Extensions
Connect the selected Saudi payer exchange workflow.
NPHIES
Confirm provider and payer identifiers, the supported exchange package and the responsible organization. Record onboarding evidence and agreed sandbox and production endpoints before connection testing.
Prepare member, policy and service context for supported eligibility and authorization exchanges. Validate the request and preserve payer responses, validity and unresolved coverage information.
Assemble supported claims and attachments, apply package validation and keep message and claim identities traceable. Transmission is permitted only after the production activation gates and required evidence are accepted.
Track supported responses, polling and payment advice. Distinguish platform errors from payer decisions and reconcile returned business references under the accepted retry and correction rules.
Your configuration
Use the registered details of your organization. Do not enter patient records here.
Upload in the matching account setup step, review the preview, apply the values and Save and continue. The tenant version may define different columns; download its template inside setup.
| Column | Required | Format | Example |
|---|---|---|---|
Registered organization namelegal_name | Yes | text | Example Healthcare Organization |
Commercial registration numberregistration_number | Yes | text | EXAMPLE-CR-001 |
Countrycountry | Yes | SA / AE / BH / KW / QA / OM / EG / OTHER | SA |
Tax registration numbervat_number | Optional | text | — |
Add every facility included in your subscription. These become real, separate facilities in your app.
Upload in the matching account setup step, review the preview, apply the values and Save and continue. The tenant version may define different columns; download its template inside setup.
Load / review first: Your organization
| Column | Required | Format | Example |
|---|---|---|---|
Facility namename | Yes | text | Example Facility |
Facility typetype | Yes | hospital / clinic / polyclinic / laboratory / other | clinic |
Facility licenselicense_number | Yes | text | EXAMPLE-LICENSE-001 |
Addressaddress | Yes | text | Example training address |
Phonephone | Yes | text | +966500000000 |
Time zonetimezone | Yes | Asia/Riyadh / Asia/Dubai / Asia/Qatar / Africa/Cairo / UTC | Asia/Riyadh |
Create departments, consultation rooms, wards and beds. You can add more inside your app.
Upload in the matching account setup step, review the preview, apply the values and Save and continue. The tenant version may define different columns; download its template inside setup.
Load / review first: Facilities
| Column | Required | Format | Example |
|---|---|---|---|
Facility number (starting at 1)facility | Yes | integer 1–1000 | 1 |
Department namename | Yes | text | Example Department |
Create departments, consultation rooms, wards and beds. You can add more inside your app.
Upload in the matching account setup step, review the preview, apply the values and Save and continue. The tenant version may define different columns; download its template inside setup.
Load / review first: Facilities
| Column | Required | Format | Example |
|---|---|---|---|
Facility numberfacility | Yes | integer 1–1000 | 1 |
Location namename | Yes | text | Example Room |
Typekind | Yes | room / ward / bed | room |
Inside location (optional)parent | Optional | text | — |
Your verified account becomes the facility administrator. Invite staff in the account portal; staff seats are enforced.
Upload in the matching account setup step, review the preview, apply the values and Save and continue. The tenant version may define different columns; download its template inside setup.
| Column | Required | Format | Example |
|---|---|---|---|
Namename | Yes | text | Example Staff |
Work emailemail | Yes | staff@example.invalid | |
Clinical rolerole | Yes | facility_admin / doctor / nurse / pharmacist / reception / billing / member | doctor |
Registry function settings applied to native scheduling closures with readback
Upload in Your products · configuration data. Apply, then Save and continue checks cross-file references. Launch imports supported records in one transaction and reconciles counts. Function settings are validated against the supported registry, applied natively and read back; prices, catalogue mappings and hardware require approval before activation.
Load / review first: Rooms, wards and beds
| Column | Required | Format | Example |
|---|---|---|---|
Facility numberfacility | Yes | integer 1–1000 | 1 |
Selected feature IDfeature | Yes | scheduling | scheduling |
Function settingfunction_key | Yes | scheduling.closures | scheduling.closures |
Closure namename | Yes | text | Example closure |
First closed datevalid_from | Yes | YYYY-MM-DD | 2026-12-01 |
Last closed datevalid_to | Yes | YYYY-MM-DD | 2026-12-01 |
Closed fromstart_time | Yes | HH:MM | 08:00 |
Closed untilend_time | Yes | HH:MM | 17:00 |
Room (blank closes the whole facility)location | Optional | text | Example Room |
Create the legal payer, insurer, administrator/TPA and provider counterparties that every downstream contract, policy, tariff and integration route names.
