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Company Services

  • Your Reliable Healthcare

Medexa Group – Managed Care Experts

  • Use of most advanced technology in the world
  • Provision of high quality healthcare services
  • Tools for reducing abuse and fraud
  •  Focus on reducing healthcare cost while maintaining quality of services
  •  Flexibility in dealing with all parties, especially requirements and needs of risk carriers (insurance and reinsurance companies)

Our GOAL is offering high quality healthcare services by implementing international standards in managing, analyzing and auditing medical claims using modern international coding systems which were developed by WHO for implementing e-health.

Distinguished advantages of Medexa Group:

Adapting universal coding system used by the World Health Organization (WHO).

  • The Group has developed an advanced research center for studying the global coding systems and its implementation in the management of all aspects of health insurance to achieve highest accuracy and quality of performed work.
  • Strategic partnership with a leading software company called CoreTech, developer of advanced softwares with excellent capabilities to manage health insurance business.
  • Pioneers in using smart cards.

 

Medexa Services - Smart Cards

      • On spot patient’s eligibility check
      • Medical file for each patient
      • Secured patient’s personal confidentiality
      • No debits on employees (real time and online transaction)

 

Medexa Services - Chronic Drugs

Members with chronic diseases can dispense their medications from any network pharmacy without any exception. In order to assure effectiveness, the member’s details and treatment information are built in the system including required quantities to achieve the following:

    • Dispensing drugs on monthly basis for each patient
    • Drugs are not repeated and consumption is accurately calculated
    • Correct diagnoses, dose and coparticipation
    • Avoid excessive treatments with no need (home pharmacy)

 

Medexa Services - Medical Audit

Medical claims audit (disease, treatment, intervention, laboratory tests, radiology procedures):

    • Relations with patent's sex, age, social status
    • Relations with the doctor's specialty
    • Relations with planned procedure, prescribed treatment, requested laboratory and radiology tests
    • Relations with the health insurance coverage

 

Medexa Services – Preapprovals

  • A customer service center is available 24/7 days a week to answer all customer queries without delay
  • Following and monitoring all hospitalized cases
  • Identifying cases that require specific medical management (case management)
  • Online authorization especially for emergency cases

 

Medexa Services – System

  • The system was developed by CoreTech, a local company with extensive experience in developing softwares for health insurance administration
  • Software features:
    • Use of most advanced programming languages to meet customers’ expectations, i.e.:
          • Oracle platform
          • Oracle DB 10g
          • NET framework
    • Online capabilities for health insurance services inside and outside the company
      • Ability to track claims workflow, documentation of performed entries and changes (by employee name / user) according to authority for each employee
      • Ability to manage all services related to claims handling from received date until full settlement to providers
      • Ability to link branches of the organization or the company and dealing with them as one entity and issuing reports for each branch separately
      • Ability to issue reports in several formats, for example doc, pdf, xls, html, web pages
      • Availability of electronic archiving capabilities
      • Mobile phone apps - under development