Direct Billing Process
Direct billing (cashless facility) allows you to receive medical treatment at network providers without paying upfront. The provider bills Al Wathba directly through NAS Neuron for covered services.
How Direct Billing Works
- Visit Network Provider: Choose any provider within your plan's network
- Present Your Card: Show your Al Wathba/NAS insurance card
- Verification: Provider verifies your eligibility with NAS
- Treatment: Receive necessary medical services
- Pay Only: Deductible/co-payment if applicable
- Provider Bills NAS: Remaining amount settled directly
What You Need for Direct Billing
| Required Item | Details |
|---|---|
| Valid Insurance Card | Physical or digital card via myNAS app |
| Emirates ID | For identity verification |
| Pre-approval Reference | For services requiring authorization |
| Payment Method | For deductible/co-payment if applicable |
Direct Billing Coverage by Service Type
Automatic Direct Billing (No Pre-approval Needed):
- General practitioner consultations
- Basic laboratory tests
- X-rays and ultrasounds
- Emergency room visits
- Pharmacy prescriptions (within limits)
Requires Pre-approval for Direct Billing:
- Hospital admissions
- Surgery procedures
- MRI/CT scans
- Physiotherapy sessions
- Maternity services
Understanding Your Financial Responsibility
Basic Plan Example:
- Doctor consultation: AED 300
- You pay: AED 100 (deductible) + AED 40 (20% co-pay of remaining AED 200)
- Total out-of-pocket: AED 140
- NAS pays provider: AED 160
Premium Plan Example:
- Doctor consultation: AED 300
- You pay: AED 0
- NAS pays provider: AED 300
Common Direct Billing Issues and Solutions
| Issue | Solution |
|---|---|
| Card not recognized | Ask provider to manually enter member ID or call NAS: 800-2311 |
| System shows "Inactive" | Contact HR to verify active employment/premium payment |
| Limit exceeded | Check remaining limits on myNAS app; pay difference or seek alternative treatment |
| Provider refuses card | Confirm provider is in network; call NAS for immediate assistance |
| Pre-approval missing | Request provider to obtain approval or call NAS for emergency approval |
Direct Billing at Pharmacies
- Present prescription and insurance card
- Pharmacist verifies medicine coverage
- Pay applicable deductible/co-payment
- Collect medicines and receipt
Note: Only medicines prescribed by network doctors are eligible for direct billing
When Direct Billing May Not Be Available
- Services not covered under your plan
- Provider outside your network
- Annual or sub-limits exhausted
- During waiting periods
- Excluded treatments or conditions
- Cosmetic or elective procedures
Alternative: Pay and Claim
If direct billing isn't available:
- Pay provider full amount
- Obtain detailed receipt and medical report
- Submit reimbursement claim within 30 days
- Receive refund minus deductible/co-payment
Pro Tips for Smooth Direct Billing
- Always carry your physical card as backup
- Save NAS helpline (800-2311) in your phone
- Check provider network status before visits
- Understand your plan's deductible and co-payment
- Keep track of annual limits via myNAS app
- For expensive treatments, verify coverage in advance