Upload in Account setup → Implementation files & acceptance evidence. The data is saved in your account implementation records. Review with the named owner, record approval and attach the evidence. This register records decisions; it does not activate production configuration.
| Column | Required | Format | Example |
|---|---|---|---|
internal codeinternal_code | Yes | Source-backed value | TO-CONFIRM |
legal name arlegal_name_ar | Yes | Source-backed value | TO-CONFIRM |
legal name enlegal_name_en | Yes | Source-backed value | TO-CONFIRM |
country codecountry_code | Yes | Source-backed value | SA |
statusstatus | Yes | Readiness condition: status=active | draft |
evidence stateevidence_state | Yes | Readiness condition: evidence_state in activation-grade evidence | absent |
commercial registrationcommercial_registration | Optional | Source-backed value | TO-CONFIRM |
tax numbertax_number | Optional | Source-backed value | TO-CONFIRM |
license numberlicense_number | Optional | Source-backed value | TO-CONFIRM |
parent organizationparent_organization | Optional | Source-backed value | TO-CONFIRM |
contact directorycontact_directory | Optional | Source-backed value | TO-CONFIRM |
Approval referenceapproval_reference | Yes | text | EXAMPLE-REF-001 |
Mark which organization is the risk-bearing payer/insurer so policy, claim and settlement decisions do not infer that a TPA is the payer.
Upload in Account setup → Implementation files & acceptance evidence. The data is saved in your account implementation records. Review with the named owner, record approval and attach the evidence. This register records decisions; it does not activate production configuration.
Load / review first: organizations
| Column | Required | Format | Example |
|---|---|---|---|
organizationorganization | Yes | Source-backed value | TO-CONFIRM |
rolerole | Yes | Readiness condition: role=insurer | insurer |
effective fromeffective_from | Yes | Source-backed value | 2026-10-09 |
statusstatus | Yes | Readiness condition: status=active | draft |
evidence stateevidence_state | Yes | Readiness condition: evidence_state in activation-grade evidence | absent |
effective toeffective_to | Optional | Source-backed value | 2026-10-09 |
network scopenetwork_scope | Optional | Source-backed value | TO-CONFIRM |
notesnotes | Optional | Source-backed value | TO-CONFIRM |
Approval referenceapproval_reference | Yes | text | EXAMPLE-REF-001 |
Declare delegated administrator/TPA roles when claims, eligibility, authorizations or portals are handled by an intermediary.
Upload in Account setup → Implementation files & acceptance evidence. The data is saved in your account implementation records. Review with the named owner, record approval and attach the evidence. This register records decisions; it does not activate production configuration.
Load / review first: organizations
| Column | Required | Format | Example |
|---|---|---|---|
organizationorganization | Yes | Source-backed value | TO-CONFIRM |
rolerole | Yes | Readiness condition: role=tpa | tpa |
effective fromeffective_from | Yes | Source-backed value | 2026-10-09 |
statusstatus | Yes | Readiness condition: status=active | draft |
evidence stateevidence_state | Yes | Readiness condition: evidence_state in activation-grade evidence | absent |
effective toeffective_to | Optional | Source-backed value | 2026-10-09 |
portal referenceportal_reference | Optional | Source-backed value | EXAMPLE-REF-001 |
escalation matrixescalation_matrix | Optional | Source-backed value | TO-CONFIRM |
Approval referenceapproval_reference | Yes | text | EXAMPLE-REF-002 |
Bind insurer-to-administrator delegation terms so routing and SLA ownership are explicit instead of inferred from names.
Upload in Account setup → Implementation files & acceptance evidence. The data is saved in your account implementation records. Review with the named owner, record approval and attach the evidence. This register records decisions; it does not activate production configuration.
Load / review first: insurer roles · tpa roles
| Column | Required | Format | Example |
|---|---|---|---|
insurer orginsurer_org | Yes | Source-backed value | TO-CONFIRM |
administrator orgadministrator_org | Yes | Source-backed value | TO-CONFIRM |
effective fromeffective_from | Yes | Source-backed value | 2026-10-09 |
claim submission deadlineclaim_submission_deadline | Yes | Source-backed value | TO-CONFIRM |
payment slapayment_sla | Yes | Source-backed value | TO-CONFIRM |
statusstatus | Yes | Readiness condition: status=active | draft |
evidence stateevidence_state | Yes | Readiness condition: evidence_state in activation-grade evidence | absent |
effective toeffective_to | Optional | Source-backed value | 2026-10-09 |
portal urlportal_url | Optional | Source-backed value | TO-CONFIRM |
authorization slaauthorization_sla | Optional | Source-backed value | TO-CONFIRM |
appeal slaappeal_sla | Optional | Source-backed value | TO-CONFIRM |
contact matrixcontact_matrix | Optional | Source-backed value | TO-CONFIRM |
Approval referenceapproval_reference | Yes | text | EXAMPLE-REF-001 |
Store facility identifiers, certified package pins and live-submission permission for the national NPHIES exchange.
