Jordan, Syria, Libya, Egypt, Oman by xcu79604

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									Medexa
Moving in the world to achieve better health care
 Jordan, Syria, Libya, Egypt, & Oman
[Company Profile] 2009




                                  Usage of unified global adopted and approved notations in the
                                  medical and healthcare sectors leads to an orderly sequence of
                                  better services and promptly manage, control and audit medical
                                  and healthcare data and information, thus, providing precise
                                  data, statistical information and better services for all sectors’
                                  parties.
                                            Medexa @Glance


Medexa is a privately-owned, Third Party Administrator (TPA) located in Amman, Jordan.
Founded in 1999, Medexa has grown tremendously over the last 10 years, both in its customer
base as well as in its knowledge and skills on current trends and emerging healthcare and
insurance sectors.

Medexa prides itself on its dynamic environment – never content with the status quo, Medexa
constantly strives to challenge conventional knowledge in healthcare and insurance sectors to
bring the best solutions any for a given client.

Medexa business approach is based on partnering with our clients and understanding their
exact needs to encourage success through mutual benefit and over the past 10 years our
business has grown; however, our commitment to customer satisfaction has not been
deterred. In fact, the changes the company initiated were for the sole purpose to fit the ever
changing needs of our customers.

                                               Established 1999.
                                               Neutral Third Party Administrator (TPA).
                                               Capital exceeds 3,000,000 U.S. dollar.
                                               Passionate for Technology.
                                               1st regional smart card implementer.
                                               Serves 150,000 satisfied subscribers.
                                               Serves 5 countries in Middle East & Africa
                                                regions.
                                               Enjoys 87th skilled & specialized staff members.
                                               Availability & support 365 x 7 x 24.
                                               Serves more than 20 satisfied Client.

Medexa working to provide health insurance expenses management services, for insurance
and self-funded companies, using the most advanced and sophisticated technologies, to
provide distinguished and quality healthcare and billing service, that helps in the reduction of
misuse and/or fraud malpractice which ensures the reduction and reduce the high-costs
resulting, without decreasing the rights of any parties.
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                                           Global Domination


Medexa continually seeking to better serving its clients and disseminate its knowledge and
expertise gained from more than 15 years, in order to achieve business excellence, clients’ and
customers’ satisfactions by providing unparalleled and outstanding healthcare services for all
parties.

Medexa since inception have established a number of regional branches, and will continue
establishing several branches in the globe, however, Medexa currently exists and covering 5
countries in Middle East and Africa regions.




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                                          Success Elements

Medexa continue its success by developing key points and elements continuously outlines the
management structure of health insurance, which distinguish Medexa from others.

Medexa strongly believes in the six essential success factors that allowed accomplishing so
much more than the rest of similar competitors and having a sophisticated understanding of
how to provide and shape our services competitively while still making a satisfactory profit.

                                           Self-awareness
                                          Medexa & its staff are eagerly passionate learning
                                          and developing their knowledge & skills.
                                           Specific Goals
                                          Medexa have strategically developed its goals
                                          targeting to contribute to the world economy.
                                           Powerful Networks
                                          Medexa is partnering with its clients, which means
                                          that their success is its success.
                                           Surprising Idealism
                                          Medexa want to make a difference, fulfill a life-
                                          purpose, & pursue a dream. Medexa motivated by
                                          a desire to create a better world.
                                           Extraordinary Curiosity
                                          Medexa concern of every aspect & it gives
                                          attention to every details, even small issues &
                                          details.
                                           Personal Discipline
                                          Medexa when it comes to honesty and business
                                          are true, & clear in its communication &
                                          commitments with mutual respect.




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                                          Distinguished Factors

Medexa managed to adopt a unified global standards certified and approved by the World
Health Organization (WHO) that distinguished and moved Medexa to a new level in health
insurance management.

Medexa established state-of-the-art Advanced Research & Development Center (R&DC) for
the purpose of studying world global notations and standards and its implementation at all
aspects, moreover to continue develop and modernize the mechanisms of standard operation
(SOP) actions to gain accurate and ideal access to insurance solutions and services for all
insurance parties.

Medexa established a unique strategic partnership with CoreTech, an advanced software
development company, where Medexa’s R&D center and CoreTech teams managed to
develop and implements state-of-the-art artificial intelligence products that facilitates and
promotes the health insurance management to the 21st century in unparalleled professionalism
and quality.




