmBP118/76Resp. rate18 / min
Chief Complaint0:42
Patient History0:42 · 1:05
Examination2:10
Primary Diagnosis3:02
Secondary Diagnosis0:42
Plan3:20
Prescription3:34
#
Drug name
Dosage
Frequency
Duration
Instructions
1
Paracetamol 500 mg tablet
1 tablet
Every 6 hours if needed
3 days
After food. Maximum 4 doses a day.
2
Oral rehydration salts
1 sachet
Twice daily
3 days
Dissolve in 200 ml of water.
3
Dry cough syrup
5 ml
Up to three times daily
3 days
At night if cough disturbs sleep.
Suggested codes readyR50.9R059921385025
SuccessSummary successfully generated
Approved · pushed to Your HIS systemEncounter HO-AE-1042 · consultation note filed
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TRANSCRIPT IDHO-AE-1042
General practice
Dr. Demo Clinician
23-10-2026
30-10-2026
Chief complaint: Fever and dry cough for three days. History: Intermittent fever up to 38.6 °C, dry cough, mild sore throat, body aches. No shortness of breath. Examination: Temp 38.4 °C, SpO₂ 98%, throat mildly erythematous, chest clear. Plan: CBC to rule out bacterial infection. Paracetamol, fluids, rest. Review in three days.
Consultation note · approved Pushed from AI Scribe
Chief complaint Fever and dry cough for three days.
History Intermittent fever up to 38.6 °C with dry cough, mild sore throat and body aches. No breathlessness. No known sick contacts. No chronic illness.
Examination Temp 38.4 °C · SpO₂ 98% · HR 92 · BP 118/76. Throat mildly erythematous. Chest clear on auscultation.
Plan CBC to rule out bacterial infection. Paracetamol, fluids and rest. Review in 3 days or sooner if worse.
Diagnoses & services Waiting for codes
Code
Description
Type
R50.9
Fever, unspecified
Dx · primary
R05
Cough
Dx · secondary
99213
Outpatient visit, established
CPT
85025
Complete blood count
CPT
Claim Scrubber
No file loaded · 0 engine rows · 0 findings
DHA · DubaiRule libraryClear
XML
HO-AE-1042.xmlExported from Your HIS system
Drop claim XML hereor browse. Exported from Your HIS system.
XML
HO-AE-1042.xml3 KB · 3 claims
Parsing claim XML
Applying DHA rule library · 214 rules
Scoring denial risk per claim
01Exposure KPIsClaims flagged, clean rate and value at risk.
02Failure concentrationSee where your team needs to act first.
03Top causes to clearThe highest-priority findings in the batch.
✓Validated 3 XML files · 3 claims · batch HO-AE-1042
Submission ready67%2 of 3 claims can go out today
Exposure at riskAED 600.001 flagged claim
Recoverable by RCMAED 0.00Awaiting documentation review
Blocked outside RCMAED 600.001 claim waiting on the HIS
87%
High denial risk
HO-AE-1042 is likely to be denied if submitted today
2 findings: authorisation reference missing from the claim XML, and the ordering clinician ID does not match the facility licence record.
Claim value AED 600.00High priorityDHA rule set
Risk drivers
Authorisation
Provider ID
Coding
Failure concentration this batch
Missing authorisation reference1AED 600
Ordering clinician ID mismatch1AED 600
Diagnosis–procedure mismatch0AED 0
Modifier / payer format0AED 0
Recurring pattern sample history
Lab order+No authorisation reference→Denied
This bundle caused most sample denials at this facility. Fixing it at registration and in the HIS prevents the next one.
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…
3lines matched to claims
1paid · AED 600
1awaiting · AED 800
1rejected · AED 400
Finance overview
From claimed to paid, in one view. Every step links to the claims behind it.
Where the money is
AED 1,800Claimed
AED 0Price difference
− AED 400Rejected
− AED 800Awaiting remittance
AED 600Paid
Rejected AED 400 → work queueAwaiting AED 800 → ageing & deadlinesPaid AED 600 → period statement
Claimed, paid and open balance
ClaimedPaidOpen balance
Unpaid balance by payer
Sample insurer AAED 700
Sample insurer BAED 500
AED 1,200 open across 2 payers
Rejections & resubmissions
Every rejected line has an owner, a deadline and a next step.
UNASSIGNEDAED 4001 open denied line nobody ownsFOLLOW-UPS OVERDUEAED 00 past follow-up · 0 due todaySTALE OVER 7 DAYSAED 0nothing sitting in one statusOWNED0across 0 owners
All eligibleDue todayOverdueUnassignedClosing within 21 days
Work queue
Claim · activity
Payer
Denial
Value
Work
HO-AE-1044Sample patient · MRN 1044
Sample insurer
MNEC-004
AED 400.00
OPEN
1Submitted
2Rejected · MNEC-004
3Resubmitted
Rejection reasons
Each rejection code has a type, a preventable flag and a plain-language description.
Top rejection codes
By amount. The line is the running share of all rejected value.
Preventable at the front door
71%of rejected value
1
EligibilityCheck pre-approval need at registration
2
Claim ScrubberAdd a rule for the repeating MNEC-004 pattern
Missing prior authorisations, incomplete documentation and coding errors lead to rejected claims, delayed payments and revenue loss. Incorrect claims can also trigger audit-related recoveries.
Incorrect Eligibility or Registration
Claims can be rejected when the patient's eligibility or registration details are wrong.
Incomplete Clinical Documentation
When documentation does not support the billed service, claims can be rejected or recovered after an audit.
Coding Errors
The ICD-10 diagnosis must justify the CPT service billed. A mismatch can lead to rejection.
HOW IT WORKS
One Connected Healthcare Revenue Cycle
Six steps on one RCM platform. Each step passes cleaner data to the next, so fewer errors reach the payer.
Eligibility Check
At registration
Automates insurance eligibility checks to cut patient waiting time and rejections.
What is revenue cycle management in UAE healthcare?+
It covers every step from patient eligibility to insurance payment, including documentation, medical coding and claim submission under DHA, DOH or MOHAP rules.
Why do insurance claims get rejected in the UAE?+
Common causes are wrong eligibility details, missing approvals, incomplete clinical notes, and ICD-10 codes that do not justify the CPT service.
How does AI RCM software help hospitals?+
It catches coding, documentation, and claim errors before submission, so your team spends less time on rework and resubmissions.
Does HealthOrbit AI support DHA, DOH and MOHAP rules?+
Yes. Claim checks follow DHA requirements, DOH Shafafiya modifier rules, and MOHAP coding standards for the Northern Emirates.
What is the difference between coding validation and claim scrubbing?+
Coding validation checks codes against the clinical notes. Claim scrubbing then reviews the full claim XML file before submission.
Does HealthOrbit AI replace medical coders?+
No. It suggests codes, and your coders review and confirm them.
READY TO REVIEW YOUR CLAIMS?
See What Your Claims Are Missing
Book a session with our UAE team and see how HealthOrbit AI finds coding, documentation, and claim errors early.
For UAE hospitals and clinics working with local insurers and TPAs.
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