Frequently asked questions

General

Email csmanagers@marpaihealth.com or call 855-389-7330 and one of our customer service representatives will be happy to assist you.

Visit myMarpai.com, which is a portal designed to answer questions quickly for members, providers, brokers, and employers. You can also email csmanagers@marpaihealth.com or call 855-389-7330 and one of our customer service representatives will be happy to assist you.

You can visit myMarpai.com or simply email or call us, and one of our customer service representatives will be happy to assist you. Please email csmanagers@marpaihealth.com or call 855-389-7330.

Marpai provides access to world-class national provider networks so employers can deliver unmatched quality, flexibility, and value for each member.

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The SMART system is responsive to the unique needs of members, providers, practitioners, and employers. It delivers a personalized experience that streamlines processes, eliminates inefficiencies, and delivers 24/7 service so everyone can easily get what they need, when they need it.

The FutureSight Advantage provides our members with actionable insights that may help reduce or even prevent future health issues, with an emphasis on possible chronic illnesses and major procedures. We analyze a large amount of data, including demographic information, claim information, and social determinants of health in order to provide you with these important alerts. The FutureSight Advantage is designed to help you get ahead of your health.

TopCare Providers is an exclusive Marpai feature that connects health plan members with the top 10% of in-network providers, including health practitioners, retail health centers, telehealth providers, labs, and more. It ensures you receive the right care, at the right time, and from the most qualified practitioner. Although it may seem counterintuitive, research shows that seeing a top-quality provider actually reduces healthcare costs and saves you money. The ratings are provided by a reputable research company, Quantros, which generates quarterly risk-adjusted, peer-reviewed ratings based on provider quality, safety, and patient satisfaction.

Marpai Care Guides are medically-trained experts in care areas such as diabetes, cancer, general health, pediatrics, and orthopedics. They provide the decision support you need to map the best journey across the care continuum. When things get complicated, they are there to help. In addition to support during your care journey, our Care Guides also monitor care transitions and post-discharge information across providers.

No, never. All of your information is protected by law. The U.S. protects your privacy with HIPAA, the Health Insurance Portability and Accountability Act of 1996. We are compliant and operate fully under HIPAA-mandated guidelines.  We do not share, reveal, or distribute any of your personal health information to anyone, including your employer.

Employers

Traditional TPAs focus almost exclusively on uncovering savings through reviewing claims that are of high cost, out of the PPO network, or for specific procedure and diagnosis codes. They often only operate on a post-adjudication basis. Marpai goes further to save money in four ways. First, Marpai’s SMART system empowers members to act in ways that lead to improved outcomes and lower costs. The FutureSight Advantage helps members prevent and reduce costly chronic illness and major procedures, while TopCare Guides members to visit the top 10% of providers based on quality. Second, the Marpai system predicts future health costs and events across the employee population, which helps employers intervene early to reduce stop-loss premiums and lasers. Third, with SMART automation, the system rigorously reads claims data with deep granularity to root out fraud, abuse, and excess, and flags problem centers with cost transparency to help uncover further savings.

Marpai takes the mystery and surprise out of self-funding by providing cost and event predictions that enable employers to anticipate future costs. Although Marpai cannot predict sudden events, our claims-based predictions are able to identify expected financial demands, which allows companies to better finance those needs.

Marpai is the only health plan administrator that uses Deep Learning to drive greater plan ROI on multiple levels. Not only does Marpai act as a SMART gatekeeper and adjudicator of eligible claims, we also employ the most advanced AI to map the future health of each plan member. Only Marpai analyzes pre-adjudicated claims data and uses its “early detection” findings to proactively alert members to take preventative action. This unique use of AI enables proactive rather than reactive member behavior, which can avert and reduce costly chronic diseases like diabetes and COPD, as well as major procedures like knee replacements.

Marpai is working on detecting over 50 diseases, including many major diseases like COPD, cardiovascular disease, diabetes, and kidney disease. Our algorithms also help to reduce or eliminate the need for high-cost orthopedic procedures such as joint surgery and knee replacement. No other health plan administration company has this capability or offers this breadth of predictive detection.

