Policy Management

Policy Setup and Coordination

We handle all aspects of policy initiation, from coordinating with the insurer to reviewing and submitting complete, compliant documentation. We ensure every policy is accurately set up and activated with care.

Ongoing Policy Administration

Throughout the policy year, we manage all service requests, including member additions or removals, plan updates, payment adjustments, and lost card replacements. We also maintain up to date records and policy data on our platform for reliable tracking and reporting.

Membership and Document Management

We oversee the issuance and delivery of membership cards, certificates, and all non-medical policy-related documents. Our team ensures accurate documentation and timely fulfillment at every stage.

Subscription and Billing Services

We manage all financial aspects of the policy, including billing reviews, invoice reconciliation, transaction monitoring and debt reporting. Our focus is on ensuring clarity, accuracy, and transparency in all client financials.

Medical Service

24/7 Medical Assistance and Support

Our team of licensed doctors, pharmacists, and trained professionals supports members around the clock through a dedicated hotline.

Full Claims Management

We manage both reimbursement and in-network claims locally and internationally. This includes receiving, scanning, and archiving documents, assessing claims medically, issuing approvals or rejections, and generating clear payment statements and Explanation of Benefits for each member.

Claims Risk Management

Our system applies strict internal controls to maintain accuracy and prevent misuse. These include automated approval limits, alerts for pre-existing conditions, automated application of deductibles and co-insurance, audit-ready document archiving, and review of suspicious billing with providers or members.

Claims Analysis and Reporting

We provide in depth reporting across multiple dimensions including benefit consumption by policy year, inpatient versus outpatient analysis, and turnaround time insights, giving clients clear visibility into claims performance.

Medical Approvals

Every hospitalization request is assessed for medical necessity, treatment plan, and eligibility based on the member’s coverage terms and underwriting status.

Provider Network Engagement

We maintain strong relationships with a wide network of hospitals, labs, clinics, pharmacies, and specialists. Our team monitors service delivery, resolves issues promptly, and works to ensure a consistently high-quality member experience.

Medical Underwriting Support

Our experts evaluate medical histories and pre-existing conditions to ensure accurate premium assignments and appropriate policy exclusions.

Medical Assistance and Evacuations

Members receive access to trusted local and international medical referrals, hospital coordination, and case follow-up. In critical cases, we arrange air evacuations through our global network of partners.

Customer Care

Multichannel Member Support

Our in house contact center is the main point of contact for all member inquiries. Through phone, email, social media, and walk-in support, we ensure every client is heard, assisted, and updated at every stage of service.

Emergency Response Support

Our hotline provides immediate help for emergency admissions, preauthorization updates, and urgent care needs. We communicate directly with providers to facilitate approvals and medical coordination in real time.

Proactive Member Outreach

We stay in touch with clients through outbound calls, messages, and emails to share updates, request missing documents, and provide clarifications. Every interaction is documented and tracked.

Case Resolution Management

We manage escalated cases with precision. Our team validates concerns, coordinates resolutions with internal departments, and keeps clients informed throughout the process to build trust and accountability.

Inpatient Experience Support

We assist members through the entire hospitalization process, from preauthorization to discharge, ensuring clear communication, timely updates, and supportive guidance during critical care moments.

Technology & Automation

Unified Digital Platform

All operations are managed through a fully customized Salesforce-based platform that integrates policy administration, claims processing, client communication, and reporting in one secure environment. This centralization ensures speed, consistency, and data integrity across every function.

Real-Time Access and Tracking

Our platform enables real-time access to policy data, member information, service requests, and case status, ensuring transparency for both insurers and corporate clients.

Custom Reporting and Insights

We deliver tailored reports including financial breakdowns, claims trends, service utilization, and performance metrics. These insights support better decision-making, compliance tracking, and strategic planning.

Automation for Efficiency

Automated workflows reduce manual errors, improve turnaround times, and ensure faster service delivery across approvals, claims, and communications.

Partners

Tabibi

Online shop for prescription ordering, eRX gateway for approvals automation and Pharmacy network for faster deliveries. We review and manage chronic prescriptions and ensure medications are delivered to patients, every month. End-to-end tracking and significant cost savings you can benefit from

Docspert

Klarity

Care Hub

Yodawy

DRAPP

SOS