East Legon - Greater Accra
Product Details
Third Party Administration Services
We leverage on our expertise to provide Third Party Administration to Large organization who opt for this service. Under the TPA Scheme, the clients sublet all their medical administration services to us, such as the Management of a network of approved service providers; Provision and management of membership identity cards; Claims adjudication and administration; Eligibility of healthcare beneficiaries, Medical benefit limits, Medical policy exclusions, etc. Other services we provide our TPA include ;
- Providing third party administration (TPA) to clients who have their own panel of clinics and hospitals.
- Helping corporate institution to negotiate service charges and cost of drugs from health service providers.
- Cosmopolitan Health Insurance comprehensively study’s the contract that governs the health service relationship between corporate institution and the health service providers and provides advice.
- With this agreement all claims shall be submitted to Cosmopolitan Health Insurance for vetting by Cosmopolitan Health Insurance Medical Director. Afterwards vetted claims will be submitted to corporate institution for payment to health service providers.
- An alternative payment option is for client to make a down payment against which vetted claims will be drawn.
- Cosmopolitan has a team of doctors who will vet all claims on time for onward payment.
- Cosmopolitan will go to the extra mile of coming over to client’s office to register the entire staff members.
