For insurers, TPAs and self-funded employers
MedCover runs your health portfolio end to end — enrolment, pre-authorisation, claims, settlement and reporting — with ten automated checks on every claim and a benefit ledger that never pays the same limit twice.
10
automated checks
run on every claim before review
12
ready-made reports
including loss ratio and PMPM
3
decimal places
the dinar kept to the fils
2
equal languages
Arabic and English on every screen
01 Claim journey
Each step has an owner and a permission — and nobody approves what they entered.
Step 1 of 5 01
Shows a digital card; cover is confirmed in seconds.
Step 2 of 5 02
Submits the claim through the portal or your team.
Step 3 of 5 03
Ten checks run and the amount is reserved.
Step 4 of 5 04
A medical reviewer approves or rejects with a coded reason.
Step 5 of 5 05
Finance batches approved claims and pays by transfer.
02 Product
Four places where health portfolios usually leak — and how MedCover closes each one.
Fig. 2.1 Claims
Ten rules run the moment a claim is entered, so your medical team reviews exceptions instead of re-checking everything.
Fig. 2.2 Pre-authorisation
Calls, provider-portal requests and referrals land in one queue, ordered by how soon each answer is due.
Fig. 2.3 Reporting
From loss ratio on earned premium to cost per member per month — in Arabic or English, exported to Excel or PDF.
03 Benefits
Balances are a record of movements, not a number someone edits. Every reservation, payment and reversal has a source you can open.
| Movement | Source | Amount |
|---|---|---|
| Annual limit | PLAN · OUTPATIENT | 1,000.000 |
| Reserved for a claim under review | CLM-2026-0412 | −170.000 |
| Paid to the provider | CLM-2026-0389 | −380.000 |
| Released — approval expired unused | AUTH-2026-0051 | +95.500 |
| Available now | 545.500 JOD | |
04 Portals
Your team, your provider network and your members each see exactly what they work on.
05 Languages
Not a translation layer: every screen, report, letter and message is written for both languages. Switch the card and watch it follow — while the amounts stay put.
Your Arabic-speaking reviewers and English-speaking finance team work in the same system, on the same records.
06 Security
Personal health data is protected on the server, not just hidden in the interface.
Seven roles and more than sixty action-level permissions. Each person sees and does only what their job needs.
Whoever enters a claim cannot approve it, and whoever approves it clinically cannot pay it.
Every change to a policy, plan, balance or decision is kept with who made it and what it was before.
Encrypted connections only, protected sign-in and rate limits on every public form.
Deploy on your servers or a cloud region you choose. No health data is sent to third parties.
Daily backups and periodic restore drills — because a backup nobody has restored is not a backup.
07 Questions
Yes. Migration starts with a data-quality report that shows every conflict before a single record moves, then runs in stages with balances and open claims reconciled at each step.
Built in. Screens, reports, letters and search were designed for Arabic from the start — including spelling variants in names — and English has the same depth.
On your servers or in a cloud region you choose, including in-country. MedCover does not depend on a particular provider and sends no health data to third parties.
Every screen follows the same pattern, and refusal messages say what is wrong and what to do next. Typical training is two days for administrators and half a day for each other role.
Reference data imports and exports through Excel templates, an API serves eligibility checks, and medical codes keep their coding system (ICD-10, ATC, the Jordanian tariff) so they remain exchangeable.
By number of members and the modules you enable. Request a demo and we will send written pricing after a short call to agree on size and scope.