Upload in Account setup → Implementation files & acceptance evidence. The data is saved in your account implementation records. Review with the named owner, record approval and attach the evidence. This register records decisions; it does not activate production configuration.
Load / review first: production endpoints · production routing rules
| Column | Required | Format | Example |
|---|---|---|---|
facility identifierfacility_identifier | Yes | Source-backed value | TO-CONFIRM |
environmentenvironment | Yes | Readiness condition: environment=production | test |
certification statuscertification_status | Yes | Readiness condition: certification_status=certified | not_started |
package pinpackage_pin | Yes | Source-backed value | TO-CONFIRM |
allow live submissionallow_live_submission | Yes | Readiness condition: allow_live_submission=true | false |
onboarding referenceonboarding_reference | Optional | Source-backed value | EXAMPLE-REF-001 |
certification expirycertification_expiry | Optional | Source-backed value | — |
notesnotes | Optional | Source-backed value | TO-CONFIRM |
Approval referenceapproval_reference | Yes | text | EXAMPLE-REF-002 |
Configure the production integration endpoint and secret references without storing raw credentials in configuration rows.
Upload in Account setup → Implementation files & acceptance evidence. The data is saved in your account implementation records. Review with the named owner, record approval and attach the evidence. This register records decisions; it does not activate production configuration.
Load / review first: organizations
| Column | Required | Format | Example |
|---|---|---|---|
labellabel | Yes | Source-backed value | TO-CONFIRM |
environmentenvironment | Yes | Readiness condition: environment=production | test |
endpoint urlendpoint_url | Yes | Source-backed value | TO-CONFIRM |
secret referencesecret_reference | Yes | Source-backed value | EXAMPLE-SECRET-REF-001 |
effective fromeffective_from | Yes | Source-backed value | 2026-10-09 |
statusstatus | Yes | Readiness condition: status=active | draft |
effective toeffective_to | Optional | Source-backed value | 2026-10-09 |
timeout secondstimeout_seconds | Optional | Source-backed value | — |
mtls profilemtls_profile | Optional | Readiness condition: mTLS_profile | TO-CONFIRM |
Approval referenceapproval_reference | Yes | text | EXAMPLE-REF-001 |
Map production eligibility, prior authorization, claim and payment transactions to the correct endpoint and payer/administrator route.
Upload in Account setup → Implementation files & acceptance evidence. The data is saved in your account implementation records. Review with the named owner, record approval and attach the evidence. This register records decisions; it does not activate production configuration.
Load / review first: production endpoints · administration agreements
| Column | Required | Format | Example |
|---|---|---|---|
transaction typetransaction_type | Yes | Readiness condition: transaction_type in eligibility/prior_authorization/claim/payment | claim |
environmentenvironment | Yes | Readiness condition: environment=production | test |
endpointendpoint | Yes | Source-backed value | TO-CONFIRM |
prioritypriority | Yes | Source-backed value | 1 |
effective fromeffective_from | Yes | Source-backed value | 2026-10-09 |
statusstatus | Yes | Readiness condition: status=active | draft |
effective toeffective_to | Optional | Source-backed value | 2026-10-09 |
payer scopepayer_scope | Optional | Source-backed value | TO-CONFIRM |
retry policyretry_policy | Optional | Source-backed value | TO-CONFIRM |
fallback queuefallback_queue | Optional | Source-backed value | TO-CONFIRM |
Approval referenceapproval_reference | Yes | text | EXAMPLE-REF-001 |
Freeze products, versions, facilities, delivery mode and acceptance scope.
