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Medical Insurance TPA

FAQs

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1. Who is FMC Network UAE?

FMC Network UAE is a leading Third Party Administrator (TPA) in UAE, who manages medical insurance claims on behalf of reputable insurance companies and clients who are self-insured.

2. What role does FMC Network Play?

FMC Network UAE ensures that insured members will be provided with  an affordable and efficient medical treatment when they visit healthcare facilities within the FMC Network. FMC Network will also ensure that reimbursement claims and payment to our healthcare provider partners are processes in a swift, fair, and professional manner.

3. What are the Network Types under FMC Network?

FMC Network has various Network programs to meet the financial and medical specialization needs of each employer and its employees. FMC Network currently has four main Network categories starting with the most comprehensive to the basic plan established by the Dubai Health Authority. These include, starting with the Network that is most inclusive:

  • FMC Gold Network.

  • FMC Premium Network.

  • FMC Standard Network.

  • FMC DHA Plus Network

  • FMC DHA Basic Network to meet the minimum requirements stipulated by the Dubai Health Authority.

4. How can I contact FMC Network?

You may contact FMC Network by phone;

  • For Existing Insured Members please call us Toll-Free at 800 3426.

  • For Medical Providers and Pre-Approval Requests, please call us at 04-3871 900.

  • For New Business Enrollment Requirements please call 04-3977841.

  • You may contact FMC Network E-Mail at customercare@fmchealthcare.ae

5. How do I use my FMC Network card?

Your employer and Insurance Company have chosen FMC Network to manage the medical claims of its employees (You). As an insured member, you will receive a medical insurance card co-branded with the FMC Network logo, which specifies the Network Type or category that you belong to. You may visit select medical facilities and access select pharmacies who are part of the Network to obtain the necessary medical care and treatment or purchase doctor-subscribed medication from a pharmacy affiliated with our network. Upon entering a healthcare facility / pharmacy within the network, please present your medical insurance card for validation by your hospital administrator or pharmacist prior to undergoing the necessary treatment.

6. What is a Deductible, Co-Payment and what does the term Out-Patient(OP)or In-Patient(IP) Printed on my medical insurance card mean?
  • Deductible is the fixed amount, which is required to be paid by the insured member on every out-patient (OP) / In-patient (IP) visit to a healthcare provider.

  • Co-payment is the percentage of total billed amount, which is required to be paid by the member for each in-patient (IP) and out-patient (OP) visit made to a healthcare provider.

7. Who are the available Healthcare providers and facilities under FMC Network?

Please visit our website https://www.fmcnetwork.net/provider-network or you can call our Customer Service Toll free no 800 3426 to check the Healthcare providers available near your area/location.

8. How can I check the benefit coverage and Pre-existing/chronic is covered in my medical insurance?

Please contact our Customer Care Department Toll-free at 800 3426 for details about your medical insurance benefits and pre-existing chronic coverage.

9. How can I complain about the services rendered by provider?

Kindly contact our 24/7 dedicated Customer Service in Toll Free No 800 3426 to provide your Complaints or mail to complaints@fmchealthcare.ae . Our Customer Service Executive will review and respond to your complaint as soon as possible.

10. What is pre approval & pre authorization and how do to get approved?
  • The Pre-approval is a process to get the official permission granted before initiating certain medical service from your insurer based on your Table of Benefits. Your health service provider takes the pre-approval.

  • The Pre-Authorization is a decision by your health insurer on specific healthcare services, treatment, and prescription for drugs before you receive them, which is medically necessary.

Kindly contact FMC Network pre approval department through online submission, by FAX – 04 3977842, 04 3977825 or email- approval@fmchealthcare.ae

11. How can I get a reimbursement form?

This form is available with your company’s Human Resources Department or from your Insurance Company (named on your medical insurance card).

12. How can I submit my reimbursement claims?

Kindly follow the steps below to complete your reimbursement claim:

  • At the time of treatment pay the bill and request an itemized invoice, which lists each detailed cost by individual service.
  • If the doctor has requested laboratory tests, x-rays, special tests or scans, obtain copies of the results and reports. Original valid prescriptions for medications are also needed.
  • For hospitalizations and same day procedures, please ask your doctor for a complete medical report, surgical report and discharge summary.
  • Official translation into English or Arabic is required for international claims.
  • Sign the declaration on the claim form and make sure you include your mobile number. Attach all original receipts of payments, invoices and other relevant documents.
  • Keep a copy of all documents for your record, which will help to check the status of the claims. 
  • Send a copy of the claim document in an envelope to the HR office in your company.
  • Reimbursement forms must be submitted within 60 days of the treatment date to be eligible for reimbursement.

Submit all original claims & relevant documents to the insurance companies within 60 days after the service date.

13. How can I get medical insurance for my Employees?

Please contact our Customer Care Department Toll-free at 800 3426 or 04-3977841 and we will guide you through this process.

14. How can I join FMC Network UAE?

Please contact our Healthcare Provider Network Department by Phone at 04 3871924 or email to uaenetwork@fmchealthcare.ae