ENHANCED HEALTH PLANS, REDUCED COSTS
Marpai (Mar-pay) is a cutting-edge technology-powered TPA supporting employers with self-funded health plans. We strive to lower costs while providing better healthcare options for employees and their families. Experience the difference with Marpai and optimize your health plan offerings for a healthier and happier workforce.
EXCELLENCE IN TPA SERVICES
Marpai is your one-stop shop for best-in-class health plan administration that delivers the best value for your health plan dollar. We provide access to top provider networks nationwide and competitive discounts that translate into substantial savings. Our worry-free claims processing ensures seamless operations, while our proven cost containment strategies result in cost reductions. We also administer dental, vision, and COBRA benefits, and our in-house clinical team oversees chronic condition, acute care,
and utilization management.
PLAN ADMNISTRATION
Health, COBRA, Dental, Vision
Pharmacy Benefits Management
Compliance
Actionable Analysis
Plan Design
QUALITY CARE NATIONWIDE
Top Providers
Value-Based Care Network (Marpai Connect)
National Pharmacy Networks
In-house CM, UM, Acute and Chronic CM
Telehealth
PROVEN COST CONTAINMENT
Competitive Network Discounts
Out-of-Network Repricing
Pharmacy Cost Savings Program
Reference-Based Pricing
Captive Solutions
Subrogation
SMART Claims Processing
Value-Based Care (Marpai Connect)
Stop Loss Discounts
PROACTIVE MEMBER SERVICES
Gaps in Care Outreach
High Quality Provider Guidance
myMarpai Portal and App
myMarpai Shopping Tool
Top Rated Customer Service
Value-Based Care (Marpai Connect)
UNMATCHED SAVINGS
WITH TOP QUALITY NETWORKS
Discover top provider networks nationwide, featuring competitive discounts that lead to significant cost reductions. Our solutions include reference-based pricing and non-network options through direct contracting, ensuring unparalleled flexibility for your healthcare needs. Transitioning from full-ensured plans? You’ll be pleased to find savings of 40% or more with our network discounts. Embrace our top-notch networks, unlock big savings, and experience a transformative approach to healthcare. Trust in our commitment to quality and affordability for brighter financial future.
EFFECTIVE COST CONTAINMENT: SAVINGS AT EVERY TURN
Experience the power of our proven cost containment strategies, generating savings every step of the way. We proactively fill gaps in care and guide members to high-quality providers, preventing avoidable, overpriced, and excessive costs.
Our comprehensive approach includes competitive network discounts, out-of-network (OON) repricing, SMART claims processing, a Pharmacy Benefit Management (PBM) solution, Pharmacy Savings Program, captive solutions, and a value-based care network. Each element contributes to tremendous savings, ensuring your healthcare expenditures are optimized.
Trust in our proven cost containment measures to protect your bottom line and empower you with the financial stability you deserve. Experience the benefits of effective cost management and enjoy a healthier financial outlook.
EXCEPTIONAL SAVINGS ON OUT-OF-NETWORK CLAIMS
Unlock unbeatable savings of up to 60% on out-of-network (OON) claims with our end-to-end claims repricing solution. Our HIPAA-compliant platform is backed by the industry’s most comprehensive and up-to-date price reference database, ensuring accuracy and efficiency.
We provide in-house oversight and member support, including rapid resolution of claims. Our team expertly negotiates provider reimbursements and engages a supplemental provider network with pre-negotiated rates, further driving down costs.
Leveraging Medicare Plus and Cost Plus, our innovative approach ensures unsurpassed OON savings for you and your members. Experience the difference with our cost-effective solution and optimize your healthcare spending today.
SEAMLESS CLAIMS PROCESSING FOR PEACE OF MIND
With our worry-free claims processing, you can leave the complexities to us. Utilizing SMART automation, we carefully review high-cost codes and clinically assess high-dollar claims that may be excluded based on network contracts. This diligent approach ensures we capture savings opportunities with your claims.
We conduct additional pre-certification reviews on specific procedures and diagnosis codes, particularly for high-cost and complex cases. This process ensures the validity of each procedure, verifying it is not a plan exclusion, overpriced, or provided by a low-quality provider. With our comprehensive claims processing, you can have the confidence and peace of mind that your claims are handled with utmost precision and care.
MEMBER-CENTRIC APPROACH: TRUST. PROTECTION. EMPOWERMENT.
At Marpai, our members always come first. We prioritize building member trust every step of the way by protecting and empowering them throughout their health journey. We proactively send appointment reminders to prevent gaps in care, guide members to high-quality in-network providers, and engage at-risk members to enroll in proven clinical solutions from our value-based care network. With Marpai, we make it easy for members to embrace a healthier lifestyle and enjoy life to the fullest. Your well-being is our top priority.
