Abstract

Objective: To determine the level of preparedness of Saudi doctors in terms of basic ideas of medical insurance and practices related to claims processing.
Methodology: This research utilized a descriptive cross-sectional study design, and data collection involved an electronically delivered, self-administered structured questionnaire. The descriptive statistics, frequency counts, and percentage distributions were analyzed using SPSS, and correlation analysis was conducted between demographic variables and knowledge levels.
Results: Out of 66 participants who were surveyed, 74.2% had limited knowledge of basic concepts in insurance, such as premiums, deductibles, copays, and provider networks. Additionally, 69.6% of participants did not know anything about the form structure and workings of claim forms, and 63.6% did not know anything about procedural coding systems. Notably, just 36.4% showed sufficient knowledge in CPT codes as well as their usages. Statistical analysis showed there were no significant relations between knowledge of insurance and physicians' age (p=0.73), gender (p=0.84), and professional experience (p=0.62).
Conclusion: The research uncovered that Saudi doctors are not equipped to handle medical insurance networks and settling of claims. They were clinically competent, but they did not have administrative experience to handle insurance terminology, documentation of claim forms, and coding standards.

Key words: Physician preparedness, medical insurance, coding systems, administrative knowledge, Saudi Arabia, healthcare financing.