The SMART system delivers a proactive health experience that seamlessly becomes part of our members’ everyday lives. With the SMART app and our contact system, we take care of members by providing friendly nudges, alerts, and reminders that keep them on track and encourage healthy activity.

No. Marpai is not Alexa. It uses Deep Learning, the most advanced artificial intelligence, to conquer the complexities of the healthcare system that stand in the way of better outcomes and lower costs. Deep Learning is necessary to glean valuable insights from vast amounts of data, which in turn enables our members to lead healthier lives and lower their costs. The data collected across the SMART system is embedded into AI models and used to further improve plan design, member empowerment, proactive health guidance, care quality, and cost reductions. Member data is not shared with anyone, not even employers, and is protected by encryption.

Marpai’s SMART system is in operation across a sample of its client base today, and we aim to make it universal for all clients by January 1 enrollments. This means all features, including TopCare Providers, the FutureSight Advantage, the SMART app, Care Guides and SMART end-to-end automation (including claims adjudication) will be activated for all clients so they can reduce costs, improve outcomes and deliver a simple but positive experience.

Marpai develops and owns its SMART technology. Marpai Labs, the Marpai R&D center, developed, built, and maintains the proprietary Marpai technology and continues to pioneer it. At Marpai Labs, world-renowned Deep Learning scientists work alongside healthcare providers to build algorithms that make a difference. All technology remains exclusive to Marpai Health.

Extremely. It is an intuitive and responsive system that collects data, learns, and adapts in order to deliver a personalized, proactive experience. It tackles complexity to deliver a simple but positive experience, and anticipates needs so that all Marpai members can get ahead of their health. By using friendly nudges, alerts, and reminders, it reaches out to keep members on track with their health.

Brokers & Consultants

TPAs focus almost exclusively on uncovering savings through reviewing claims that are of high cost, out of the PPO network, or for specific procedure and diagnosis codes. They often only operate on a post-adjudication basis. Marpai goes further to save money in three ways. First, Marpai’s SMART system empowers members to act in ways that lead to improved outcomes and lower costs. The FutureSight Advantage helps members prevent and reduce costly chronic illness and major procedures, while TopCare Providers guides members to visit the top 10% of providers based on quality. Second, the Marpai system predicts future health costs and events across the employee population, which helps employers intervene early to reduce stop-loss premiums and lasers. Third, with SMART automation, the system rigorously reads claims data with deep granularity to root out fraud, abuse, and excess, and flags problem centers with cost transparency to help uncover further savings.

Marpai is the only health plan administrator that uses Deep Learning to drive greater plan ROI on multiple levels. Not only does Marpai act as a SMART gatekeeper and adjudicator of eligible claims, we also employ the most advanced AI to map the future health of each plan member. Only Marpai analyzes pre-adjudicated claims data and uses its “early detection” findings to proactively alert members to take preventative action. This unique use of AI enables proactive rather than reactive member behavior, which can avert and reduce costly chronic diseases like diabetes and COPD, as well as major procedures like knee replacements.

Marpai is working on detecting over 50 diseases, including many major diseases like COPD, cardiovascular disease, diabetes, and kidney disease. Our algorithms also help to reduce or eliminate the need for high-cost orthopedic procedures such as joint surgery and knee replacement. No other health plan administration company has this capability or offers this breadth of detection.

No. Marpai is not Alexa. It uses Deep Learning, the most advanced artificial intelligence, to conquer the complexities of the healthcare system that stand in the way of better outcomes and lower costs. Deep Learning is necessary to glean valuable insights from vast amounts of data, which in turn enables our members to lead healthier lives and lower their costs. The data collected across the SMART system is loaded into AI models and used to further improve plan design, member empowerment, proactive health guidance, care quality, and cost reductions. Member data is not shared with anyone, not even employers, and is protected by encryption.

Marpai’s SMART system is in operation across a sample of its client base today, and we aim to make it universal for all clients by January 1 enrollments. This means all features, including TopCare Providers, the FutureSight Advantage, the SMART app, Care Guides and SMART end-to-end automation (including claims adjudication) will be activated for all clients so they can reduce costs, improve outcomes and deliver a simple but positive experience.

