45122-1st_Jul_2013_to_30th_June_2014-PD.XLSX

XLSX spreadsheet 42 KB Posted Oct 2, 2014

Attached to: Health Insurance Services
Solicitation number: STC10014R0001-1
Issued by: Department of State US Embassy Abu Dhabi

About this file

From the source

Claim Reports

View the file

Other files

File	Type	Posted
Synopsis_FBO_Award.pdf	PDF	Dec 17, 2014
45122-1st_Jul_2011_to_30th_Jun_2012-PD_(2).xlsx	XLSX spreadsheet	Oct 2, 2014
Qs_ _As_additional_2.pdf	PDF	Oct 2, 2014
45122-1st_Jul_2012_to_30th_Jun_2013-PD.XLSX	XLSX spreadsheet	Oct 2, 2014
Qs_ _As_additional.pdf	PDF	Sep 30, 2014
SF30_-_Amendment_1.pdf	PDF	Sep 26, 2014
Health_Insurance_Solicitation_REVISED.pdf	PDF	Sep 26, 2014
New_Table_of_Benefits.pdf	PDF	Sep 26, 2014
Existing_Table_of_Benefits__.pdf	PDF	Sep 26, 2014
List_of_Active_Members.xls	XLS spreadsheet	Sep 26, 2014
US_Embassy_LR.PDF	PDF	Sep 26, 2014
Exhibit__A_-_List_of_Health_Insurance_Coverage_REVISED.pdf	PDF	Sep 26, 2014
Meeting_Minutes_STC10014R0001.pdf	PDF	Sep 26, 2014
Qs_ _As.pdf	PDF	Sep 26, 2014
Exhibit_F_-_Employees_Statistics.xls	XLS spreadsheet	Sep 26, 2014
SF33_cover_page.pdf	PDF	Sep 5, 2014
Exhibit_B_-_ORE_Staff_Rider.pdf	PDF	Sep 5, 2014
Cover_Letter.pdf	PDF	Sep 5, 2014
Exhibit_E_-__List_of_Exclusions.pdf	PDF	Sep 5, 2014
Exhibit_C_-_AEEA_Staff_Rider.pdf	PDF	Sep 5, 2014
Exhibit__A_-_List_of_Health_Insurance_Coverage.pdf	PDF	Sep 5, 2014
Exhibit_D_-__MSG_Staff_Rider.pdf	PDF	Sep 5, 2014
Exhibit_F_-_Employees_Statistics.xls	XLS spreadsheet	Sep 5, 2014
Health_Insurance_Solicitation.pdf	PDF	Sep 5, 2014
Synopsis_FBO.pdf	PDF	Aug 21, 2014

Show all 25

On GovTribe

Work with this file

Download the original file
Contacts named in this file
Similar government files
Ask GovTribe AI about this file

Try for free Login

Text version

The file's text, extracted by GovTribe without its formatting.

Page1

CS Claims Analysis
	Policy number: 45122-
Paid date
from : 2013-07-01	to : 2014-06-30
Claims Range/USD	No.of claims	Paid Amount
<= 100	8,488	329,471
101-250	2,625	426,497
251-500	623	205,691
501-1000	126	82,266
1001-2500	72	148,422
2501-5000	24	87,012
5001-10000	9	92,224
10001-50000	4	56,347
Total	11,971	1,427,931

Top 10 Diagnosis	No.of Claimant	Paid Amount	% of Total
DIABETES MELLITUS WITHOUT MENTION OF COMPLICATION TYPE II OR UNSPECIFIED TYPE NOT STATED AS UNCONTROLLED	45	39,266	3.0%
HYPERLIPIDEMIA/DISPLIPIDEMIA	98	37,803	2.9%
BRONCHITIS ACUTE	139	33,337	2.5%
NORMAL DELIVERY ADMISSION (MATERNITY)	10	32,713	2.5%
UPPER RESPIRATORY INFECTION (URTI / URI)	202	29,002	2.2%
VITAMIN D DEFICIENCY UNSPECIFIED / (RICKETS)	146	28,843	2.2%
HYPERTENSION	63	26,704	2.0%
SORE THROAT / PHARYNGITIS ACUTE	178	20,925	1.6%
CORONARY ATHEROSCLEROSIS OF NATIVE CORONARY ARTERY	7	17,651	1.3%
HYPOTHYROIDISM - ACQUIRED	37	17,139	1.3%
Top 10		283,384	19.0%
Others		1,144,546	81.0%
Total		1,427,931	100.0%