Upload in Account setup → Implementation files & acceptance evidence. The data is saved in your account implementation records. Review with the named owner, record approval and attach the evidence. This register records decisions; it does not activate production configuration.
| Column | Required | Format | Example |
|---|---|---|---|
Catalogue product IDproduct_id | Yes | text | outpatient |
Agreed releaserelease | Yes | text | TO-CONFIRM |
Operating modemode | Yes | native / connected | native |
Facility scopefacility_scope | Yes | text | all |
Included in this projectincluded | Yes | true / false | true |
Accountable roleowner_role | Yes | text | Project owner |
Acceptance evidenceacceptance_test | Yes | text | Approved end-to-end test |
Approval referenceapproval_reference | Yes | text | EXAMPLE-REF-001 |
Map roles to permitted actions and verify access across facility boundaries.
Upload in Account setup → Implementation files & acceptance evidence. The data is saved in your account implementation records. Review with the named owner, record approval and attach the evidence. This register records decisions; it does not activate production configuration.
Load / review first: Facilities · Planned team
| Column | Required | Format | Example |
|---|---|---|---|
Rolerole | Yes | text | doctor |
Facility scopefacility_scope | Yes | text | EXAMPLE-FACILITY-001 |
Resourceresource | Yes | text | Patient record |
Actionaction | Yes | text | read |
Allowedallowed | Yes | true / false | true |
Approverapprover_role | Yes | text | Security owner |
Test evidenceevidence_reference | Yes | text | EXAMPLE-REF-001 |
Define services and approved code mappings before orders, tariffs and interfaces.
Upload this preparation file in Account setup → Implementation files & acceptance evidence. It is saved in your account records. Use the secure migration workspace for actual clinical data. Approve the source-to-target mapping and import adapter for the selected release before any load. Run a dry run, reconcile counts and retain the result log.
Load / review first: Departments
| Column | Required | Format | Example |
|---|---|---|---|
Local service codeservice_code | Yes | text | EXAMPLE-SVC-001 |
English namename_en | Yes | text | Example service |
Arabic namename_ar | Yes | text | خدمة تدريبية |
Department codedepartment_code | Yes | text | EXAMPLE-DEPT-001 |
Unit of serviceunit | Yes | text | TO-CONFIRM |
Code systemcode_system | Yes | text | TO-CONFIRM |
Catalogue releaserelease | Yes | text | TO-CONFIRM |
Approved external mappingexternal_code | Yes | text | TO-CONFIRM |
Effective fromeffective_from | Yes | YYYY-MM-DD | 2026-10-09 |
Record locally approved pathways, responsibilities and exception handling.
Upload in Account setup → Implementation files & acceptance evidence. The data is saved in your account implementation records. Review with the named owner, record approval and attach the evidence. This register records decisions; it does not activate production configuration.
Load / review first: Departments · Access & approvals
| Column | Required | Format | Example |
|---|---|---|---|
Workflow IDworkflow_id | Yes | text | EXAMPLE-WF-001 |
Product IDproduct_id | Yes | text | outpatient |
Entry evententry_event | Yes | text | Patient arrival |
Responsible roleresponsible_role | Yes | text | Nurse |
Required informationrequired_information | Yes | text | Verified identity and visit context |
Next eventnext_event | Yes | text | Clinical consultation |
Handover ownerhandover_owner | Yes | text | Doctor |
Exception pathexception_path | Yes | text | Identity mismatch to review |
Workflow approvalapproval_reference | Yes | text | EXAMPLE-REF-001 |
Define the agreed message contract. Store references to credentials, never the credentials themselves.
Upload in Account setup → Implementation files & acceptance evidence. The data is saved in your account implementation records. Review with the named owner, record approval and attach the evidence. This register records decisions; it does not activate production configuration.
Load / review first: Facilities · Service catalogue · Existing systems & versions
| Column | Required | Format | Example |
|---|---|---|---|
Interface IDinterface_id | Yes | text | EXAMPLE-IF-001 |
Source systemsource_system | Yes | text | SRC-EPIC-001 |
Target systemtarget_system | Yes | text | MANSOQ |
Directiondirection | Yes | inbound / outbound / bidirectional | inbound |
Protocol and versionprotocol_version | Yes | text | TO-CONFIRM |
Message scopemessage_scope | Yes | text | TO-CONFIRM |
Identifier mappingidentifier_mapping | Yes | text | TO-CONFIRM |
Secret manager referencesecret_reference | Yes | text | REFERENCE-ONLY |
Retry and duplicate policyretry_policy | Yes | text | TO-CONFIRM |
Failure ownerfailure_owner | Yes | text | Integration owner |
Test evidencetest_reference | Yes | text | EXAMPLE-REF-001 |
Record complete positive, negative, boundary, access and failure tests per product.
