24/7 Operations
Operated by qualified and well experienced personnel in the field of health insurance TPA services. Our customer services are available 24/7, responding immediately to all kind of inquiries from members and providers.
Case Management:
Well-qualified medical doctors act as “Case Managers”, monitoring the quality of deliverables by assuming full responsibility of a case from admission to discharge and intervene suitably to control unnecessary tests, medicines and malpractice.
Pre-authorization and post-audit: Our expert medical team consisting of Doctors, nurses, pharmacists and dentists is available 24/7 to assess, authorize and audit health care procedures to provide following services:
- Member admissions & Pre-authorization.
- Claims settlement, price discount negotiation, and best healthcare services resulting in controlled expenses and savings of medical costs.
- Medical counseling.
- Audit control and monitoring.
- Prompt settlement of reimbursement claims.
Personalized Client services:
Dedicated client servicing executives assist the members from admission through discharge thereby ensuring prompt delivery of services by the provider.
We facilitate to our members the access to health care by providing:
- Administration of the Insurance Policy and implementing related controls.
- Personalized membership cards.
- Direct Billing facility.
Through personal meetings, the client servicing team acquaints the members with coverage and other benefits relate to the insurance products.
Reporting:
We provide reports and analysis of utilization of medical procedures and resources. It assist efficiently in understanding expenses and savings related to necessary procedures as well as avoided extra costs or expenses.
Managed care Information System – the powerful and pragmatic software developed in-house, is a complete suite of products that automates all process among corporates, Network Providers, Insurance Company and TPA. Access to information and activities of all the parties can be readily access any time through the web. The software application installed at both the provider and WAPMED enables us to directly interact with providers through a remote access services. The in-house information system has enabled us to cut down the turnaround time (TAT) significantly in all our operations.
