Why Choose MAKL?

1. Health Insurance Administration : MAKL offers end-to-end health insurance administration services, including policy management, claims processing, member enrollment, and premium collection. We work closely with insurance providers to streamline operations, reduce administrative burden, and enhance customer satisfaction.

2. Partnerships : We forge strategic partnerships with leading insurance companies, and healthcare organizations to leverage synergies and deliver innovative solutions. These collaborations enable us to incorporate cutting-edge technologies and stay at the forefront of healthcare administration.

3. Provider Network Management : We collaborate with healthcare providers to establish and manage robust networks of hospitals, clinics, and specialized medical practitioners. MAKL negotiates favorable contracts, conducts credentialing and quality assessments, and handles network performance monitoring to ensure optimal service delivery.
To enhance service delivery and ease of access, MAKL has accredited over 800+ healthcare providers across the country and within Eastern Africa. The provider network comprises of County and National Government, Faith based and Private health facilities.

4. Customer Support and Engagement : MAKL places great emphasis on providing exceptional customer support and engagement services. We have dedicated helplines, online portals, and mobile applications to assist members, healthcare providers, and insurance partners with inquiries, issue resolution, and information dissemination.
The below initiatives are what makes our contact center outstanding by having a real-time member engagement through:
  • Inbound and Outbound calls management.
  • Toll free numbers: Member are able to reach out through the toll-free number.
  • WalimuCare mobile application: members with smart-phone can be able to monitor their benefit and track utilization through the mobile app.
  • SMS prompts for members seeking services: members receive real-time SMS prompt when a request has been processed through the PSMS system giving instant feedback to the member.
  • Automated call backs for admitted clients. Members receiving services under inpatient care receives automated calls on their treatment progress.
  • Feedback prompts from members seeking services: Members receives SMS prompts to rate services of the medical service provider as well as rating their experience.
  • Dedicated and real-time interactive social media platforms. -with active member presence on Facebook, Instagram, Twitter and WhatsApp account.
  • Routine customer satisfaction surveys

5. Claims Management : We offer robust health information management solutions, including electronic medical record (EMR) systems, data analytics, and secure health information exchange. Our technology platform enables healthcare providers to store, access, and analyze patient data efficiently, leading to improved decision-making and better patient outcomes
MAKL manages medical schemes on a paperless mode through an online Medical Claims Management System for preauthorization, claiming and payment of claims. The web-based Patient Service Management System is used for:
  • Verification of the member through use of the members’ fingerprints
  • Medical scheme benefits cover verification before servicing
  • Capture of medical expenses incurred
  • Submission of claims
  • Reconciliation of the accounts and payment
  • Submission of necessary supporting documents such as APDK Disability Card, Proof of Schooling, Claim and Preauth forms.

6. Compassionate and professional medical team : Our expert team efficiently handles claims processing and adjudication, ensuring accuracy, transparency, and timely approvals. We utilize advanced technologies and stringent quality controls to minimize errors and streamline the claims settlement process
Our culture is key and our team is paramount to creating it. Our team is made up of innovative and imaginative employees that work together to break the mold. We also know that happy employees translate to happy client.
For efficiency and optimization of productivity, the team is grouped according to the below departments:
(i) Outpatient team
They handle outpatient, optical dental and maternity. They do online approval of preauthorization requests sent from these departments and also issue offline approval via email where there is a system challenge.
(ii) Inpatient team
They issue preauthorization approval for medical and surgical cases for patient seeking hospitalization. The team is further grouped into:
  • Admission Team - handling admission requests and providing adequate response in line with the request.
  • Discharge team – they handle the request to discharge patient who are on discharge.
  • Extension team - Handling request for patients still admitted and require further treatment.
  • Escalation team - Handling all enquiries requests coming through emails and coordinating timely response.

7. Quality Assurance : At MAKL, we are committed to maintaining the highest standards of quality in all our services. We adhere to internationally recognized healthcare regulations and industry best practices. Our team undergoes continuous training and professional development to stay updated with the latest advancements in healthcare administration