MAI has its own claims system developed in house which complies with legal requirements on data protection and business continuity. A dedicated team of engineers accommodates our clients’ requirements.
MAI performs the following claim administration functions :
- Evaluates medical necessity of services and uses second opinion when appropriate
- Adjudicates claims and pays them within 5 to 7 working days
- Reimburses in more than 130 currencies by bank transfer
- Emergency pre-certification services available 24/7 and 365 days/year
- MAI International Network provides wide access to health care facilities worldwide
- Members benefit from cashless services – Hospitals paid directly based on agreements
- Verifies and renegotiates invoices based on reasonable and customary basis
- Negotiates preferential rates with providers
- Performs statistical monitoring of claims and cost control recommendations
- MAI provides worldwide services regardless of location of member, language or nationality
- We speak many languages internally (English, French, Spanish, Russian, Japanese, Greek, Thai…)
- Our experienced administrators have strong technical and linguistic skills with each one having personally experienced what it means to be an expatriate
- Our IT tools developed internally permitting flexibility and maximum security
- Our Consulting Physicians have substantial international experience
At its clients’ request, MAI creates and maintains personalised white-labelled multilingual partner web sites for the following purposes :
For insured members :
- E-claiming, Pre-auth and GOP request services through mobile phone
- Secure access to personal claims and payment information
- Personal data
- Personalized insurance cards
- Personalized insurance certificates
- Useful forms and documents (claim forms, employee booklets)
- Access to policy wording
- Access to the list of insured persons (census)
- Consumption statistics
- Premium collection information
- Personalized insurance cards
- Personalized insurance certificates
- Useful forms and documents (claim forms, employee booklets)
For brokers and insurance companies :
- Access to the list of insured persons (census)
- Claims and payment information
- Consumption statistics
- Premium collection information
MAI is the claims administrator for 24.000 expatriate persons around the world.
We offer our customers access to a large number of medical providers throughout the world.
We are committed to settling invoices within a maximum of 10 working days and assisting our medical Providers in verifying the eligibility of our members in real-time, 24 hours a day to facilitate prompt payment
MAI has created unique software tools built to handle expatriate employee benefit programs :
- Online Enrolment Systems
- Online Billing Systems
- Online Claims Adjudication Systems
The online systems we provide are :
- Multi-currency
- Multilingual
- White-labeled
A dedicated team of engineers accommodates our clients’ requirements
The system complies with legal requirements on data protection and business continuity.
The information collected by ExpaTPA is saved in a database file in France. This treatment is necessary for the administration of health insurance contracts. It can be used to meet internal control obligations and within the framework of legal provisions concerning the fight against money laundering and the financing of terrorism.
The data collected will be communicated to the following recipients only: authorized staff of MAI, of the insurer of the contract, of service providers and other partners involved in the administration of the insurance contracts.
They are kept for the duration of your contract plus the time legally determined depending on the nature of the data.
In accordance with the French data protection law n° 78-17 of January 6 1978 as amended in 2004 and 2018 and to EU regulation 2016/679 of April 27th 2016, insured members can exercise their rights of interrogation, access, rectification, erasure, limitation, portability and opposition without charge, by sending an email to dpo@medical-administrators.com. To find out more about the administration of their personal data, they can consult their personal data policy on their personal online account.
The personal data of insured members, or that of other parties concerned by or benefiting from the contract, may be transferred outside the European Union if necessitated by the administration of their contract. The recipients or categories of recipients authorized to receive the data are the authorized staff of MAI, of the insurer of the contract, of service providers and other partners involved in the administration of the insurance contracts. These transfers are made according to the regulations relating to the protection of personal data applicable in the European Union.
Insured members may send a complaint:
- On the CNIL website by filling out the online form.
- By postal mail writing to CNIL – 3 Place de Fontenoy – TSA 80715 – 75334 PARIS CEDEX 07 FRANCE
- By email to dpo@expatpa.com