Medical claims management & settlement
Healthcare claims& benefits, madeclear.
Tamayah is a specialized provider of medical claims management and settlement solutions. We bring technology, specialized expertise and operational excellence together to make claims and benefits administration efficient, transparent and reliable.
Regulatory standing
- Insurance Authority supervised
- Authorized via Nphies
Tamayah operates under the supervision and oversight of the Insurance Authority and is authorized to conduct transactions through the Nphies platform.
1,700+ healthcare providers supported
About Tamayah
Who we are.
We bring together advanced technology, specialized expertise and operational excellence to simplify and streamline the medical claims lifecycle. From medical authorization management and claims processing to settlement and financial reconciliation, our solutions are designed to deliver greater efficiency, accuracy, transparency and speed.
By combining intelligent digital solutions with experienced operational teams, we help our partners optimize claims operations, enhance service quality and maintain compliance with applicable regulatory and professional standards.
Who we serve
Built for every party in the claims journey.
Effective claims management is more than processing transactions. It is creating an efficient, transparent and reliable experience for all stakeholders.
Insurers
The technology, network and expertise to run health programs efficiently, transparently and at scale.
Self-funded employers
Structured processes and clear handling of claims and settlement activity for the programs you fund.
Health systems
Accurate processing and timely resolution across the claims lifecycle, with transparent settlement.
Healthcare providers
Timely processing and responsive operations that help you reach faster, more efficient claim resolution.
Beneficiaries
A smoother experience through our call center and customer service, with concierge and elite services.
What we do
One connected claims-and-benefits ecosystem.
At Tamayah, we manage the healthcare claims and benefits administration journey through an integrated approach that combines technology, expertise and operational discipline. Our services support partners throughout the claims lifecycle, enabling efficient processing, accurate decision-making and transparent settlement.
The claims journey
Select a stage to see what happens and which Tamayah capability supports it.
Stage 1 of 5
Medical authorization
Reviewed against benefits & policy terms
Stage 2 of 5
Claim validation
Received, reviewed, validated
Stage 3 of 5
Settlement
Processed with clear handling
Stage 4 of 5
Reconciliation
Discrepancies identified & addressed
Stage 5 of 5
Claim closed
Accurate and transparent closure
- 01
Medical Authorizations
We manage and review medical authorization requests efficiently and accurately, ensuring alignment with applicable coverage benefits, policy terms and conditions, and regulatory requirements.
- 02
Medical Claims Management
We receive, review, validate and process medical claims through advanced technology-enabled systems, helping ensure accuracy, efficiency and timely resolution throughout the claims lifecycle.
- 03
Claims Settlement & Reconciliation
We manage claims settlement and financial reconciliation processes, identify and address discrepancies, and facilitate accurate and transparent claim closure.
Health outcomes
Population Health Management
PHM programs that prevent complications, improve outcomes and reduce avoidable utilization, raising care quality and the efficiency of health spending.
Service experience
Call Center & Customer Service
Integrated call center and customer service operations that deliver responsive support and easy access to help for beneficiaries and providers across the service journey.
Premium care services
Private by design.
Two services shaped around privacy, responsiveness and effortless access to healthcare.
Concierge Medicine
Integrated, personalized healthcare that gives the beneficiary a smoother and more private experience.
Care manager · 8 AM – midnight
- Dedicated care managerPersonal assistance and continuous follow-up from 8 AM to midnight.
- Private medical supervisionA dedicated physician oversees the health plan and follows medical needs.
- Priority accessAppointments at major hospitals made easier.
- Medical coordinationPre-surgery approvals and procedures managed, with accommodation arranged when needed.
- Medication servicesHome delivery and management of prescription refills.
- Proactive check-upsRegular health follow-up and preventive screening, and more.
Elite & VIP Services
Services designed for a high level of privacy, responsiveness and ease of access to healthcare.
Account manager · 9 AM – 9 PM
- Dedicated account managerAvailable 9 AM to 9 PM, with booking support in under two hours.
- Priority accessAppointments at major hospitals made easier.
- Medical coordinationPre-surgery approvals and procedures managed, with accommodation arranged when needed.
- Medication servicesHome delivery and management of prescription refills.
- Proactive check-upsRegular health follow-up and preventive screening.
Why Tamayah
Better claims management starts with the right combination of technology and expertise.
At Tamayah, we understand that effective claims management is more than processing transactions. It is about creating an efficient, transparent and reliable experience for all stakeholders.
Our technology-enabled operating model allows us to manage complex claims processes while maintaining a strong focus on accuracy, efficiency, transparency and service quality.
We work closely with our partners to understand their operational needs and deliver solutions that support their objectives and contribute to a more efficient healthcare ecosystem.
We strive to deliver accurate processing, timely resolution and reliable outcomes while creating sustainable value for our partners and their customers.
Our value
- 01
Technology-Driven Efficiency
We leverage modern technology and digital solutions to streamline claims processes, reduce operational complexity and enhance processing efficiency.
- 02
Accuracy & Quality
Our structured processes and specialized expertise support accurate claims handling and consistent service quality across the claims lifecycle.
- 03
Speed & Responsiveness
We are committed to timely processing and responsive operations, helping our partners achieve faster and more efficient claims resolution.
- 04
Transparency
We promote transparency throughout our operations, with structured processes and clear handling of claims and settlement activities.
- 05
Regulatory Compliance
We operate within the applicable regulatory framework and maintain a strong commitment to professional and regulatory standards.
Our vision
To be the region’s most trusted health benefits administrator, where every riyal spent buys better health.
Our mission
We give insurers, self-funded employers and health systems the technology, network and expertise to run their health programs efficiently, transparently and at scale.
Our commitment
We are committed to continuously improving the way healthcare claims and benefits are managed by combining specialized expertise, operational excellence and advanced technology.
Through continuous development and operational excellence, we aim to help our partners achieve greater efficiency while delivering a smoother and more reliable claims experience.
Leadership
Mohammed AlSaeed
Chairman Board of Managers
Sultan Alkhomashi
Board Member
Abdullah Abahussain
Board Member
Eng. Mohammed Hamad Al-Quraishah
Chief Executive Officer
Partner with Tamayah.
Whether you are looking to enhance claims processing efficiency, streamline medical authorization management, or improve settlement and reconciliation processes, Tamayah is ready to support your journey.
Together, we can build a more efficient, transparent and technology-enabled healthcare claims and benefits administration ecosystem.
Send an enquiry
Tell us about your organization and we will prepare an email to our team.