Mediator between hospitals and insurance

Feb 16, 2023 | Business & Trade

Question

Assalamualikum,

I work in a private company that works with U.S. (United States) healthcare clients. The company works as a mediator between Doctors/Hospitals and Medical insurance companies.

I work on behalf of U.S. Doctors, Hospitals, and Labs not insurance companies. I do not sell or purchase insurance, but we check the websites of insurance companies.

E.g. https://www.availity.com/, to see which medical plan patients have.

We obtain patient details from insurance companies to check whether we have the correct information or not.

Sometimes we call or check the websites of insurance companies for patient information. We check the patient eligibility (active, inactive, plan type, services, liabilities, etc ) according to the medical service, taking approval from insurance companies before providing service in hospitals and doctor’s offices.

We add or remove Medical Insurance plans in our record as per the received information. Our motive is to arrange all the correct information about the patient and process it further for medical billing.

Then send bills to the Insurance company or the patient accordingly. In Simple words, it’s called medical billing or RCM.

Companies, where I worked.

1 :- https://www.r1rcm.com/ Past company

2:- https://www.pacificbpo.com/ Currently working.

Please guide me on whether my job is Lawful or Not.

If not then what should I do with my income? I have saved around 3 Lakh rupees for my marriage from this job only.

And I have spent money on my house construction and daily life also. What Should I do about this?


Answer

Based on the information provided, it can be determined that your current occupation and the associated income are permissible within Islamic principles.

Your primary role involves acting as an intermediary on behalf of medical providers. Your responsibilities revolve around facilitating the medical billing process through interactions with insurance companies. Importantly, you are not engaged in the sale or purchase of insurance, nor are you a representative of insurance companies or individual patients. Instead, your work is dedicated to verifying patient information, ensuring eligibility, and managing billing procedures exclusively on behalf of healthcare providers.

Nevertheless, it is worth considering alternative employment options. It is generally advised to explore career paths that do not involve insurance-related roles, as this approach may be more aligned with the ideals of shari’ah.

Answered by:
Ifta Research Fellow

Checked & Approved by:
Mufti Abdul Rahman Mangera
Mufti Zubair Patel