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                                           Corporate Staffs

Medexa corporate operates by highly talented and skilled professional administrative, gained
more than twenty years of practical experience in the health insurance management.
Medexa's professional team is committed to acting in the best interests of its regional clients

Medexa polarized 87 talented, intelligent and precognition staff, where the company provided
all the support and training in faith and believes that medical claims management needs to
possess a distinct specifications to work and operate on specialized and advanced systems.



                             Staff [87 Employee]
                  Secretary             Consultants           Pharmacists
                  Doctors               Accountants           IT & MIS


                                 17%                         26%
                  8%
               9%                                                         8%


                                            32%




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                                           Global Medical Network
Medexa realized the importance of medical service providers in achieving optimal medical
health insurance services, which focused the company's to build a network based on strict
pillars such as:

                            Client’s needs
                            Scientific qualifications and service quality
                            Medical Specialization
                            Geographical location to suit the subscriber’s residential and
                             work sites.

Medexa provides wide range of services to manage health insurance; therefore the adoption
of regional geographical medical service providers’ network distinguished us from others, as
Medexa is the first TPA providing a Global Medical Service Providers’ Network. Medexa
annually issuing the medical service providers’ network booklet indexed geographically based
on the international categories taken in consideration the Prevailing custom for each country
according to country, governorate, city, area, street, and building.




Page |7                                                    Medexa| Company Profile
                                           Outstanding Services
                                           Optimal Care
Medexa is a market leader in TPA business process and healthcare claim management,
Medexa’s team spirit and initiatives shapes the future of TPAs with imagination, creativity and
intelligence. Medexa provides the region's most innovative structures and services for
managing health insurance services.

Medexa provides wide range of services shaped to suits every customer needs, Medexa’s
Services ranges from providing captive insurance services, insurance management services,
insurance and risk management consulting.

                        Feasibility studies.
                        Formation support.
                        Insurance management.
                        Insurance financial management.
                        Administrative services.
                        Insurance advisory services.
                        Ongoing client support.
                        Programs design, development, implementation and administration.




Page |8                                                     Medexa| Company Profile
                                             Facts & Actions
We do care for all our insured members, risk-carriers, medical providers and insured
companies, therefore we have provided and established plan of action to solve, support and
follow-up health insurance parties by providing:

      A dedicated helpdesk operated 24x7x365 tailored and devoted to communicate with all
       health insurance parties that are qualified to solve any issues and/or enquiries raised by
       any parties instantly.
      A dedicated hotline and emergency for immediate plan of action whenever needed
       especially for inpatient cases and for all health insurance parties.
      A dedicated online information services categorized and developed for each health
       insurance parties’ needs through our URL [www.medexa.net].

We do care for our health insurance claim management and services quality for all parties,
while providing state-of-the-art technological and science services by providing:

      Free automated software’s that facilitates medical providers’ services.
      Accurate and prompt claims settlement and payments.
      Advanced and detailed statistical and MIS automated reports.
      Unparalleled and accurate automated claims management and auditing through a very
       advanced and sophisticated health insurance management system.

We do care for our risk carriers (insurance and self-funded), by constantly evolving our
knowledge in favor to provide distinguished health services and simplifies day-to-day routine
activities that positively reflected to all health insurance parties by providing:

      Customized communication mechanisms that suits the way they like it.
      Accurate and detailed implementation of issued policies whatever its rules.
      Consultancy and training for our clients’ staff, medical service providers, and our staff.




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Medexa periodically follow-up with insurance parties, either through direct telephone contact
or through site visits which assures the quality of services provided.

Medexa contribute and/or organize specialized seminars, conferences or participate as
lecturer which is valuable in terms of mutual cooperation, learning, expanding knowledge and
sharing expertise are important to develop the health insurance sector and staff.

Medexa arranged and/or participated in more than 20 health insurance seminars and
conferences worldwide, especially in the middle east region (Jordan, Syria, Saudi Arabia,
Oman, Egypt, Libya… etc.).

Medexa is first regional TPA implements the smart card technology and techniques in the
health insurance services.




Medexa is the first regional TPA adopts and implements unparalleled health insurance and
claim management system that implements business intelligence, WHO standard notations
and complies with the 21st century e-health demands.

Medexa business process uniquely automates hundreds of checking rules and conditions when
performing health insurance claims auditing and managements (such as medical factoid,
eligibility information, contracts rules and conditions… etc).




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                                            Online Technologies
                                            Innovation &Partners
Medexa always seeking for the best in their fields, where innovation, flexibility and
performance their targets, that’s why Medexa realized and established a strategic partnership
with CoreTech [www.coretechit.com], both teams have been able to produce a fully
automated health insurance and claim management system, that caters to all the industry’s
requirements.

