Direct billing means the clinic sends the bill straight to your insurer, so you pay only your share at the visit, such as a co-payment. Without it, you pay in full and claim the money back yourself. myPediaclinic in Dubai Healthcare City bills fifteen insurers directly for pediatric care and three for dental care, and checks your cover before the appointment.

What does direct billing mean?

Direct billing, also called cashless billing, is an agreement between a clinic and an insurer. When your child is seen, the clinic claims the cost from the insurer. You pay what your plan says you owe, if anything.

With reimbursement, you pay the clinic yourself and then send the receipt and documents to your insurer to claim the money back. It can take weeks, and some costs may not be covered.

Direct billing does not mean everything is free. It means the payment process is handled between the clinic and the insurer. What the insurer pays for is set by your own policy.

Which insurers does myPediaclinic bill directly?

The agreements are not the same in every department, so we list them separately.

Pediatric department (fifteen insurers)
Adnic, Afiyah, Al Khanza, Almadallah, Dubai Insurance, Inayah, Mednet, MetLife, NAS, Neuron, Nextcare, Now Health, Oman Insurance, Saico and Wapmed.
Dental department (three insurers)
Almadallah, NAS and Neuron.

Our insurance page always shows the current list. Agreements change, so if your insurer is not listed, ask us anyway. Reception can tell you where you stand before you book. For orthodontic care, ask reception which insurers apply to your child’s plan.

What decides whether my child is covered?

Being on the list means we can bill your insurer. It does not mean every service is covered. These factors decide what the insurer pays:

Your plan and its network.
Some plans only cover clinics in a certain network or tier.
The co-payment.
Many plans ask you to pay a percentage or a fixed amount at each visit.
The deductible and annual limit.
Some plans have an amount you pay first, or a yearly cap on certain benefits.
Pre-approval.
Some treatments, especially in dentistry and orthodontics, need the insurer’s approval before they are done.
Waiting periods.
New plans, or new family members, may have a waiting time for certain benefits.
Exclusions.
Some conditions or treatments are excluded, for example cosmetic orthodontics.

Pediatric visits, vaccinations, dental care and orthodontics are often treated differently inside the same policy. A plan may cover a child’s check-up and routine vaccines but limit or exclude dental or orthodontic care. That is why we check cover per department.

What should I bring to the first visit?

Bring:

  • your insurance card, either the physical card or the one in your insurer’s app
  • your child’s Emirates ID or passport, and yours
  • any referral, report or test result that relates to the visit
  • your child’s vaccination card, if the visit is for vaccinations or a check-up

Tell us when you book which insurer you hold and which department you need: pediatrics, dentistry or orthodontics. That is what lets us check your cover before you arrive.

How does myPediaclinic check my cover?

The check happens before the appointment, so you are not left to sort it out at the front desk with a child on your arm.

  1. You give us your insurer’s name when you book on WhatsApp or by phone.
  2. We check the policy with the insurer and tell you what to expect.
  3. You come to the visit with the card and IDs, and we handle the billing.

What your own plan covers is a separate question from whether we bill your insurer, and that is the one we check for you.

What if a treatment is not covered?

If the insurer does not cover a treatment, or your cover has run out, we tell you before the treatment starts, so there are no surprises. Treatment that is not covered can be split into four payments with Tabby. Ask reception for a written plan before you agree to anything.

What should I ask my insurer?

If you want to check for yourself, these questions get a clear answer:

  1. Is myPediaclinic in my child’s network, and is direct billing available?
  2. Are routine pediatric visits and vaccines covered, and is there a co-payment?
  3. Is dental care covered, and is there a yearly limit?
  4. Is orthodontic treatment covered, and does it need pre-approval?
  5. Are there waiting periods or exclusions on my child’s plan?
  6. How do I get a pre-approval, and how long does it take?

Keep the answers, with the date and the name of the person you spoke to. Our guide to choosing a pediatric clinic in Dubai lists more questions worth asking any clinic.

When to call us before you book

Call or message us before booking if:

  • your insurer is not on our list and you want to know your options
  • your child has a new insurance card, a new policy or a new employer plan
  • your child needs treatment that may require pre-approval, such as dental work or orthodontics
  • your cover has changed, or you have reached a yearly limit
  • you are unsure which department you need

If your child is unwell, do not wait for an insurance check. Go to the nearest emergency department or call 998 for an emergency, and sort out the paperwork afterwards.

How we can help at myPediaclinic

Reception is the first point of contact for insurance. They check your cover, explain what to expect and book the right department. Our pediatric care is led by Dr. Medhat Abu-Shaaban and Dr. Tala Belbeissi, both consultant pediatricians, and our dental department is directed by Dr. Mustafa Abdalla. All consult in English and Arabic.

To ask about your cover, contact us.

Frequently asked questions

Do I pay anything at the visit if my insurer is on your list?

You may. If your plan has a co-payment or deductible, you pay that share at the visit, and anything your plan does not cover. We tell you what to expect when we check your policy.

Is direct billing available for vaccines?

Vaccines are part of pediatric care. Many plans cover routine childhood vaccines in line with the national schedule, but cover varies by plan, so we confirm it before the visit. Our guide to the UAE vaccination schedule explains which vaccines are due when.

Can I switch insurers and still use direct billing?

Yes, if the new insurer is on our list. Send us the new details before the visit so we can check the policy. If the insurer is not on the list, we explain the alternatives.

What happens if my insurer rejects a claim?

We tell you straight away and explain the options. Depending on the reason, the insurer may need more information, or you may need to pay for that visit yourself. We never leave you to find out at a later date.

Does direct billing apply to emergencies?

If your child needs emergency care, the nearest emergency department is the right place, whatever the insurance. Our direct billing applies to appointments at our clinic.

To book, message us on WhatsApp at 052 218 1662 or call reception on 04 430 5926.