EGYMED was established as an Egyptian joint stock company. Its board of directors consists of a distinguished group of experiences that gathered together to serve the purpose for which this company was established, which is to provide health care to its clients, including individuals, groups, and companies, by providing the necessary technical and medical administrative support for the success of managing such a quality of Health care, and the formation of this company completely coincides with its goal and the purpose of its establishment, as it collects these experiences from many fields, including insurance, medical and financial fields.
Dr / Hatem El Gamal
EGYMED, a company that operates a global system for managing medical treatment systems, is honored through one of the company's programs developed by a group of experts in the field of health care and a group of doctors with great experience in this field and a group of accountants and financial analysts have developed these programs specifically to suit The need of companies and organizations in the Egyptian market for their members to obtain the highest level of medical service at the lowest costs and to provide a high-end service that reaches every subscriber through a distinguished medical network and through a distinguished program based on a database and information that serves the purpose for which this company was established.
The program provides periodic and accurate follow-up to the management of health care contracts. It is also possible to extrapolate the future costs that will be contracted, as well as follow up the cost of each individual at any time, as well as follow up the ceilings of coverage. And disbursement of claims and compensation within the health care contract program with successful and accurate follow-up because the success of claims management, compensation, and risk management reflects the success of managing health care contracts.
● The company provides service and medical care to a wide range of government, media, educational, hotel, tourism, banking, educational, medical, petroleum and investment sectors.
● The company is distinguished by the continuity of medical care contracts with its clients in terms of a common desire of the company and the client for the annual renewal of medical care contracts, which reflects the customer’s satisfaction with the level of service provided by the company.
● The company's system aims to link health with production by providing the best advanced medical care through an integrated medical network consisting of a selection of the best hospitals, specialized medical centers, medical laboratories, specialized radiology centers and an elite of consultants in various branches of medicine in addition to an automatic group of pharmacies Selected.
From the above, it is clear that our company understands the details of managing health care contracts by facilitating the administrations and details of this process and providing a distinguished medical service to each client according to the desires of each client, which is in line with our general policy and preserving our credibility with our customers.
The customer for Egymed is the main goal. We can take care of our clients and provide the highest level of medical services.
We respect service providers as well as our customers. Therefore, our clients will be one of the EGYMED family, through which they can build their needs to reach the highest level of integrated medical services.
EGYMED has the honor to offer you one of the modern global systems for managing health care programs through one of the company's programs developed by a group of foreign experts specializing in the field of health care and a group of doctors with great experience in this field and a group of accountants and financial analysts. These programs are specially designed to suit the needs of companies and bodies in the Egyptian market for their members to obtain the highest level of medical service at the lowest costs and through a distinguished medical network spread throughout the Republic, and this is through the following:
The company manages the medical treatment system for the companies contracting with it after setting up a medical system for each company separately, in proportion to the requirements of each company in the program for treating its employees, and the company manages the process for the benefit of you.
● The system aims to link health with production by providing the best advanced medical care through an integrated medical network consisting of a selected group of the best hospitals, specialized medical centers, medical laboratories, specialized radiology centers and a group of consultants in various branches of medicine in addition to a group of selected pharmacies With the benefit of the discount rates contracted from these authorities.
● EGYMED company appoints a general practitioner for your esteemed company upon request, who is a private doctor to treat your workers at your company’s headquarters and provides many services.
Primary care physician (general practitioner) services:
Initial examination of the employees.
Examining patients and giving the necessary treatment for the cases presented to him.
Transfer to consultants and medical examination centers (x-rays - laboratories ... etc.).
Making medical files for patients from among the employees.
Transfer to hospitals within the medical network.
Follow-up of hospital admissions to ensure the quality of the medical service provided to the employees and to check on their condition.
Follow up the implementation of medical quality standards.
Ensuring the speedy performance of medical service and resolving any complaints.
● EGYMED company creates a medical card for every individual included in the medical program, and he will benefit from the medical services provided through the Egymed company, and this medical card is personal that contains a picture of the individual, the name of the company that belongs to it and the date of validity of this card and through which he can deal with all affiliated medical service providers Aegemed company and receive medical service without any hindrance.
