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Few Words About Us
Insurance is right for you and your treatment is our duty.
WHO WE ARE?
Medical Insurance Specialist [MIS] is a medical insurance and specialist administration company, offering services as a third party administrator (TPA) for medical and health care administration. MIS was established in February of 2005 by a group of health care professionals and doctors.
Its’ main objective as a TPA is to administer health insurance policies and co-operative self-funded health insurance plans for the private and public sectors in the Republic of Yemen
Health Insurance and (TPA)
The company does this through insurance and TPA programs that do the following:
• Reducing or removing the administrative burden on senior management bodies in determining eligibility and priority of those receiving medical services.
• Providing medical reports for each Subscribe with the financial cost for him, and providing a permanent central file for each patient.
• The use of modern technologies in managing medical expenses according to the various contractual terms, and preventing any violations so that claims are examined before they occur to be subjected to the terms of the contract and making decisions automatically using the appropriate communication mechanism:
o Availability of limits or ceilings for benefits (wages – recipes – services) to create self-censorship.
o Agreement with service providers on specific costs for procedures, medicines, supplies, and others.
Regulating the treatment mechanism inside and outside the hospitals:
• Matching the procedure with the physician’s specialization, and matching the procedure with another procedure, and observing the period from one procedure to another (repeating the procedures).
• Matching the procedure with the diagnosis, then matching them all with the dispensed medicine while observing the amount of procedures with the status of the disease.
• Conformity of medical procedure with age and gender.
• Monitor the doctor’s right to perform, check, or dispense a specific drug.
• Monitor the average days of stay and the average cost per case.
• The company has the right to see the patient’s file.
• Apply a mechanism that leads service providers to bear any increases in treatments
Regulating the medicine dispensing mechanism:
• Monitor the compatibility of the drug with sex and age.
• Monitoring the periods between drugs (repeated dispensing of drugs).
• Monitor the compatibility of the drug with other drugs.
• Monitor the prices and quantities of prescribed medications.
• Determining the price, the insurance company incurs for each drug scientific name.
Competitive Advantages
The name of MIS is known as the pioneer name in the health insurance industry, this put the company in the lead of market competitors, and as well as a high performer reference and as a focal point for the industry in Yemen.
As the leading Yemen’s company specialized in medical insurance, MIS has strictly focused on medical service, medical expenses management for our subscribers, training, and consultancy for medical providers as Hence, we have contributed to improving the performance of medical service providers. Our specialization and devotion to this type of insurance has made us establish an Information and Support Center (around the clock), to answer inquiries of service providers and thousands of subscribers by our excellent staff who received exceptional in-home and abroad training. We also train personnel of medical institutions and insurance companies, researchers and whoever interested in this field. Our training is offered through MIS Training Center that is registered at the Ministry of Technical Education and Vocational Training, and has had a great role in qualifying staff specialized in medical insurance at all insurance companies and institutions.
Our high professionalism enables us to provide the best and most suitable medical service under well-advised technical controls and at the lowest possible cost. Thus, our offers are competitive and suitable to affordability of firms seeking medical insurance for their staff along with their dependents, away from competition based on low rates for the purpose of merely gaining new contracts at the expense of services’ quality
In addition to introducing the medical insurance for the first time in Yemen and developing the general features of relations between the insured and medical service providers, we exclusively have a 15 years accumulated diverse practices and expertise in medical insurance provision.
Our relations have over years been deeply established with medical service providers in different conditions, furthering our firmness at the market and constancy in providing our subscribers with nonstop services. Although companies specialized in medical insurance had been established locally and regionally, but they had not last for long
Research and development (R&D) aims at obtaining new knowledge that it might be used to improve current and/or create new technology, products, services, or systems that it will either be used or sold. The goal is to take new products and services to market and add to the company’s bottom line. Research is usually basic or applied. Both types of research helps in acquiring new knowledge, the basic research is initiated without a specific application or use in mind, while applied research is done with a specific goal, use, or product in mind.
In a global industrial landscape that is changing fast, firms must continually revise their design and range of products. This is necessary as well due to the fierce competition and the evolving preferences of consumers putting their needs first. In general, it has been found that there is a positive correlation between the R&D and firm productivity across all sectors, but that this positive correlation is much stronger in high-tech firms than in low-tech firms.
Instead of outsourcing R&D to an external specialist or a university, MIS is doing it internally to tap into its own innovations. Accordingly, MIS seizes every opportunity to modernize its systems, mechanisms and procedures, so (thanks to Allah, for the efforts of its staff and cooperation of its customers) it has become the first, most important and largest company active in medical insurance in Yemen, and still striving to stay a head of and on top of its competition.
Our medical network is a qualitative network that has been carefully selected; any service provider found to be failure, cheater or incapable will be excluded. Monitoring and follow-up approach is constantly adopted to ensure that the best and most cost-effective health services available are provided.
MIS is determined to enhance insurance awareness in the community. It carried out educational, training and awareness activities through the MIS medical insurance consultation and training center, and issued a medical insurance magazine. It has also contributed to community awareness through the company’s website and Facebook page, as well as sponsoring seminars and related events.
It is a matter of great pride for MIS that its founder is Dr. Adel Ahmed Al-Emad, who has bear the responsibility of introducing this insurance activity in Yemen. As a university professor in health economy and health management, he has begun to include (for the first time) medical insurance education as part of the curriculum for students of medicine, pharmacy and laboratories at Sana’a University. During the past years, he has successfully prepared staff of high-level performance to participate effectively in the company’s management beside him.