Upload in Account setup → Implementation files & acceptance evidence. The data is saved in your account implementation records. Review with the named owner, record approval and attach the evidence. This register records decisions; it does not activate production configuration.
Load / review first: Project scope · Clinical workflow configuration
| Column | Required | Format | Example |
|---|---|---|---|
Test IDtest_id | Yes | text | UAT-001 |
Product IDproduct_id | Yes | text | outpatient |
Scenarioscenario | Yes | text | Visit from arrival to financial follow-up |
Preconditionspreconditions | Yes | text | Approved setup and synthetic data |
Exact actionsactions | Yes | text | TO-CONFIRM |
Expected resultexpected_result | Yes | text | TO-CONFIRM |
Actual resultactual_result | Yes | text | NOT-RUN |
Statusstatus | Yes | not_run / pass / fail / blocked | not_run |
Evidence referenceevidence_reference | Yes | text | EXAMPLE-REF-001 |
Approverapprover_role | Yes | text | Product owner |
Inventory every source EHR, department system, archive and ERP separately, including the exact installed product and licensed extraction route.
Upload this planning CSV in Account setup → Implementation files & acceptance evidence. Preview, apply and save. Keep source clinical files and identity crosswalk records in the approved secure migration workspace. Record actual evidence references after review; this register does not run a vendor connector or import patient history.
Load / review first: Project scope
| Column | Required | Format | Example |
|---|---|---|---|
System IDsystem_id | Yes | text | SRC-EPIC-001 |
Vendorvendor | Yes | text | Epic |
Installed productproduct | Yes | text | Epic EHR |
Installed releaserelease | Yes | text | TO-CONFIRM |
Environmentenvironment | Yes | test / production / archive | test |
Facilities coveredfacility_scope | Yes | text | EXAMPLE-FACILITY-001 |
Source administrator rolesource_owner | Yes | text | Source EHR administrator |
Approved extraction routeexport_route | Yes | text | EHI export assessment pending |
Licence/access evidencelicence_reference | Yes | text | EXAMPLE-REF-001 |
Release-specific specificationspecification_reference | Yes | text | https://open.epic.com/TechnicalSpecifications |
Illustrative operating cases
A provider uses a specifically accepted NPHIES package for supported insurance transactions.
The exact package, provider, request identities and response references are recorded for review.
A sandbox transaction succeeds while required provider onboarding or package evidence remains unresolved.
Sandbox success is not mistaken for certified production readiness.
Worked operating scenarios
Retain the original exchange identity and payload; use the accepted retry rules and verify whether the target received the transaction.
Keep production submission disabled, resolve the package and provider evidence and repeat the affected acceptance tests.
Delivery boundary
NPHIES capability is subject to package support, onboarding, credentials and certification evidence. Built exchange code and sample reference data do not establish certified production readiness.
Supported eligibility, authorization and claims exchange, with onboarding, credentials, versions and activation agreed explicitly. Prepare provider identity: Confirm provider and payer identifiers, the supported exchange package and the responsible organization. Record onboarding evidence and agreed sandbox and production endpoints before connection testing. Check eligibility & authorization: Prepare member, policy and service context for supported eligibility and authorization exchanges. Validate the request and preserve payer responses, validity and unresolved coverage information. Exchange claims: Assemble supported claims and attachments, apply package validation and keep message and claim identities traceable. Transmission is permitted only after the production activation gates and required evidence are accepted. Follow responses & reconcile: Track supported responses, polling and payment advice. Distinguish platform errors from payer decisions and reconcile returned business references under the accepted retry and correction rules.
Explore the detailsConfigure the selected release using the account templates, then validate references and preview before import. Required planning and setup files include nphies configurations (rcm_nphies_configurations.csv); production endpoints (rcm_production_endpoints.csv); production routing rules (rcm_production_routing_rules.csv); Interface specification (interfaces.csv); Function settings · scheduling closures (product_settings.csv); Acceptance tests (uat_cases.csv). Each file’s field guide identifies whether it imports setup records or documents a migration/decision.
Explore the detailsTransport failure Retain the original exchange identity and payload; use the accepted retry rules and verify whether the target received the transaction. Unsupported package or incomplete onboarding Keep production submission disabled, resolve the package and provider evidence and repeat the affected acceptance tests.
Explore the detailsNPHIES capability is subject to package support, onboarding, credentials and certification evidence. Built exchange code and sample reference data do not establish certified production readiness.
Explore the details