Providing 24/7 Call Center service through the number (15132) in order to obtain the required medical approvals by telephone, and all services and approvals can be obtained through the Mobile Application and Approval system in order to facilitate the service for the customer
● This system supports a set of integrated computer programs through which we can provide you with detailed financial statistics and periodic reports that clearly show the amounts spent on each worker separately in pharmacies, outpatient clinics, laboratories, X-rays, various medical examinations, hospitals, glasses. Teeth, pregnancy and childbirth.
We explain to you the detailed reports of the computer group that we can print and send to you through a special program, as follows: -
First: Reports of the Issuance Department: -
Pricing medical treatment programs according to the required coverage for each document separately.
Information about the company covered within the medical program.
Information about the ages of the beneficiaries of the service.
Information about the cost per person within the medical program.
Information on the conditions of each policy in terms of the general coverage ceiling and the sub-coverage ceiling for each medical service.
Information about all medical service providers, the prices they deal with and the discount rate.
Information about the document’s start, end, prices, and renewal date.
- Information about each disease is covered.
Information about the deductible percentages and discount rates granted.
Information on coverage of chronic diseases and pre-contracted diseases.
Information about any financial download for any individual benefiting from the service within the medical program.
Second: Reports of the Claims and Compensation Section:
Date of claim.
The date the claim was entered on the computer.
Expected claims value.
The value of the invoice submitted by each service provider.
The value of the invoice that was approved by our company for disbursement.
- The value of what was consumed by each individual in the general financial ceiling and in the ceiling of all medical coverage.
The rate of recovery for each compensation.
Details of bills submitted by hospitals, laboratories and radiology centers.
- The value of each compensation approved for disbursement for the service in which it was used.
Third: Periodic Reports:
Reports on service providers.
Reports of claims for each individual benefiting from the medical service separately.
- Periodic medical reports showing a picture of the performance of your employees in terms of the medical history of each worker, explaining the diseases that the worker contracted during the year, and whether they are acute diseases or chronic diseases that impede him from performing his work in a good manner as well as the number of times visiting the medical clinic and the sick leave granted to the worker And a list of workers ill and who are using the service provided in a poor way.
Detailed financial reports on all medical service providers in the various branches of medicine.
- Compensation report and detailed claims explaining (the company name and number - the date of the start and end date of the document - the expected compensation value - the compensation value provided - the serial number of each compensation - the type of service provided - the name of the medical cover - the type of visit - the type of disease - the compensation details in hospitals, laboratories and centers Radiology).
A report on medical program risk management for each operation separately, indicating:
(Average numbers - the total net premium - the number of total compensation - the number of expected total compensation - the total value of all compensation - the expected value of all compensations - the average compensation - the percentage of loss per company).
-Reports on the dates of installments for each document separately, what was paid out of it, and the rest.
When adopting the modern and developing approach to health care contracts at the present time, it must take into account that health care companies must introduce new advanced services, take more commitments and pledges, and accept financial risks related to health care contracts. Therefore, modern medical treatment programs must face the following:
1- Problem of claims and compensation:
Where the subscriber receives effective medical services and pays the financial cost of these services and then completes a complex set of administrative and routine procedures, forms and papers, then the insurance companies refund his payment, which forces him to wait for long periods of time that may reach months to recover the compensation owed to him, and this is no longer acceptable to the customer. We organize and plan to pay cash to medical service providers for medical services provided to the subscriber, which saves with him a lot of anxiety, distrust, effort and time for the customer.
2- Immediate follow-up of medical services:
Modern medical programs must, at the present time, provide immediate, direct and accurate follow-up of the quality and quantity of medical services provided to the insured by all medical service providers.
3- The difference and multiplicity of health care programs:
In the context of the changing needs of each group, it is difficult to impose a medical program or even specific medical programs with fixed insurance coverage on clients.
4- Risk pricing for healthcare contracts:
When pricing risks for health care contracts, the pricing must be commensurate with the financial, economic and social conditions of each group separately. Market conditions cannot be applied to another market as a fixed case, meaning that each case has its own circumstances.
5- Compensation follow-up:
The compensation in the field of health care contracts is compensation from the first day of the implementation of the contract and the health care companies must have accurate technical and financial follow-up for each compensation separately and effectively.
Deputy General Manage