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EnglishTPA
(THIRD PARTY
ADMINISTRATOR)
CLAIMS ADMINISTRATOR
We offer the complete services of our service centers for the external administrator (TPA) modality. Likewise, we focus on reducing risk through cost containment, repricing, and direct negotiations with suppliers. We have important alliances forged with the main HMOs, PPOs, and agreements with providers worldwide. This translates into preferential prices and savings opportunities.
We are registered and approved as Delegated Claims Administrator ('DCA') of Lloyd's of London
Risk Reduction
Immediate intervention to reduce risk exposure, through cost containment, repricing, and negotiations with suppliers, according to our volumes.
Risk Management and Auditing
Our case management department is focused on risk management and auditing. It is dedicated to the review and orientation of the services provided by our team made up of doctors, nurses, and specialized personnel.
Case Management
Systematic monitoring of each incoming case and throughout the process. Online reports with service and satisfaction indicators.
Contact Center
We offer our multinational and multilingual Contact Center, a place where customer calls are sent in a personalized way.
Its CONTACT CENTER manages all queries, orders and claims from users 24/7, through all means of communication.
Evaluation & Control
98% of our cases are coordinated directly with our own providers without intermediaries
Quality control performed to 100% of the services, through monitoring each customer.
Constant providers evaluations to offer the best service.
Daily quality control of 25% of our calls, including each of the coordinators, this allow us to improve our team constantly.
97% of calls are answered within 6 seconds by people and not machines, and abandoned calls are below 1.4%.
SPECIALIZED IN COST CONTAINMENT
SOFT SAVINGS
We analyze and review the provision of the different services to avoid additional treatments and costs. We achieve this after triaging the patients and thus providing optimal care at the lowest cost.
HARD SAVINGS
After the provision of the service, we proceed to manage direct negotiations with suppliers. This translates into greater opportunities for savings, discounts and preferential prices.
CUSTOM CASE MANAGEMENT PROGRAMS
The client can propose care to control and reduce costs in care and health management. This translates into a better quality of life for the patient.
Accompaniment in the development processes of the local health system.
The coordination and control for the reduction of costs are in charge of nurses and doctors, specialists of the health administration.
White Label
Our value proposition
We have tools for the development of our own brand, which enables customers to have an issuance system. With it they will be able to manage their agents and their sales more efficiently.
Claims Coverage
Personalized quoting and issuance platform
Multilingual Contact Center
Case management and control
Marketing, advertising and technology solutions
Access to our Global Provider Network
