Insurers & MGAs

A member is admitted in Munich at 2 a.m. Here's what happens next.

We act as your claims and medical team in Europe: guarantees of payment, case management and invoice auditing, under your authority and visible in MediClaim.

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One case, start to finish

Anna's knee surgery, from admission to audited invoice.

Anna holds an international health plan with one of our insurer clients. She lives in Dubai and injures her knee on a trip to Germany. This is how her claim runs.

A woman on crutches checking in at a clinic reception

1
Admission
The hospital calls us, not Anna.
Our team answers around the clock, checks her cover against your policy rules and issues a guarantee of payment. Anna pays nothing up front.
2
Before surgery
A doctor checks the plan.
One of our in-house doctors reviews the proposed surgery with the treating team before it happens, so it is medically justified and priced at usual and customary rates.
3
During the stay
Someone follows the case every day.
Our case manager stays in touch with the hospital and with Anna, and flags anything that would extend the stay or change the cost.
4
The invoice
Every line is checked.
Our medical coders audit the discharge bill against local UCR rates and the care actually given, and challenge duplicates, coding errors and charges that don't belong.
5
Settlement
You see the whole case in one place.
We settle with the hospital. The case notes, the audit and the corrections are in MediClaim, with the audit trail your auditors expect.