TPAs

Consultations, Project Implementation, Trainings & Workshops

  • Develop a Vision & Mission Statement
  • Generate marketing & Business opportunities for subsidiary verticals basis market needs
  • Review operations processes, identify gaps and process re-engineering for robustness
  • Time Management
  • Stress Management & Stress busters
  • Systems review, identify gaps and systems upgrading/modifications for robustness
  • Data Analytics using MS Excel and Analytics software such as SAP, SSPS etc.
  • Anti-Fraud measures, develop EWS (Early Warning Signals), Red Flags & Training team with case studies from the industry
  • Train team on medical matters and treatment protocols to identify deviations from standard treatment, up coding and cross coding
  • Review empanelment and negotiate package rates with hospitals
  • Time & Motion Studies to improve performance with Performance management
  • Benchmarking standards with industry
  • Dispute resolution on claims payments amounts and claim decisions
  • Hospital Audits & Billing system ¬†review
  • Specific Bill Review
  • Fraud Prevention, Detection & Mitigation
  • Tailor-made need based services