CLAIM MANAGEMENT

We are a leading TPA Service Solution provider and our outstanding services include the following.

 

1. Claim Adjudication and Settlement

We provide total solutions for claim management to comply with the adjudication standard and reasonable settlement under each insurance policy with our professional team of doctors, nurses, and expert staff to manage the services as follows.

  • Managing system and data entry of the insured members
  • Reviewing and assessing medical claims based on the terms and conditions of the coverage providers
  • Detecting abnormality of claim data and eligibility for fraud verification
  • Managing paperwork both on paper and in electronic form

 

2. Cashless Hospitalization Service

We provide our system for eligibility verification before hospitalization for our network hospital to let the eligible insured member use the cashless service with no need of cash advance.

3. Hospital Network Management and Expansion

Our network hospital coverage is nationwide with high standard and quality services. We expand our network every year with TPA eligibility verification system provided. We also conduct TPA system training regularly to enhance the convenience and increase the satisfaction of the insured, including strengthening the confidence in our services to our customers.

4. Hospital Direct Payment

We provide direct settlement to all hospitals to improve efficiency and reduce payment processing cost of insurers.

5. Call Center 24/7

We offer assistance through our call center to coordinate among the insured, hospitals, and insurers. We also respond to inquiries i.e. coverage conditions, suggestion and complaint from the insured with our experienced team to provide highly satisfied services to customers 24/7.

6. Data Analytics and Report Service

The fast and precise data acquisition will help a company to analyze a situation and tendency timely and accurately. We provide our customers necessary data access with convenience and agility for both system input and data analytics under our highest information security standard.

 

 


For more information of our service, please contact Marketing Department
Tel: 02-660-1277 or 02-660-1234 Ext.3209
Email: tpainfo@thaireservices.com
line@ : @tpainfo