Marpai develops and owns its SMART technology. Marpai Labs, the Marpai R&D center, developed, built, and maintains the proprietary Marpai technology and continues to pioneer it. At Marpai Labs, world-renowned Deep Learning scientists work alongside healthcare providers to build algorithms that make a difference. All technology remains exclusive to Marpai Health.

Extremely. It is an intuitive and responsive system that collects data, learns, and adapts in order to deliver a personalized, proactive experience. It tackles complexity to deliver a simple but positive experience, and anticipates needs so that all Marpai members can get ahead of their health. By using friendly nudges, alerts, and reminders, it reaches out to keep members on track with their health.

Providers

Marpai’s SMART claims adjudication process uses AI to detect and correct errors across all our claims data. This approach allows us to rapidly process claims so providers get paid without the administrative headache. Marpai is 100% digital, so claims are submitted electronically at myMarpai.com with a unique Marpai EDI code and are rapidly processed in the SMART system.

Marpai provides multiple channels of communication on the myMarpai.com provider portal. Marpai will soon be rolling out a 24/7 SMART service so providers can ask questions and get answers any time of day.

Unlike a traditional TPA or payor, Marpai partners with providers to drive their businesses forward in the new world of consumer-driven healthcare. Marpai operates a SMART Health Plan Services System that delivers multiple levels of tech-enabled benefits, including services that meet new patient demands for cost savings, convenience, data, and control. The SMART system, rolling out this year, also radically reduces the administrative work associated with each patient, as everything is digital, including the health ID cards and claims submissions. Further, Marpai encourages members to visit providers, facilitates appointments, and provides friendly appointment reminders, all of which increase volume. Supporting the growth of providers is part of how we achieve our mission of saving lives, improving lives, and radically reducing healthcare costs.

Marpai is the only health plan administrator that uses Deep Learning to drive greater plan ROI on multiple levels. Not only does Marpai act as a SMART gatekeeper and adjudicator of eligible claims, we also employ the most advanced AI to map the future health of each health plan member. Only Marpai analyzes pre-adjudicated claims data and uses its “early detection” findings to proactively alert members to take preventative action. This unique use of AI enables proactive rather than reactive member behavior which can avert and reduce costly chronic diseases like diabetes and COPD, as well as major procedures like knee replacements.

Marpai is working on detecting over 50 major diseases, including many major diseases like COPD, cardiovascular disease, diabetes, and kidney disease. Our algorithms also help to reduce or eliminate the need for high-cost orthopedic procedures such as joint surgery and knee replacement. No other health plan administration company has this capability or offers this breadth of detection.

The SMART system delivers a proactive health experience that seamlessly becomes part of our members’ everyday lives With the SMART app and our contact system, we take care of members by providing friendly nudges, alerts, and reminders that keep them on track and encourage healthy activity.

No. Marpai is not Alexa. It uses Deep Learning, the most advanced artificial intelligence, to conquer the complexities of the healthcare system that stand in the way of better outcomes and lower costs. Deep Learning is necessary to glean valuable insights from vast amounts of data, which in turn enables our members to lead healthier lives and lower their costs. The data collected across the SMART system is downloaded into AI models and used to further improve plan design, member empowerment, proactive health guidance, care quality, and cost reductions. Member data is not shared with anyone, not even employers, and is protected by encryption.

Marpai’s SMART system is in operation across a sample of its client base today, and we aim to make it universal for all clients by January 1 enrollments. This means all features including TopCare Providers, the FutureSight Advantage, the SMART app, Care Guides and SMART end-to-end automation (including claims adjudication) will be activated for all clients so they can reduce costs, improve outcomes and deliver a simple but positive experience.

Marpai develops and owns its SMART technology. Marpai Labs, the Marpai R&D center, developed, built, and maintains the proprietary Marpai technology and continues to pioneer it. At Marpai Labs, world-renowned Deep Learning scientists work alongside healthcare providers to build algorithms that make a difference. All technology remains exclusive to Marpai Health.

Extremely. It is an intuitive and responsive system that collects data, learns, and adapts in order to deliver a personalized, proactive experience. It tackles complexity to deliver a simple but positive experience, and anticipates needs so all Marpai members can get ahead of their health. By using friendly nudges, alerts, and reminders, it reaches out to keep members on track with their health.