EFFECTIVE IN-HOUSE CARE MANAGEMENT SAVES MONEY AND IMPROVE OUTCOMES
Our proactive, nurse-led, multi-disciplinary in-house care management team is committed to delivering exceptional results. With a consistent track record, we guide members 1:1 across the care continuum, ensuring they avoid unnecessary, overpriced, excessive, and inappropriate care. Count on our expertise in Utilization Management (UM), Case Management (CM), Acute Care Management, and Chronic Care Management services to make a positive impact on your healthcare outcomes. Learn more about our comprehensive care management services and experience the benefits firsthand.
CUTTING PHARMACY
COSTS WITH EASE
Pharmacy costs can be overwhelming and challenging to control. That’s why we introduce our member-centric pharmacy savings program, generating up to 75% in savings on specialty and high-cost medications. With our innovative approach, employers pay only a portion of the savings when they are generated. This seamless program integrates with Marpai Care Management, ensuring members receive the best healthcare journey possible. Available year-round and compatible with most PBMs, our program empowers you to save on pharmacy costs hassle-free.
MARPAI RX: YOUR
PBM FOR SAVINGS
MarpaiRx, our in-house Pharmacy Benefit Management (PBM) solution is designed to deliver substantial savings for you. Enjoy more than 25% savings on total pharmacy spend, with eligible rebates passed directly to employers and reduced member copays. With our straightforward approach, pay one flat fee and say goodbye to hidden costs. We outperform minimum guarantees, boast a network of 60,000 in-network pharmacies nationwide, and members can compare Rx discounts to find the lowest cost.
Experience the convenience of 12 pharmacy discount card reductions applied at the point of sale, ensuring immediate savings. Our in-house specialty and mail order pharmacy services add to the ease of access for members. Emphasizing affordability, we achieve an impressive 88.84% Generic Dispensing rate (GDR). Trust MarpaiRx for transparent, efficient, and cost-effective PBM solutions.
UNLOCK VALUE WITH
PROACTIVE VALUE-BASED CARE
Marpai Connect introduces an exclusive system that maximizes value through proactive, outcome-driven healthcare. By connecting costly at-risk members with proven clinical solutions under value-based care contracts, we ensure optimal health outcomes while driving costs down. Through proactive enrollment and engagement with our proven clinical health partners, Marpai Connect empowers a transformation in healthcare that benefits both members and the bottom line.
MARPAI VITALITY: SMALL EMPLOYER SOLUTION
The Marpai Vitality Plan sets itself apart from other self-funded insurance plans by catering exclusively to small employers with under 100 employee lives. With enhanced cost savings, user-friendly administration, quick implementation, and big-business benefits, it offers a comprehensive and holistic solution for small employers to elevate their health insurance strategy and promote the well-being of their workforce.
SIMPLIFY WITH myMARPAI: YOUR HEALTH PLAN APP
With myMarpai, managing your health plan becomes effortless. Our user-friendly portal and app allow members to access a digital health ID card, view benefits, track deductibles and spending, find providers, manage family care, review claims, and access Telehealth services, among other features. Available for both Apple and Android devices, myMarpai brings all your health plan needs to your fingertips. Experience the convenience and ease of myMarpai today.
MAESTRO HEALTH:ELEVATING THE MARPAI EXPERIENCE
Maestro Health is a Marpai brand, bringing with it a world-class health plan experience for members and significant savings for employers. As a Marpai brand, Maestro Health offers a dedicated member portal, providing seamless access to all the benefits of our comprehensive system. Explore the enhanced advantages and exceptional services that Maestro Health brings to the Marpai family. Together, we are committed to delivering unmatched value to our members and providers.
myMarpai Medical Shopping Tool
Make Informed Decisions: Stay Compliant with Confidence
With the myMarpai Medical Shopping Tool, members gain full price transparency on in-network medical services, empowering them to make smart choices. This essential service is required by the Transparency in Coverage Rule and No Surprises Act, Ensuring health plans remain compliant with current legislation. Rest easy knowing your plan is in line with the latest regulations while providing members with the information they need to take charge of their health.
TRUSTED GUARDIANS OF YOUR HEALTH PLAN AND MEMBERS
We are your reliable partner for seamless health plan administration and exceptional member care. With our dedication to empowering better health journeys, granting access to quality care, and containing plan costs, we ensure your members’ well-being while taking care of your bottom line. You can rest assured that we have you and your members under our wing, providing the care and support you deserve.