Page2

CS Claims Analysis
	Policy number: 45122-
Paid date
from : 2013-07-01	to : 2014-06-30
Top 10 Claimant	Paid Amount	% of Total	Major Conditions
1	40,110	3.0%	ABDOMINAL PAIN GENERALIZED
			ABNORMAL WEIGHT GAIN
			ACUTE GASTRITIS WITHOUT MENTION OF HEMORRHAGE
			BENIGN ESSENTIAL HYPERTENSION
			BLEPHARITIS
			CHEST PAIN (UNSPECIFIC REASON)
			CHOLESTEREMIA - CHOLESTEROLEMIA - HYPERCHOLESTEROLEMIA
			CONJUNCTIVAL CONCRETIONS
			CONJUNCTIVAL CYSTS
			CONTACT DERMATITIS AND OTHER ECZEMA DUE TO OTHER SPECIFIED AGENTS
			CORONARY ATHEROSCLEROSIS OF NATIVE CORONARY ARTERY
			DEGENERATION OF CERVICAL INTERVERTEBRAL DISC
			DIABETES WITH KETOACIDOSIS
			DRUG INDUCED HEADACHE NOT ELSEWHERE CLASSIFIED
			EPIGASTRIC PAIN
			EPIPHORA UNSPECIFIED AS TO CAUSE
			FATTY LIVER
			FEVER UNSPECIFIED
			FLATULENCE / ERUCTATION / GAS PAIN
			GASTRIC ULCER UNSPECIFIED AS ACUTE OR CHRONIC WITHOUT MENTION OF HEMORRHAGE OR PERFORATION WITHOUT MENTION OF OBSTRUCTION
			HEADACHE / HEAD PAIN
			HELICOBACTER PYLORI INFECTION
			HIDRADENITIS / HIDRADENITIS SUPPORATIVA
			HORDEOLUM INTERNUM
			INTERVERTEBRAL DISC
			ISSUE OF REPEAT PRESCRIPTIONS
			KNEE PAIN
			LUMBAGO / LOW BACK PAIN
			MIXED HYPERLIPIDEMIA
			NECK PAIN / CERVICALGIA
			OSTEOARTHRITIS
			OSTEOARTHROSIS GENERALIZED MULTIPLE SITES
			OSTEOARTHROSIS LOCALIZED NOT SPECIFIED WHETHER PRIMARY OR SECONDARY LOWER LEG
			OSTEOPOROSIS
			OTHER SPECIFIED DIFFUSE DISEASES OF CONNECTIVE TISSUE
			OTHER SPECIFIED DISORDERS OF ROTATOR CUFF SYNDROME OF SHOULDE/ BURSAE AND TENDONS IN SHOULDER REGION
			OTHER SPRAINS AND STRAINS OF ANKLE
			REFLUX ESOPHAGITIS
			ROUTINE EXAMINATION OF SPECIFIC SYSTEM
			SACROILIITIS
			SHOULDER PAIN
			SPONDYLOSISUNSPECIFIC
			SPRAIN OF SACROILIAC LIGAMENT
			TENDINITIS / CAPSULITIS
			TRICHIASIS OF EYELID WITHOUT ENTROPION
			URINARY TRACT INFECTION (UTI)
			UTERINE LEIOMYOMA / FIBROID UTERUS
			VARICOSE VEINS OF LOWER EXTREMITIES WITH INFLAMMATION
			VERTIGO / DIZZINESS / GIDDINESS
			VITAMIN D DEFICIENCY UNSPECIFIED / (RICKETS)
2	27,520	2.1%	ADHESIVE PERICARDITIS
			ALLERGIC RHINITIS DUE TO OTHER ALLERGEN
			ANEMIA IRON DEFICIENCY
			ASTHMAUNSPECIFIED TYPE UNSPECIFIED
			BACTERIAL INFECTION, UNSPECIFIED
			BRONCHIAL ASTHMA
			BRONCHITIS ACUTE
			CEREBRAL EMBOLISM WITH CEREBRAL INFARCTION
			CHEST PAIN (UNSPECIFIC REASON)
			CORONARY ATHEROSCLEROSIS DUE TO LIPID RICH PLAQUE
