What is SBS V3 coding and why is it mandatory?

SBS V3 (Saudi Billing System Version 3.0) is the standardized medical coding framework established by the Council of Health Insurance (CCHI). It is mandatory for all healthcare providers in Saudi Arabia for insurance reimbursement through NPHIES. Accurate SBS V3 coding prevents claim rejections and ensures CCHI compliance.

How does RCMHelper reduce healthcare claim rejections?

RCMHelper uses AI-powered validation to audit claims before NPHIES submission. It identifies coding errors, mismatches between diagnoses and procedures, and violations of CCHI billing rules. Real-time SBS V3 mapping and CDI suggestions ensure claims are clean, compliant, and optimized for full reimbursement.

What is the difference between SBS and standard ICD-10?

The Saudi Billing System (SBS) is a Kingdom-specific modification of the Australian ICD-10 (ICD-10-AM). Unlike standard ICD-10, SBS V3 includes localized Chapter 23 codes for Saudi-specific services and incorporates the ACHI procedure classification. It is the only coding standard recognized by CCHI for private sector billing in Saudi Arabia.

Does RCMHelper support NPHIES and CCHI billing?

Yes. RCMHelper is fully optimized for the Saudi healthcare ecosystem — CCHI billing workflows and NPHIES-compatible output. Our engine maps clinical documentation to SBS V3 and CCHI price lists, facilitating faster prior authorizations and claim processing.

How accurate is the AI-driven SBS V3 medical coding?

RCMHelper achieves over 95% accuracy in SBS V3 medical coding using clinical concept normalization and advanced reranking models. The AI is trained on Saudi-specific healthcare services and validated against official SBS V3 mapping procedures.

Can RCMHelper handle prior authorization for Saudi insurance payers?

Yes. RCMHelper includes a PreAuth CDI analyzer that reviews clinical notes to ensure they meet medical necessity requirements for Saudi insurance payers including BUPA Arabia, Tawuniya, and MedGulf. It reduces prior authorization denials on NPHIES and ensures authorized codes match final billed services.

Intelligence for Modern Healthcare

AI-Powered Medical Coding for the
Saudi Billing System (SBS V3).

Automate SBS V3 clinical code mapping, reduce MOH and CCHI claim rejections, and streamline prior authorization for Saudi healthcare providers.

Get Startedarrow_forward EXPLORE TOOLS

WE SURVEYED HEALTHCARE PROFESSIONALS — HERE'S THE INTEREST IN OUR PRODUCTS

0+Clinicians Expressed Interest

0+Services Mapped During Testing

0+Clinical Notes Assessed During Testing

Automation tools

Intelligent modules designed to accelerate your RCM outcomes.

account_tree

SBS Mapper

Live

Map medical procedures to SBS V3 billing codes in seconds using AI. Reduce CCHI claim rejections and ensure full compliance with MOH and NPHIES standards.

Get mapping arrow_right_alt

verified_user

PreAuth CDI Analyzer

Live

Automate pre-authorization clinical documentation integrity checks for Saudi payers (BUPA Arabia, Tawuniya, MedGulf). Flag ICD-10 gaps, suggest supporting diagnoses, and accelerate CCHI approval.

Analyze case arrow_right_alt

psychology

Clinical Notes

Coming Soon

Automatically structure patient narratives into standard clinical formats. Eliminate manual transcription and improve documentation quality.

Built for Saudi Arabia's revenue cycle management reality.

Reduce Claim Rejections

Reduce SBS V3 claim rejections by catching ICD-10 and CPT coding errors before they reach the NPHIES clearinghouse — saving your billing team hours of rework.

EHR Agnostic

Export clean data easily to your existing Electronic Health Records and standard X12 formats.

CCHI-Aligned Security

Enterprise-grade encryption at rest (AES-256) and in transit (TLS 1.3). Aligned with CCHI data governance standards and Saudi Arabia's Personal Data Protection Law (PDPL).

Fair, Transparent Pricing

Scale from small to organisation without hiring

free

0.00 SAR/mo

data_usage12 Queries / mo
check_circle2.50 SAR per query
check_circleBasic Matching Model

Start Free

starter

350.00 SAR/mo

data_usage2,000 Queries / mo
check_circle0.50 SAR per query
boltEverything in Free
check_circleLatest Matching Model
check_circlePriority Support

Choose Starter

professional

799.00 SAR/mo

data_usage8,000 Queries / mo
check_circle0.25 SAR per query
boltEverything in Starter
check_circleLatest Matching Model
check_circleEarly Access to New Features
check_circleLowest cost per query
check_circlePriority Beta Access
starBuilt for the best.

Choose Professional

AI-Powered Medical Coding for the Saudi Billing System (SBS V3).