Claim Management Service

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Claim Management Service

Our comprehensive Third Party Administrator (TPA) services include efficient and accurate claim management. Our professional team of doctors, nurses, and expert staff ensures adherence to adjudication standards and reasonable settlements. Here’s how we handle claims:
Claim Adjudication and Settlement
We meticulously review and assess medical claims based on the terms and conditions of coverage providers. Our system manages data entry for insured members. We detect anomalies in claim data and verify eligibility to prevent fraud. Both paper and electronic paperwork are efficiently managed.
Cashless Hospitalization Service
Eligibility verification before hospitalization allows insured members to enjoy cashless services without upfront payments.
Hospital Network Management and Expansion
Our nationwide network of high-standard hospitals ensures comprehensive coverage. Regular TPA system training enhances convenience and customer satisfaction.
Hospital Direct Payment
We provide direct settlement to hospitals, improving efficiency and reducing processing costs for insurers.
24/7 Call Center Assistance
Our experienced team coordinates among insured individuals, hospitals, and insurers. We promptly address inquiries, coverage conditions, and complaints.
Data Analytics and Report Service
Timely and accurate data acquisition supports informed decision-making. We prioritize information security while providing necessary data access.
Employee Benefit Management
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