Interhealth Egypt is bringing into the Egyptian Market an international standard of excellence which is already appreciated by a number of International insurance companies, International Assistance companies, International TPS’s and individual corporations,
In a short period of time, Interhealth Egypt is rated as one of leading TPA’s in Egypt, with an excellent track record with its clients, as well as providers.
These services are available to health insurance companies; local or international, as well as large corporate groups wishing to provide medical services for their staff on a self insured basis.
Interhealth Egypt has the infrastructure in place to provide these services at a professional level.
Interhealth Egypt has one of the largest service provider networks in place covering the whole of Egypt, where Interhealth Egypt already has contractual arrangements in place.
Included in the fully functional Third Party Administration services that are being offered, some of the specialist services are Medical Case Management and the management of Self Insured Funds Management.
The fully comprehensive Third Party Administration services that are being offered are backed by market leading computer systems, as well as highly skilled medical staff managing all the claims.
The computer system allows for internationally recognised medical claims management reporting, allowing our clients to manage their membership portfolios efficiently.
The main operational services are:
Health care services
Cost Containment Services
Health care services:
Administration of Medical Insurance Products.
Management of medical and healthcare budgets.
Development of Health Maintenance Organisations (HMO).
Local Medical Assistance Services.
International Medical Assistance Services through our branches .
Providing medical discount cards.
Cost Containment Services:
• Preferential Contracts with hospitals & clinics.
• Agreement of the package deals.
• Monitoring & approval of treatments.
• Regular visits to nominated hospitals to monitor standards & patient care.
• Direct billing from nominated providers.
• Scrutiny of accounts to ensure that only agreed treatment is paid.
• Account auditing to ensure charges are in accordance with agreed prices.
• Administrative system "analysis and design.”
• Printing of personal data on medical ID card.
• Detailed statistical reports.
• 24/7 “CALL CENTER" for assistance and support.
• Distribution of claims payment to medical services providers as well as insured.
Our I T activities include applications for:
- Insurance Companies.
- Medical healthcare providers.
- Medical Third Party Administrators.
- Healthcare consultancy firms
Healthcare fund management
* SAMPLE OF MANAGEMENT REPORTS PROVIDED TO THE
INSURANCE COMPANY (FOR EACH POLICY )
- NUMBER OF INSURED PERSONS AT EXPIRY
- NUMBER OF INSURED PERSONS AT INCEPTION
- NUMBER OF ACTIVE INSURED PERSONS AT ANY ONE PERIOD OF TIME
- DELETIONS WITHIN THE PERIOD ADDITIONS WITHIN THE PERIOD
- DISTRIBUTION OF CLAIMS BY NUMBER OF INSURED, CLAIMANTS AND CLAIMS
-DISTRIBUTION OF CLAIMS BY TOTAL COST OF CLAIMS
- IN /OUT MEDICAL SERVICES PROFILE
- PROVIDERS PROFILE
- MAJOR SERVICES PROFILE
- ENROLLEES SPECIFIC-CLAIMS PROFILE
- ABUSES BY ENROLLEES
- ABUSES BY PROVIDERS
Data System management
• Administrative system analysis and design.
• Supply of medical ID card.
• Regular portfolio reviews & management reports.
• Detailed statistics.
We offer services to different types of firms and institutions.
Our primary services can be categorized as follows:
• Program monitoring and updating
• Progress chasing of "routine" claims and amendments
• Periodic market reports
• Statistical and performance analysis embodied in client management reports.
• Exposure analysis
• Discussion of requirements
•Monitoring and approval of services.