MCI CARE

The health partner that cares about you

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WHO ARE WE ?

Created in 2013, MCI Care aims to offer policyholders easy access to quality care, while ensuring control of health expenditure for insurers.

Easy access

via direct billing makes it possible to access healthcare without advancing payment (only the co-payment is payable by the insured party).

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Our business line

MCI Care manages the benefits of health insurance contracts on behalf of the guarantors "insurance companies, compulsory health insurance schemes, mutuals, direct customers". As such, MCI Care handles both the processing of policyholder reimbursement files in the event of an advance of costs by the policyholder, as well as access to third-party payment care from providers in its contracted care network.

    • • Control the costs of health expenditure.
    • • Provide visibility and levers to anticipate risk.
    • • Organize periodic monitoring committees on the evolution of the plan.
    • • Provide reliable, analyzed and commented statistical reports.
    • • Facilitate access to care.
    • • Guarantee quality medical care in a dedicated care network.
    • • Reimburse as soon as possible when the insured chooses to use a different network.
    • • Contract health providers.
    • • Monitor network activity and quality.
    • • Control, liquidate and settle the bills of care providers in record time.
    • • Raise awareness of good practice through periodic meetings.
    • • Set management objectives and performance indicators to enforce.
    • • Call center, to respond to any type of request and need from our customers.
    • • Mobile app.
    • • Web portal.
    • • TPA: Management of health products on behalf of Insurance Companies, Processing and settlement of all types of healthcare files (Group/ Individual/ Complementary), Direct management of Health files for customers.
    • • Quotation, Advice: Actuarial studies, data analysis and Pricing, Claims audit and advice on cost control.
    • • Tailor-made projects: Implementation of call center solutions, personalized support programs for policyholders with ALD in the process of access to care and monitoring of therapies.
 

Key figures

4 countries

A presence in 4 countries (Morocco, Angola, Cameroon, Zambia).

74 employees

MCI CARE is a dynamic and innovative company, made up of 74 employees who are passionate about their work and determined to provide exceptional service to their customers.

120,000 people protected

MCI CARE is proud to protect more than 120,000 people worldwide through its health, safety, environment and project management solutions.

3254 care providers

A network of more than 3,254 healthcare providers in our countries of presence, as well as a network of 1,500 providers internationally.

DIRECT SETTLEMENT

Service provision

Third-party payment allows easy access to quality care at the best value for money. It is an innovative service that provides policyholders with a personalized and individual access card to care. Thanks to his personal care card, the insured person benefits from care within the network of MCI Care health providers and only pays the moderating ticket which corresponds to the share of the health costs remaining to be borne by him and will not have any file to be compiled. Through this scheme, policyholders benefit from :

• ACCESS TO A NETWORK OF HEALTH PROVIDERS, ACCEPTING THIRD-PARTY PAYMENT.
• COVERAGE WITHOUT THE OBLIGATION TO ADVANCE ALL THE COSTS RELATING TO THE SERVICE.
• A SIMPLIFICATION OF THE PROCEDURE SINCE NO REIMBURSEMENT FILE IS REQUIRED.
• MANAGEMENT OF THE NETWORK OF CARE PROVIDERS THROUGH THE MCI CARE PLATFORM OFFERING HEALTH MANAGEMENT SOLUTIONS AND AUTOMATED SERVICES WITH HIGH ADDED VALUE.

Our care network

FREQUENTLY ASKED QUESTIONS

  • Third-party payment exempts you from having to fully advance your health costs: you do not pay the amount covered by your medical coverage. The healthcare professional is paid directly by MCI Care. On presentation of your care card to a health professional approved by MCI Care, you only pay the amount that is not covered by your insurer: the co-payment. For example, if you have 80% coverage, you will only have to pay the healthcare provider 20%. MCI Care will pay the care provider 80%. Thereafter, you have no formalities to complete: you no longer submit a file for reimbursement.

  • The care card is individual. The head of the family, the spouse and his children each have their card. On this map are:

    • • The surname & first name of its holder
    • • The birth date
    • • The MCI CARE identifier (unique for each insured)
    • • The photo (in the case of a child under 5 years old)

  • You present your care card to the contracted healthcare professional :

    • • A control of the opening of your rights is carried out by the service provider by connecting to the MCI Care portal.
    • • If your rights are open, you then have access to the consultation. At the end of the consultation, the medical assistant gives you your invoice which includes the amount of the procedures performed. On this invoice you will be shown the amount of the co-payment.

  • On presentation of the prescription drawn up by the prescribing doctor of the network to one of the approved pharmacies :

    • • The pharmacist accesses the portal and enters the medication records online. After validation by the system, the medications are delivered.
    • • You pay the amount indicated on the invoice given by the pharmacist and corresponding to the co-payment.

  • On presentation of your card and the prescription issued by the prescribing doctor to one of the contracted laboratories or radiologists :

    • • Your rights are checked by reading your card.
    • • If your rights are open, you have access to the exams.
    • • You pay the amount indicated on the invoice given by the care provider and corresponding to the moderating ticket.
    • • Exams not supported or excluded by your contract are not supported.

  • Third-party payment is not mandatory. You can consult the doctor of your choice. But in this case, you will have to pay the healthcare provider yourself and then request reimbursement of your costs within the limits of the guarantees provided for in the contract.

  • Dependents of the employee and having the same level of coverage can access third-party payment. This access is valid as long as the head of the family is employed in his company.

    As the care card is strictly personal, each member of the family must provide the essential data for its preparation. Children under the age of 5 will be exempt from fingerprinting and will be identified on their card with their photo.

    The collection of data essential to the preparation of your care card is carried out either during a session organized by your Human Resources Department for all employees, or at your initiative in the premises of MCI Care.


    Your card will be issued to you by your employer against the signing of a discharge and confirming your agreement for the use of your personal data by MCI Care.

  • Salaried couples declared as such benefit from 100% coverage.


    However, the care card only covers the cost of each spouse up to 80%. The remaining 20% must be paid to the healthcare professional during his treatment. You can then ask MCI Care for a refund of the 20% paid by completing a refund request file.

  • MCI Care's care network can be viewed on our website.

    The evolution of the network will take into account the needs expressed and the results obtained by the analysis of the most consulted healthcare providers. The latter will be offered to integrate the network under the conditions defined by our specifications.

  • Third-party payment does not work :

    • • When consulting a non-contracted care professional.
    • • For all treatments not reimbursed by the Insurer (medicines not reimbursed, contractual exclusions, etc.).
    • • When medical coverage, even temporary, is suspended by the Insurer.

  • MCI Care and its teams will be happy to answer any questions or requests, do not hesitate to visit our website, or call our call center.

Contact

For more information, contact us.

Adresse

Belas Business Park, edificio Malange, 6 andar

Center

00244226425562