Medexa is the first in the regions that implements comprehensive state-of-the-art
technologies through the Medex Management System which developed by Medexa and
CoreTech teams that specifically designed to:

       Contain all the notations of the World Health Organization (WHO).
       Shape customized pricing techniques based on different factors for each insurance
        party such as each medical provider, insurer, insured, medical procedure… etc.
       Simplify claims data entry from the point of receiving till the end of settlement cycle.
       Facilitates and customize the health insurance policies rules and conditions whatever
        the needs are.
       Incorporate business intelligence techniques, such as auto translation, identification,
        management… etc.

                                                          The solution tailored to facilitate
                                                          all health insurance management
                                                          aspects, rules and conditions that
                                                          are simply demonstrated to
                                                          facilitate business life cycle.




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                                                                      Smart Card Benefits
Medexa as technology passionate always implements the latest technologies. Medexa
provides its clients and health insurance parties with premier sophisticated and integrated
Internet-based services, combining electronic transactional techniques with a comprehensive
infrastructure that is specifically designed to facilitate our customers' needs in an efficient and
timely manner which allows instant:

          Electronic claim data and information transfer.
          Claim data checking, validation, and auditing.
          Data and information updates.
          Financial payments and settlements.
          Risk control and management.
          Secure online authentication.
          Statistical and aggregate MIS reports for health insurance parties, through Medexa’s
           URL [www.medexa.net].




     Computer
                                                                                  Internet




                               nection(s)
                Internet Con
                                            Firewall
     Computer
                                    ·   Automatic Claim validation, checking and response.
                                    ·   Adding and/or Modifying Subscribers.
                                    ·   Filing and logging transactions and system auto responses.

                                    ·   Manage TPA doctors monitoring & approvals.                                                     n
                                    ·                                                                                              tio
                                        Claims Sorting.                                                                   n   ec
                                    ·   Sending Manual Responses when required.                                    C   on
                                                                                                              et
                                                                                                        ern
                                                                                                     Int
     Computer


 ·   Login to dedicate interface, using secure
     authentication (Smart Card and/or User Name
     &password)
 ·   Filling Electronic claim data form                                                                                                    Database Server
 ·   Sorting Claims
                                                                       Medex Claim Management System
 ·   Confirming and Sending Claims
                                                                         & Other Application Servers




P a g e | 12                                                                                   Medexa| Company Profile
                                           Promise &Contacts
Medexa is the first and leader regional TPA Company uses the smart card technology in the
healthcare insurance sector, positioning Medexa regional TPA leader in the sector due to the
facts that smart card allows to instantly:

       Check and authenticate the patient eligibility information.
       Retrieves patient medical history when required.
       Assures no financial debits are logged on patient
       Validate and audit claim information such as medical procedures (HCPCS), ICD… etc.
       Improve the quality of medical care
       Reduces costs and administrative issues.
       Optimize claim management processes

Medexa realized that smart cards can provide clean data for eligibility verification and claims
processing. They not only can prevent administrative errors and streamline the payment
process; they also can prevent medical errors that arise when one practitioner doesn’t know
what another has been doing. In addition, test results conducted by one practitioner can be
available to all practitioners. Before prescribing a drug, a physician can review a patient’s
recent diagnoses, allergies, and prescription history and be aware of any over-the-counter
drugs that could conflict with the proposed course of treatment. In the long run, the data
carried by smart cards not only can prevent illness and save lives; they also can save the
healthcare industry billions of dollars.

Smart cards are among the few technologies that enhance both control and privacy, with
ability to disaggregate data and encrypt information to protect an individual’s right and
privacy.




P a g e | 13                                                Medexa| Company Profile
Medexa makes one simple promise, to provide our clients with unparalleled and unequalled
services in professional, timely and friendly environments.

Medexa’s teams and partners are dedicated to making Medexa and its services’ your first and
most preferred TPA Company worldwide as we also provides our customers tailored services
with a commitment and passion.

Thank you for choosing Medexa TPA, you can count on




                                                Headquarter
                                                Wadi Saqrah, Qaraman Building (7)
                                                Amman, Jordan
                                                Telephone: +962 6 552 9833
                                                Fax: +962 6 552 9835
                                                Email: tpa@medexa.net
                                                URL: www.medexa.net




P a g e | 14                                              Medexa| Company Profile

								
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