			CORONARY ATHEROSCLEROSIS OF NATIVE CORONARY ARTERY
			DEHYDRATION
			DEVIATED NASAL SEPTUM
			DIABETES MELLITUS WITHOUT MENTION OF COMPLICATION TYPE II OR UNSPECIFIED TYPE NOT STATED AS UNCONTROLLED
			DIABETES MELLITUS WITHOUT MENTION OF COMPLICATION TYPE II OR UNSPECIFIED TYPE UNCONTROLLED
			DIABETES WITH NEUROLOGICAL MANIFESTATIONS TYPE II OR UNSPECIFIED TYPE UNCONTROLLED
			FEVER
			FOLLOW-UP EXAMINATION FOLLOWING OTHER SURGERY
			HEART TUMOR - BENIGN
			HYPERLIPIDEMIA/DISPLIPIDEMIA
			LOSS OF WEIGHT
			MALAISE / FATIGUE
			MITRAL VALVE DISORDER
			MYOFASCITIS / MYALGIA
			NEOPLASMS OF UNSPECIFIED NATURE OTHER SPECIFIED SITES
			NEVUS NON-NEOPLASTIC
			OTHER AFFECTIONS OF SHOULDER REGION NOT ELSEWHERE CLASSIFIED
			OTHER FORMS OF EPILEPSY AND RECURRENT SEIZURES WITH INTRACTABLE EPILEPSY
			OTHER OBSTRUCTION OF DUODENUM
			OTHER SPECIFIED ANEMIAS
			OTHER SPECIFIED DISORDERS OF ROTATOR CUFF SYNDROME OF SHOULDE/ BURSAE AND TENDONS IN SHOULDER REGION
			PALPITATIONS
			POLYNEUROPATHY IN DIABETES
			SINUSITIS ACUTE
			SORE THROAT / PHARYNGITIS ACUTE
			TRANSIENT CEREBRAL ISCHEMIA (TIA)
			UNSPECIFIED ADVERSE EFFECT OF OTHER DRUG
			VERTIGO / DIZZINESS / GIDDINESS
			VITAMIN D DEFICIENCY UNSPECIFIED / (RICKETS)
3	20,623	1.6%	ANGINA PECTORIS
			BENIGN ESSENTIAL HYPERTENSION
			BRONCHITIS ACUTE
			CORONARY ATHEROSCLEROSIS OF NATIVE CORONARY ARTERY
			GASTROESOPHAGAL REFLUX DISEASE (GERD/GORD)
			GENERAL SYMPTOMS
			HYPERLIPIDEMIA/DISPLIPIDEMIA
			HYPERTENSION
			KNEE PAIN
			OTHER PULMONARY EMBOLISM AND INFARCTION
			PERSISTENT VOMITING
			PITUITARY GLAND TUMOR BENIGN
4	19,776	1.5%	ALLERGIC RHINITIS / RHINORRHEA / HAY FEVER
			ANKYLOSING SPONDYLITIS
			BACTERIAL INFECTION, UNSPECIFIED
			BENIGN ESSENTIAL HYPERTENSION
			CONTACT DERMATITIS AND OTHER ECZEMA DUE TO OTHER SPECIFIED AGENTS
			CROHNS DISEASE
			DERMATITIS (& CONTACT) / ECZEMA
			DERMATOPHYTOSIS OF NAIL
			DUODENAL ULCER UNSPECIFIED AS ACUTE OR CHRONIC WITHOUT MENTION OF HEMORRHAGE OR PERFORATION WITH OBSTRUCTION
			GASTROESOPHAGAL REFLUX DISEASE (GERD/GORD)
			GOITER - NON TOXIC
			HYPOTHYROIDISM - ACQUIRED
			INTERVERTEBRAL DISC DISORDER WITH MYELOPATHY CERVICAL REGION
			IRREGULAR MENSTRUATION
			JOINT PAIN
			KERATOCONJUNCTIVITIS SICCA NOT SPECIFIED AS SJOGREN'S
			LOWER RESPIRATORY TRACT INFECTION (LRTI)
			MASTODYNIA / MASTALGIA / BREAST PAIN
			MIGRAINE
