How to join the Daman provider network and Thiqa programme

Daman (National Health Insurance Company) has the largest health insurance book in the UAE. Its network currently includes more than 3,000 healthcare facilities across the country. For a clinic in Abu Dhabi, Dubai, or Sharjah, patients who present with Daman insurance cards expect direct billing — they have no obligation to pay out of pocket and claim reimbursement later. A facility not contracted with Daman must either bill patients directly or turn away insurance-funded business.

Beyond the commercial insurance population, Daman administers Thiqa, the Abu Dhabi government's healthcare scheme for UAE nationals and qualifying non-national family members. Thiqa was established in 2008 and runs on the Daman provider network in Abu Dhabi. A private clinic contracted with Daman in Abu Dhabi is automatically part of the Thiqa network — there is no separate Thiqa provider application. For any Abu Dhabi clinic targeting UAE national patients or their sponsored dependents, Daman contracting is effectively mandatory if you want to offer cashless service.

Contracting with Daman also gives a facility access to OpenJet, the platform Daman uses for electronic prior authorization and claims. OpenJet connects providers, payers, and patients in a single system and manages the full cycle of insurance authorization from eligibility checks to claim adjudication. Without an active Daman contract, a facility cannot submit authorizations or claims through OpenJet, which means no direct billing and no cashless service for Daman members.

The network is not open-ended. Daman assesses whether it already has sufficient provider capacity in a given specialty and geography before adding new facilities. A well-run clinic with clean credentials can still be declined if Daman's coverage is already adequate for that specialty and location. That network adequacy determination is the most common reason a facility with no regulatory issues fails to get contracted.

Daman will not contract a facility that lacks current regulatory standing. Before submitting anything through OpenJet, confirm that your facility and all billable practitioners meet the requirements for your emirate.

In Abu Dhabi, the Department of Health (DOH) is the licensing authority. Your facility must hold a valid DOH facility licence for the services you intend to offer and bill. Every practitioner who will bill under your Daman contract must have a current DOH practitioner licence. DOH requires Primary Source Verification (PSV) of all professional credentials through DataFlow Group, the same third-party verification body used across UAE health authorities. DOH also requires facilities to maintain a clinical privileges register: a documented record of which procedures each practitioner is authorized to perform, based on verified credentials and demonstrated competence.

In Dubai, the Dubai Health Authority (DHA) holds equivalent responsibility. A DHA facility licence and DHA practitioner licences for all clinical staff are required before Daman will review a contracting application. DataFlow PSV applies here as well.

In Sharjah and the other northern emirates, MOHAP licensing applies for both the facility and individual practitioners.

If any of your practitioners have licences approaching expiry, or whose DataFlow verification is not current, resolve those before applying. Daman checks licensure status and will flag gaps. Practitioner licences that expire while you are already contracted can trigger suspension of that practitioner's billing privileges within the Daman system, which creates operational gaps at short notice.

On multi-emirate operations: a DHA licence does not extend clinical or billing rights into Abu Dhabi, and a DOH licence does not cover Dubai. A clinic licenced only in Dubai cannot treat Abu Dhabi Thiqa members on direct billing. If you operate in both emirates, you will need separate licences and separate contracting for each jurisdiction.

Daman's public guidance on new provider contracting is unambiguous: all contracting requests go through OpenJet. The provider management page at damanhealth.ae/shared/provider-management states: "for any future contracting requests please log your request via Openjet." The registration URL is openjet.inhealth.ae/account/register.

OpenJet is operated by inHealth (inhealth.ae), a health technology company whose platform Daman uses for authorization and claims management. Registering on OpenJet creates an account that, once your contract is active, becomes your operational interface for eligibility verification, authorization requests, and claims submission.

The application captures your facility's trade licence information, health authority licence details, physical location data, your clinical scope (the specialties and services you are licensed and intend to bill), the practitioner roster with professional licence numbers and credential details for every billable clinician, and bank account details for reimbursement.

Daman does not publish a processing timeline for contracting applications. Accounts from UAE credentialing consultants indicate the period from a complete submission to a signed contract typically runs from several weeks to several months, depending on facility type, specialty, geography, and documentation completeness. Submitting incomplete documents is the most common source of delay — an incomplete application either stalls in review or generates a request for additional information that resets the clock. Review your submission carefully before submitting.

For facilities not yet on the network that have specific questions before applying, Daman's provider management page links to a query form for non-network providers. Daman's main customer service line is 600-532626. The inHealth support team for the OpenJet platform is reachable at 800-432626 or +971 2 614 9555.

Once your OpenJet application is submitted, Daman assesses it against criteria that mirror the three metric categories used in its Medical Quality and Performance (MQP) programme: structural, clinical, and financial.

Structural evaluation covers the conditions in which you deliver care. This includes the scope of services your facility is licensed to provide, the qualifications and current licensure of your practitioners, your physical infrastructure relative to the services you are applying to bill, and whether your operations can realistically deliver on contracted services. For new facilities without a prior claims history with Daman, structural and practitioner credentials carry the most weight.

Clinical evaluation, for established facilities applying with existing claims data, assesses whether care patterns meet evidence-based standards. The benchmarks Daman uses in its MQP programme derive from frameworks developed by the National Committee for Quality Assurance (NCQA) in the United States and the Care Quality Commission (CQC) in the United Kingdom. For a new applicant with no prior Daman claims history, this dimension applies less at the application stage but becomes relevant to your ongoing network standing.

