Medical Insurance Platform · Healthcare · Malawi

Medical Aide Society of Malawi. A modern insurance platform for a national medical scheme.

The Medical Aide Society of Malawi (MASAM) is one of Malawi's largest medical aid schemes, providing health insurance coverage to thousands of members across the public and private sector. Arton Technologies designed and developed the full medical insurance administration platform — covering member enrolment, employer group management, claims submission and adjudication, provider network management, and financial reporting.

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Member & group administration Claims submission & adjudication Provider network portal Financial reporting & reconciliation

Medical insurance administration — healthcare platform Malawi

Client

Medical Aide Society of Malawi (MASAM)

Arton's Role

Platform design & development

Country

Malawi

Platform

Medical insurance administration system

The challenge

Manual processes were strangling a scheme that needed to grow.

Before the Arton platform, MASAM operated on a combination of spreadsheets, manual claim forms and siloed ledgers. Claims took weeks to process. Employer group administrators had no visibility into their member rosters without calling the office. Providers submitted claims on paper and followed up by phone to chase payment status.

The challenge was to build a platform capable of handling MASAM's full operating model — from new-member onboarding to claims adjudication and provider payment — while being accessible across Malawi's infrastructure realities: variable connectivity, a mix of device capabilities, and a user base that ranged from HR administrators at large employers to rural clinic reception staff.

Arton designed and developed the platform from the ground up, building for offline-tolerant operation, mobile-first workflows, and an integration layer capable of connecting to external laboratory and hospital systems as the network matured.

What we built

A full insurance administration platform in four modules.

Member & Group Administration

Employer group setup, principal member enrolment, dependent management, benefit plan assignment, and membership card generation. Self-service employer portal for HR administrators to manage their group without calling MASAM.

Claims Submission & Adjudication

Provider-facing claims portal for electronic submission. Rules-based adjudication engine checking eligibility, benefit limits, exclusions and tariff schedules. Exception queue for manual review. Full audit trail from submission to payment.

Provider Network Management

Provider registration and credentialling, tariff schedule management, preferred provider designation, and provider performance reporting. Provider portal for real-time claim status and payment tracking.

Finance & Reporting

Premium collection tracking, claims payments run, employer statement generation, reserve reporting, and regulatory returns. Executive dashboards for scheme directors covering claims ratios, membership trends and financial position.