Review and submit

Review each section. Select Edit to change one.

This screen answersUS-06 US-08 US-38

Acceptance criteria

US-06 Newborn Data Integrity HIGHEST

As a user submitting a newborn request, I want all NPHIES-required newborn and mother fields captured and validated on-screen, so that my request doesn't fail server-side after I've marked the step complete.

Dedicated DOB on Newborn step, or clear inline cross-reference to Patient Info DOB.
90-day rule shown as inline help, not only a late blocking error.
Newborn details appear in Review.
All 7 NPHIES-required Mother fields marked required (*) and validated client-side before Continue.
Post-fix, a real newborn submission reaches a determinate NPHIES outcome.

US-08 Facility Type Validation HIGHEST

As a provider user, I want to be warned if I enter a Facility Name without a Facility Type, so that my request isn't silently rejected by NPHIES.

Given a user enters a Facility Name and leaves Facility Type blank, when they attempt to continue, then the system displays an inline warning/error requiring Facility Type.
"Facility Type (optional)" label corrected to conditional-required.
Both fields shown in the Coverage Review card.
Given both fields are completed, when the request is submitted, then no NPHIES rejection occurs for this reason.

US-38 Wizard Navigability LOW

As a user filling long wizards, I want to save a draft and resume, plus jump between completed steps, so that I don't lose work on long forms.

Persistent step indicator with jump-to-completed-step.
Save-as-draft + resume across Eligibility, Pre-Auth, Claims.
No partial submission to NPHIES from a draft.

Wireframe state

DefaultBlockedNewbornNPHIES down

Ready to submit. Everything NPHIES needs is filled in. The request is sent only when you select Submit request.

Purpose

Purposes: Validation, Benefits
Priority: Normal
Service Date: 12 Oct 2026

Patient

Name: Noura Al Harbi
ID Number: 1087654321 (National ID)
Gender: Female
Date of Birth: 17 Apr 1991

Newborn and mother

Newborn: Not a newborn

Demographics

Phone Number: +966 50 555 0142
Marital Status: Married
Occupation: Education
Religion: Muslim

Circumstances

Address: King Fahd Road, Al Malqa, Riyadh, Saudi Arabia
Deceased: No
Transfer: No

Provider

Provider License: 10000000000457
Provider Organization: Al Raneem Hospital

Payer

Payer ID: 7000911508
Insurance Company: Bupa Arabia

Coverage

Coverage Type: EHCPOL
Subscriber ID: BP-77120934
Class: Group GRP-4471
Facility Name: Al Raneem Hospital
Facility Type: HOSP

BackDraft saved 2 minutes agoSaved in RaneemHCP only. Nothing is sent to NPHIES until you submit the request.Save draft Submit request

1 section needs attention. Newborn and mother: all 7 mother details are required. Go to Newborn

Purpose

Purposes: Validation, Benefits
Priority: Normal
Service Date: 12 Oct 2026

Patient

Name: Baby of Noura Al Harbi
ID Number: MRN-004871 (MRN)
Gender: Female
Date of Birth: 18 Aug 2026

Newborn and mother

Newborn: Yes, baby of Noura Al Harbi
Baby date of birth: 18 Aug 2026, 48 days old
Mother's Information: Required, no data entered

Demographics

Phone Number: +966 50 555 0142
Marital Status: Married
Occupation: Education
Religion: Muslim

Circumstances

Address: King Fahd Road, Al Malqa, Riyadh, Saudi Arabia
Deceased: No
Transfer: No

Provider

Provider License: 10000000000457
Provider Organization: Al Raneem Hospital

Payer

Payer ID: 7000911508
Insurance Company: Bupa Arabia

Coverage

Coverage Type: EHCPOL
Subscriber ID: BP-77120934
Class: Group GRP-4471
Facility Name: Al Raneem Hospital
Facility Type: HOSP

BackDraft saved 2 minutes agoSaved in RaneemHCP only. Nothing is sent to NPHIES until you submit the request.Save draftSubmit request

Ready to submit. Everything NPHIES needs is filled in. The request is sent only when you select Submit request.

Purpose

Purposes: Validation, Benefits
Priority: Normal
Service Date: 12 Oct 2026

Patient

Name: Baby of Noura Al Harbi
ID Number: MRN-004871 (MRN)
Gender: Female
Date of Birth: 18 Aug 2026

Newborn and mother

Newborn: Yes, baby of Noura Al Harbi
Baby date of birth: 18 Aug 2026, 48 days old
Mother's Information: Noura Al Harbi, member BP-77120934

Demographics

Phone Number: +966 50 555 0142
Marital Status: Married
Occupation: Education
Religion: Muslim

Circumstances

Address: King Fahd Road, Al Malqa, Riyadh, Saudi Arabia
Deceased: No
Transfer: No

Provider

Provider License: 10000000000457
Provider Organization: Al Raneem Hospital

Payer

Payer ID: 7000911508
Insurance Company: Bupa Arabia

Coverage

Coverage Type: EHCPOL
Subscriber ID: BP-77120934
Class: Group GRP-4471
Facility Name: Al Raneem Hospital
Facility Type: HOSP

BackDraft saved 2 minutes agoSaved in RaneemHCP only. Nothing is sent to NPHIES until you submit the request.Save draft Submit request

NPHIES is not answering. Your request is saved and will be sent when it is back. Save it now. RaneemHCP sends it when NPHIES is back.

Purpose

Purposes: Validation, Benefits
Priority: Normal
Service Date: 12 Oct 2026

Patient

Name: Noura Al Harbi
ID Number: 1087654321 (National ID)
Gender: Female
Date of Birth: 17 Apr 1991

Newborn and mother

Newborn: Not a newborn

Demographics

Phone Number: +966 50 555 0142
Marital Status: Married
Occupation: Education
Religion: Muslim

Circumstances

Address: King Fahd Road, Al Malqa, Riyadh, Saudi Arabia
Deceased: No
Transfer: No

Provider

Provider License: 10000000000457
Provider Organization: Al Raneem Hospital

Payer

Payer ID: 7000911508
Insurance Company: Bupa Arabia

Coverage

Coverage Type: EHCPOL
Subscriber ID: BP-77120934
Class: Group GRP-4471
Facility Name: Al Raneem Hospital
Facility Type: HOSP

BackDraft saved 2 minutes agoSaved in RaneemHCP only. Nothing is sent to NPHIES until you submit the request.Save draft Save and send later

Draft saved. Nothing is sent to NPHIES.