Financial and market criteria relate to network adequacy. Daman considers whether it already has sufficient providers of your specialty type and geographic area. This is the one evaluation criterion that a well-credentialed facility cannot improve by refining its documentation. If Daman's network is already adequate for your specialty in your location, a contracting application may be declined with no reflection on your quality or compliance.

Once contracted, MQP performance is evaluated biannually. Composite scores are calculated separately for clinical, financial, and structural dimensions, with risk adjustment applied so providers serving higher-acuity populations are compared fairly against peer facilities. Performance data is refreshed every six months. Daman provides biannual feedback reports to help providers identify areas to improve. MQP scores inform Daman's broader analysis of network quality but do not operate as an automatic contract termination trigger.

Thiqa is the Abu Dhabi government's healthcare programme for UAE nationals, established in 2008 and managed by Daman. It is funded by the Abu Dhabi government rather than employer premiums. Eligible members include UAE nationals from Abu Dhabi, UAE nationals from other emirates who reside in Abu Dhabi, and non-UAE nationals sponsored by eligible UAE national family members.

From a provider contracting perspective, Thiqa runs on the Daman provider network for Abu Dhabi. A private clinic that holds a valid Daman contract in Abu Dhabi is part of the Thiqa network. There is no separate Thiqa provider application or contract.

The operational implication is that treating Thiqa members in the private sector carries specific authorization requirements. Inpatient and day-treatment admissions require prior authorization before admission. Several outpatient services also require pre-authorization in private facilities: MRI, CT, and PET scans; medications prescribed for courses longer than 90 days; psychiatric treatment; physiotherapy; and certain dental procedures. Authorization requests are submitted through OpenJet.

Public network providers, specifically Abu Dhabi government hospitals and SEHA facilities, operate under different rules. Treatment at public facilities does not require pre-authorization for Thiqa members. Private clinics do not carry that latitude.

A claim submitted without the required prior authorization will be denied. The consequences are the same as any claim denial: you absorb the cost, bill the patient directly (which creates a complaint risk with a Thiqa member expecting cashless service), or pursue retrospective authorization. Daman handles retrospective authorization on a case-by-case basis for genuine emergencies; it is not available for routine planned treatments where authorization was simply not requested.

Once your Daman contract is active, your billing team needs to understand two overlapping sets of rules: the DOH or DHA claims and adjudication framework for your emirate, and Daman's own published Adjudication Rules.

Daman publishes its Adjudication Rules (ARs) quarterly, with an approximately one-month implementation window between publication and the effective date. The publication schedule runs tentatively in March, June, September, and December. Daman's coverage information page notes that it is the only insurer in the region that publishes its adjudication rules publicly — meaning your billing team can track changes before they affect claim outcomes. The rules cover five categories: medical services, pharmaceutical, dental, billing, and health technology assessment.

Claims must use ICD-10 diagnosis codes and CPT procedure codes, both coded to the highest level of specificity. Daman's published position is explicit: coverage is limited for claims that do not comply with coding and payment rules. Generic or undercoded submissions are a recurring and preventable source of partial payment or outright denial.

Reimbursement rates depend on the member's plan type. For Abu Dhabi Basic plan members, the mandatory tariff published by DOH applies. This tariff is derived from the HAAD mandatory rate schedule, which was set using a localization factor relative to US Medicare rates. For Enhanced plan members, rates are negotiated at the time of contracting between Daman and the provider. Thiqa members in the private network follow rates set by DOH for the programme.

Member reimbursement claims must be submitted within 180 days of the date of service. For direct-billing provider claims submitted electronically through OpenJet, Daman's member guides indicate a 7 working day processing window, though operational timelines vary. Questions about specific adjudication rule interpretations go to Daman's customer service at 600-532626.

If Daman declines your contracting application, the response through OpenJet should state a reason. Two categories cover most outcomes.

Network adequacy: Daman already has sufficient providers of your type in your geographic area. This is not about your facility's quality. The practical remedies are limited: reapply after a period of time (to account for turnover in the existing network), expand your licensed service scope to a specialty where Daman has a network gap, or open a location in an area with thinner coverage. Reviewing Daman's public provider directory at damanhealth.ae/members/find-a-hospital gives a reasonable sense of where the network is dense and where it is not.

Documentation or credentialing deficiency: something in your submitted information did not meet Daman's requirements. Common gaps include practitioner licences that are expired or close to expiry at the time of submission, incomplete or missing clinical privileging records, a clinical scope of services that does not match what your health authority licence actually authorizes, or bank account details that do not correspond to the facility's registered trade licence name. Review the stated reason before resubmitting rather than resubmitting the same documents.

For applications that are submitted but receive no response for an extended period, contact Daman's provider management team through the query form at damanhealth.ae/shared/provider-management, or reach inHealth platform support at 800-432626.

For formal disputes about contracting decisions, the regulatory escalation point differs by emirate. In Abu Dhabi, DOH oversees insurer conduct toward providers and the DOH Healthcare Insurers Manual establishes that providers can appeal authorization decisions through the insurer's published customer service process. In Dubai, DHA holds equivalent oversight responsibility. If you believe a contracting refusal violates the applicable regulatory framework, file a complaint with the relevant health authority rather than treating it as exclusively an internal Daman matter.