- Contracting and managing an exten – sive and geographically spread provider network in order to provide subscribers/ benef
iciaries with easy access to care - Negotiating preferred fees (lower than the going rates) with health care providers, which translate into significant savings to clients ( insurance companies and self – funded programs).
- Adjudicating claims through a process that involves medical audits based on internationally recognized medical protocols that examine the appropriateness of requested medical procedures and drug treatment.
- Performing financial audits and pro-cessing payments to providers.
- Managing hospital admissions based on internationally adopted medical protocols.
- Performing utilization and case management reviews
- Providing self- funded programs and insurance companies with consultative services that include costing and mea-surement of policy feasibility.
- Performing all administrative, health expense management, and reporting tasks on behalf of clients
- Healthcare Assistance services
- Evaluation services
A guide on how to register a complaint
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Phon
For members with Essential Benefits Plan, please call us on (967)1 412512/412606/416712 or mobile No. (967) 737222013 -
Fax
Please fax all your queries and complaints to (967)1 421270 -
Email
For members: -
Post
Iran Street, opposite Al-Boustan Hotel, Hadda, P. O. Box: 11111, Sana'a, Yemen
Quick Faq
When you need treatment, call our Customer Care Team. We can help you arrange your treatment plan, and point you in the right direction, saving you the time and hassle of looking for a hospital, clinic or medical practitioner yourself. We appreciate that there will be times when it will not be practical or possible for a beneficiary to contact us for prior approval (for example, emergencies, or when a family member is suddenly sick and the priority is to get treatment for them as soon as possible). In circumstances like these, we ask that you or the affected beneficiary get in touch with us 48 hours after treatment has been sought, so that we can confirm whether treatment is covered and arrange settlement with your provide
Log into the online find provider and you can search our directory of hospitals, clinics and doctors.
If you’ve paid for your treatment yourself, you can send your invoice and claim form to us using any of the following methods.
How to Work with Us
For information regarding the Essential Benefits Plan, please contact us at