			MIGRAINE UNSPECIFIED WITHOUT MENTION OF INTRACTABLE MIGRAINE WITHOUT MENTION OF STATUS MIGRAINOSUS
			MIGRAINE WITHOUT AURA WITHOUT MENTION OF INTRACTABLE MIGRAINE WITH STATUS MIGRAINOSUS
			NECK PAIN / CERVICALGIA
			NERVE ROOT LESION CERVICAL
			NONTOXIC MULTINODULAR GOITER
			OBSTRUCTIVE SLEEP APNEA (ADULT)(PEDIATRIC)
			OTHER SCREENING MAMMOGRAM
			OTHER SPECIFIED INTESTINAL MALABSORPTION
			OTHER SPECIFIED PRURITIC CONDITIONS
			PAIN IN JOINT HAND
			POSTSURGICAL HYPOTHYROIDISM
			REFLUX ESOPHAGITIS
			THYROID UNSPECIFIC DISEASE / DISORDER
			UNSPECIFIED MONOARTHRITIS OTHER SPECIFIED SITES
			URINARY TRACT INFECTION (UTI)
			VAGINITIS / VULVO-VAGINITIS / VULVITIS
			VITAMIN D DEFICIENCY UNSPECIFIED / (RICKETS)
5	17,409	1.3%	ATOPIC DERMATITIS / ECZEMA / BESNIER'S PRURIGO / NEURODERMATITIS
			BRONCHITIS ACUTE
			CATARRH / COLD / CORYZA / NASOPHARYNTIGIS /RHINOPHARINGITIS
			CHRONIC RHINITIS
			CONSTIPATION UNSPECIFIED
			COUGH
			EPILEPSY / EPILEPTIC CONVULSIONS / FITS OR SEIZURES
			EPILEPSY UNSPECIFIED WITHOUT MENTION OF INTRACTABLE EPILEPSY
			FEBRILE CONVULSIONS (SIMPLE) UNSPECIFIED
			INTRINSIC ASTHMA WITH (ACUTE) EXACERBATION
			OTHER FORMS OF EPILEPSY AND RECURRENT SEIZURES WITH INTRACTABLE EPILEPSY
			PNEUMONIA / PNEUMONITIS
			TONSILLITIS ACUTE
			UPPER RESPIRATORY INFECTION (URTI / URI)
6	16,844	1.3%	ACUTE VENOUS EMBOLISM AND THROMBOSIS OF DEEP VESSELS OF DISTAL LOWER EXTREMITY
			AMEBIASIS
			ANGINA PECTORIS
			BALANITIS / BALANOPOSTHITIS
			CARDIAC / CARDIO-RESPIRATORY MURMURS
			CHONDROMALACIA OF PATELLA
			CHRONIC RHINITIS
			DIABETES MELLITUS (DM)
			DIABETES MELLITUS WITHOUT MENTION OF COMPLICATION TYPE II OR UNSPECIFIED TYPE NOT STATED AS UNCONTROLLED
			GASTROESOPHAGAL REFLUX DISEASE (GERD/GORD)
			HYPOTHYROIDISM - ACQUIRED
			OSTEOARTHROSIS LOCALIZED NOT SPECIFIED WHETHER PRIMARY OR SECONDARY LOWER LEG
			OSTEOARTHROSIS UNSPECIFIED WHETHER GENERALIZED OR LOCALIZED HAND
			OTHER ORTHOPEDIC AFTERCARE
			TEAR OF MEDIAL CARTILAGE OR MENISCUS OF KNEE
			TINEA
			TINEA PEDIS
			TRIGGER FINGER
			VITAMIN D DEFICIENCY UNSPECIFIED / (RICKETS)
7	14,994	1.1%	ABDOMINAL PAIN UNSPECIFIED SITE
			ANTENATAL CARE / PREGNANCY (MATERNITY)
			CATARRH / COLD / CORYZA / NASOPHARYNTIGIS /RHINOPHARINGITIS
			FEVER
			GASTROENTERITIS / ENTERITIS OR COLITIS
			HYPOTHYROIDISM - ACQUIRED
			NORMAL DELIVERY ADMISSION (MATERNITY)
			OVARY TUMOR - BENIGN
			RESPIRATORY SYSTEM UNSPECIFIC
