We put members first
Our system is predictive and proactive allowing us to be protective of members and their risks. With proactive targeted interventions, proactive outreach to fill gaps in care, pharmacy advocacy, care management and guidance to high value in-network providers, we help members reduce excessive, avoidable, overpriced and inappropriate care.
We provide standard TPA services including access to top provider networks (e.g., Aetna, Cigna), RBP solutions, claims processing, plan design, captive solutions, cost containment, compliance and actionable analytics. However, for the same standard TPA fee, we go further. We leverage our AI-powered platform to extract savings across the system and maximize health outcomes for the member population.
Our technology makes the difference
Our predictive AI models and technology platform drive member actions to support greater outcomes and lower costs. We identify at-risk members and proactively intervene with a meaningful clinical solution and/or care management. We proactively reach out to members to fill gaps in care for annual visits. We use cost, quality and outcome data to guide members to choose high-value in-network providers and avoid overpriced, low-quality care.
Discover more by watching our team talk about Marpai technology.
“I think using AI and predictive analytics to identify health issues early and mitigate developing conditions finally has its moment in the health care industry. It will change lives and save a lot of money without cost-shifting to members.”
Vincent Kane, Health Care Actuary and Industry Expert
Personal Health GPS
The myMarpai app is a personal health GPS guiding members on the best health journey. They can show a digital health ID card, view benefits, track spending and deductibles, see claims, find a provider, access telehealth, manage family care and more. New features and MarpaiRx to be added in 2023!
Nothing is possible without member trust. We protect and guide members every step of the way with tools, information, proven clinical health solutions (vetted by our clinicians and data scientists) and direct support for navigating the complex healthcare and pharmacy landscape. Members quickly learn they can rely on Marpai for the best health journey.
“Most TPAs just focus on paying claims. Marpai is organized around the member and brings the advanced technology this sector needs to improve member health and reduce claims costs as a result. AI with a member-centric approach is a real game changer.”
Ed Ligonde, Executive Vice President of the Nielsen Benefits Group
Savings and performance
We cost efficiently maximize member population health with unsurpassed cost containment including OON repricing, RBP and captive solutions. We extract savings in claims processing with clinical reviews of claims and pre-certifications, and expert review of complex claims and high-cost codes. Our pharmacy advocacy program generates up to 75% in savings on specialty drugs.
“There is so much waste, abuse, fraud and neglect… people don’t care about your client’s claims dollars… but the difference is Marpai does care.”
Adam Russo, Founder and CEO of The Phia Group
Maximize Pharmacy Value
Our MarpaiRx PBM solution and our PACCS pharmacy savings program work together to bring pharmacy costs down. MarpaiRx can deliver a 25%+ savings on pharmacy spend, gives deep drug discounts to members and passes eligible rebates to employers. Separately, our PACCS (Pharmacy Advocacy Cost Containment Solution) works in conjunction with any PBM to deliver up to 75% savings on specialty drugs and high-cost medications. Discover more by watching our CEO and pharmacy expert discuss PACCS.
In-house clinical care management
Our seasoned, nurse-led clinical care team supports members across the care continuum so they avoid costly mis-steps, excessive care and stay on the best journey. The team proactively reaches out to at-risk members and works with them to set up an action plan for healthy outcomes. Discover more by watching our CEO and Clinical Care Management leader discuss care management services.
Clinical care ecosystem
We are building an ecosystem of proven clinical health solutions – clinical programs vetted by our clinicians and data scientists and supported by valid outcome and quality data. We connect at-risk members to these vendors for meaningful interventions that support positive outcomes. We are working toward value-based care contracts to deliver maximum value.
“We feel like we’re partners with Marpai more than we have with any other TPA or carrier we’ve ever had. Truthfully, that is a pretty huge compliment from us.”
Marnie Zimmerman, Healthcare Benefit Consultant at Ward-Kraft, Inc.
Forward thinking clients
Marpai is rapidly growing and looking for more employers committed to helping their health plan members live better through better health.
Best in class TPA partner
Marpai brings top talent with decades of experience in claims processing, provider networks, pharmacy, plan design, compliance, analytics, and strategic account management. You’ll get actionable analytics, fully compliant plans and a true partner in delivering maximum value for your clients.
A+ Stop Loss Solutions
How About a 20% Reduction in Stop Loss Premiums?
Marpai provides competitive quotes on Stop Loss solutions with A+ carriers including customized and Specialty RBP quotes. Marpai is developing captive solutions and ways to better manage large claim risk and improve loss ratio performance.