Healthcare Documentation¶

Volume 1: BrainSAIT Health Knowledge System

Overview¶

This volume covers everything related to Saudi healthcare digital transformation, including NPHIES integration, claims management, RCM optimization, and AI-powered automation.

Table of Contents¶

Part I: Foundations¶

1. Introduction to KSA Healthcare
2. KSA Health Landscape
3. Digital Transformation
4. Stakeholders

Part II: Claims & Reimbursement¶

1. Claim Lifecycle
2. Rejection Types
3. Resubmission Playbook
4. Automation Pipeline
5. Payer Integrations

Part III: NPHIES & Standards¶

1. NPHIES Overview
2. FHIR R4 Profile
3. Workflows
4. API Reference

Part IV: BrainSAIT Agents¶

1. ClaimLinc
2. PolicyLinc
3. DocsLinc
4. RadioLinc
5. Voice2Care

Part V: SOPs¶

1. Claim Submission SOP
2. Eligibility Process
3. Compliance SOP

Appendix¶

1. Healthcare Glossary

Key Concepts¶

Revenue Cycle Management (RCM)¶

The complete process from patient registration to final payment:

Patient Registration → Eligibility → Service → Coding → Claim → Payment

NPHIES Integration¶

NPHIES (National Platform for Health and Insurance Exchange Services) is Saudi Arabia's central health exchange platform.

Core Services:

• Eligibility verification
• Prior authorization
• Claims submission
• Payment reconciliation

BrainSAIT Value¶

Quick Start¶

For RCM Teams¶

1. Understand the landscape - Read Introduction
2. Learn claim flow - Review Claim Lifecycle
3. Reduce rejections - Study Rejection Types
4. Use automation - Explore ClaimLinc

Compliance Framework¶

PDPL Requirements¶

• Minimum privilege access
• Patient consent
• Breach reporting
• Data minimization
• Encryption

HIPAA-Aligned Controls¶

• Access logging
• Audit trails
• Secure sessions
• Role-based access

Related Resources¶

• Master Glossary
• Compliance Index
• Tech Infrastructure

BrainSAIT Healthcare

OID: 1.3.6.1.4.1.61026

Regional Support¶

BrainSAIT OID Namespace¶

1.3.6.1.4.1.61026          # BrainSAIT Root
├── 1.3.6.1.4.1.61026.1    # Sudan Branch
│   ├── 1.3.6.1.4.1.61026.1.1    # Healthcare Facilities
│   ├── 1.3.6.1.4.1.61026.1.2    # Medical Devices
│   └── 1.3.6.1.4.1.61026.1.3    # Health Information Systems
└── 1.3.6.1.4.1.61026.2    # Saudi Arabia Branch
    ├── 1.3.6.1.4.1.61026.2.1    # Healthcare Facilities
    ├── 1.3.6.1.4.1.61026.2.2    # Medical Devices
    └── 1.3.6.1.4.1.61026.2.3    # Health Information Systems

Regional Features¶

Sudan Branch (OID: 1.3.6.1.4.1.61026.1) - Healthcare facilities integration - Local medical coding systems - Arabic medical terminology - Sudan MOH compliance

Saudi Arabia Branch (OID: 1.3.6.1.4.1.61026.2) - NPHIES integration - Saudi health insurance standards - Hijri calendar support - Kingdom healthcare regulations