			SINUSITIS ACUTE
			SPRAINS AND STRAINS NECK / CERVICAL SPRAIN
			SUPERVISION OF OTHER NORMAL PREGNANCY
			UNSPECIFIED SYMPTOM ASSOCIATED WITH FEMALE GENITAL ORGANS
			UPPER RESPIRATORY INFECTION (URTI / URI)
			URINARY TRACT INFECTION (UTI)
			VAGINITIS / VULVO-VAGINITIS / VULVITIS
			VITAMIN D DEFICIENCY UNSPECIFIED / (RICKETS)
8	14,090	1.1%	BRONCHITIS ACUTE
			CARDIAC / CARDIO-RESPIRATORY MURMURS
			CARDIOMYOPATHY
			CHEST PAIN (UNSPECIFIC REASON)
			DENTAL
			DERMATITIS (& CONTACT) / ECZEMA
			DYSPEPSIA / HYPERACIDITY
			GASTRITIS
			HAEMORRHOIDS THROMBOSES - INTERNAL
			HYPERLIPIDEMIA/DISPLIPIDEMIA
			HYPERTENSION
			HYPERTROPHIC OBSTRUCTIVE CARDIOMYOPATHY
			PAIN IN LIMBS / HAND PAIN / LEG PAIN
			SHORTNESS OF BREATH (SOB) / DYSPNEA
			UPPER RESPIRATORY INFECTION (URTI / URI)
9	13,680	1.0%	ABDOMINAL PAIN
			ABDOMINAL PAIN OTHER SPECIFIED SITE
			ACUTE GASTRITIS WITHOUT MENTION OF HEMORRHAGE
			ALLERGIC ARTHRITIS ANKLE AND FOOT
			ALLERGY
			ANEMIA IRON DEFICIENCY
			ANEMIA B12 DEFICIENCY
			BREAST MASS / LUMP
			BRONCHITIS ACUTE
			CHRONIC RHINITIS
			COUGH
			DEFICIENCY OF OTHER VITAMINS
			DEHYDRATION
			DYSMENORRHEA
			DYSMETABOLISM SYNDROME
			FASCIA / LIGAMENT / MUSCLE (INFLAMMATORY) DISEASE
			FEVER
			GENERAL SYMPTOMS
			HIP THIGH LEG AND ANKLE INJURY
			JOINT PAIN
			LATE EFFECT OF COMPLICATIONS OF SURGICAL AND MEDICAL CARE
			LATE EFFECT OF SPRAIN AND STRAIN WITHOUT MENTION OF TENDON INJURY
			LATE EFFECT OF UNSPECIFIED INJURY
			LATERAL MALLEOLUS FRACTURE - CLOSED
			LAXITY OF LIGAMENT
			LUMBAGO / LOW BACK PAIN
			MINERAL DEFICIENCY
			OSTEOPOROSIS
			OTHER MUCOPURULENT CONJUNCTIVITIS
			OTHER SPECIFIED AFTERCARE
			OTHER SPECIFIED IRON DEFICIENCY ANEMIAS
			OTITIS MEDIA
			PAIN IN JOINT ANKLE AND FOOT
			PAIN IN JOINT MULTIPLE SITES
			PNEUMONIA / PNEUMONITIS
			ROUTINE GENERAL MEDICAL EXAMINATION AT A HEALTH CARE FACILITY
			SPRAIN OF TIBIOFIBULAR (LIGAMENT) DISTAL OF ANKLE
			SPRAINS AND STRAINS ANKLE / ANKLE & FOOT SPRAIN OR INJURY
			SUNBURN
			UPPER RESPIRATORY INFECTION (URTI / URI)
			VITAMIN D DEFICIENCY UNSPECIFIED / (RICKETS)
10	13,537	1.0%	BRONCHITIS ACUTE
			BRONCHITIS NOT SPECIFIED AS ACUTE OR CHRONIC
			COUGH
			PNEUMONIA / PNEUMONITIS
			SORE THROAT / PHARYNGITIS ACUTE
			UPPER RESPIRATORY INFECTION (URTI / URI)
			VACCINATION
			WHEEZING
Top 10	198,583	13.0%
Others	1,229,347	87.0%
Total	1,427,930	100.0%

