WHAT IS THIRD PARTY ADMINISTRATION AT FULLERTON HEALTH?

“Our third-party administrator and administration-only service helps clients manage insurance and benefits claims”

With our third-party administrator/administration-only service, we can assist insurance companies and corporate human resource departments in bridging their policyholders’ or employees’ claims with our nationwide and regional medical care providers. As such, we cooperate with more than 1,400 health providers in Indonesia alone. This service includes authorization management, case management, claim management, utilization review management, and membership data management.

Our backend system is supported by a 24/7 call center that is managed by doctors and medical professionals. In addition, by leveraging Microsoft cloud technology we are able to seamlessly provide a cashless and reimbursement claims process. Data analytics also allow us to present more than 20 utilization reports and mean we can contain costs and provide appropriate medical check-ups for members. In addition, a suite of mobile apps helps policyholders to call emergency contacts, check benefits, or to find health facilities.

Third Party Administration Process
null
Patients may visit one of Fullerton’s fully-owned medical facilities or go to any of the medical providers in our panel network.
null
Patients will be verified either through our EDC network or mobile app to enjoy cashless service.
null
(For hospitalisation cases)
Upon entering our FH Case Management process, our healthcare professionals determine and approve on behalf of our corporate clients’ behalf an Admission Letter of Guarantee to the hospitals.

Our healthcare professionals work with our network of medical providers round the clock to make sure that patients are well cared for and are able to be discharged upon recovery. They also work with hospital providers to make sure the bills are accurate for timely discharge of patients.

RANGE OF SERVICE

WITHIN TPA

  • Risk Management

  • Provider Management

  • Case Management

  • Utilization Reviews

  • Suspect Investigations

  • Limit Management as per policy designs

  • Statistical Reports

  • Monthly Report

  • 24-Hour Call Center

  • Claims Assessment/Risk Management/Case Management

  • Payment services

  • Access to our cashless network of providers

  • Statistical Reports

  • 1500+ Providers service

RANGE OF SERVICE WITHIN TPA

  • Risk Management
  • Provider Management

  • Case Management

  • Utilization Reviews
  • Suspect Investigations
  • Limit Management as per policy designs
  • Statistical Reports
  • Monthly Report
  • 24-Hour Call Center
  • Claims Assessment/Risk Management/Case Management
  • Payment services
  • Access to our cashless network of providers
  • Statistical Reports
  • 1500+ Providers service

Fullerton Mobile Apps

Fullerton mobile apps is a smartphone application with a wide range of comprehensive
feature for your health.

Why Us

PROVIDER NETWORK OF

MORE THAN 1.500 PROVIDERS