Page3

CS Claims Analysis
	Policy number: 45122-
Paid date
from : 2013-07-01	to : 2014-06-30
Top 10 Providers	Paid Amount	% of Total
NMC Specialty Hospital -Abu Dhabi	87,525	7.1%
Al Noor Hospital-Airport Road	86,331	7.0%
Al Noor Hospital - Khalifa Abu Dhabi	78,047	6.3%
Burjeel Hospital	77,550	6.3%
Mediclinic City Hospital	70,698	5.7%
Advanced Cure DiagnosticCenter	62,090	5.0%
Mediclinic Welcare Hospital	60,069	4.8%
Gulf Diagnostic Center Hospital	49,303	4.0%
International Modern Hospital	28,417	2.3%
Al Zahra Hospital	25,909	2.1%
Top 10	625,938	50.5%

Page4

CS Claims Analysis
	Policy number: 45122-
Paid date
from : 2013-07-01	to : 2014-06-30
4512200000
Top 10 Providers	Paid Amount	% of Total
NMC Specialty Hospital -Abu Dhabi	87,525	7.0%
Al Noor Hospital-Airport Road	86,331	6.9%
Al Noor Hospital - Khalifa Abu Dhabi	78,047	6.2%
Burjeel Hospital	77,550	6.2%
Mediclinic City Hospital	70,698	5.6%
Advanced Cure DiagnosticCenter	62,090	5.0%
Mediclinic Welcare Hospital	60,069	4.8%
Gulf Diagnostic Center Hospital	49,303	3.9%
International Modern Hospital	28,417	2.3%
Al Zahra Hospital	25,909	2.1%
Top 10	625,938	44.0%
Others	801,992	56.0%
4512200000 's Total	1,427,930	100.0%

Page5

CS Claims Analysis
	Policy number: 45122-
Paid date
from : 2013-07-01	to : 2014-06-30
CASH Claims	Paid Amount
	4512200000	Total
	U.A.E.
AMERICA	16,805	16,805
ASIA	11,830	11,830
COUNTRY	38,221	38,221
MIDEAST	3,180	3,180
CASH Claims	Claim Count
	4512200000	Total
	U.A.E.
AMERICA	8	8
ASIA	46	46
COUNTRY	269	269
MIDEAST	24	24

PPO Claims	Paid Amount
	4512200000	Total
	U.A.E.
Assigned Provider	21,707	21,707
BLUE	78,769	78,769
GOLD	618,492	618,492
GREEN	254,218	254,218
SILVER	280,957	280,957
PPO Claims	Claim Count
	4512200000	Total
	U.A.E.
Assigned Provider	15	15
BLUE	848	848
GOLD	3,642	3,642
GREEN	4,674	4,674
SILVER	2,445	2,445

Page6

CS Claims Analysis
	Policy number: 45122-
Paid date
from : 2013-07-01	to : 2014-06-30
	OP	IP	Psychiatric	Maternity	Dental	Optical	Other	TOTAL	% of Total
Employees	629,871	73,424	1,551	54,261	0	981	256	760,345	53.3%
Spouse	292,421	61,739	1,052	34,194		780	3	390,190	27.3%
Child	207,157	65,963	415			1,561	2,298	277,394	19.4%
Total claims	1,129,449	201,127	3,018	88,456	0	3,322	2,557	1,427,929	100.0%
Age	Paid Amount			Claim count
	Male	Female	Total	Male	Female	Total
Under 21	147,452	129,908	277,360	1,667	1,748	3,415
21-25		10,137	10,137		128	128
26-30	4,502	33,328	37,829	50	361	411
31-35	32,784	139,063	171,847	362	1,042	1,404
36-40	71,031	87,930	158,962	648	628	1,276
41-45	146,744	148,040	294,784	1,007	954	1,961
46-50	97,198	113,247	210,445	684	809	1,493
51-55	38,678	49,067	87,745	336	434	770
56-60	68,164	47,046	115,210	472	225	697
61-65	47,284	6,091	53,375	277	65	342
66-69	5,573		5,573	32		32
70 and above	1,365	3,299	4,664	23	19	42
Total	660,775	767,155	1,427,930	5,558	6,413	11,971

Note: PPO - Preferred Provider Organization, IP - In Patient, OP - Out Patient

File details come from the government source that posted it. Updated Nov 14, 2017.