Project Description

Medical Health Insurance Program

To structure a health benefit for the staff and their dependants and to negotiate for the best rate for the program.  It includes Outpatient and Hospitalisation Care. We will share with you the best practices in the market that will suit your organisation.

Group Term Life and Personal Accident lnsurance Program

Group Term Life Insurance which covers employees for Death, Critical Illness, Accident and Total or Partial Disability, is a lump sum cash benefit. Proceeds are payable tax-free to the insured individual. Critical Illness insurance can assist the patient and their family with some of the extraordinary costs of  facing a critical illness, and how the proceeds are used is completely up to the individual. They may choose to use it on experimental drug treatments, uncovered provincial diagnostic tests, home / work modifications (wheelchair ramps etc.), nursing care, debt/ mortgage repayment or perhaps towards a family holiday.

We take the time to understand the full scope of our clients’ needs and goals. This time invested up front allows us to focus on innovative and cost effective solutions, saving our client’s critical time and resources.

We firmly believe that our success and growth is a result of our people, integrity and relationships with both clients and providers.

Claims Management

  • Companies which do not have a panel of contracted clinics usually allow their employees to seek treatments from any clinics of their choice. Employees have to seek reimbursement from their companies by submitting their receipts. Larger companies which opted for such scheme usually impose co-payment features or cap a limit for each consultation for cash reimbursements. These companies may be able to control some cost by putting a cap to the amount which can be reimbursed but the employees are at risk of being over charged by the providers and have to bear the entire amount which exceeded the limit set by the employers.
  • This type of arrangement is not effective in cost control since it involves vast amount of admin works in cash reimbursements. There is also no prior negotiation on charges with the doctors who provide the services. However companies which allow employees to have a free choice of doctors to visit can manage the amount of admin works and reduce the cost of administration in the reimbursement process by using the Claims Management Portal.
  • The Claims Management Portal allows employees to submit their claims online through individual password log in. This self help method helps to eliminate the data entry processes involved in reimbursement of claims. Alternatively companies can opt to engage us as the Third Party Administrator to key in the claims made by the individual employees.
  • We have simplified the medical benefit process by making cashless consultations available at a network of clinics in Malaysia. With us, you control your company’s benefit costs because doctors’ fees are managed at the point of transaction. Doctor’s fees are made transparent because billings are based on pre-agreed fee schedules and drug formulary. All transactions are captured online through Electronic Health card and made available to you through Claims Management Portal.

Through Claims Management Portal, you can access your network of clinics without having to manage individual providers. The system eliminates the tedious reimbursement process and manual tracking of medical benefit use. The system allows you to:

  • Track and manage cost
  • Update policies and coverage
  • Monitor use of employee benefits
  • View reports and trends such as doctor hopping and much more
  • Clinics can log into the system and complete various tasks such as:
  • Verify members
  • Check on benefit entitlement and other necessary items.
  • Your employees can also log in to view records of expenditures and visits.

Reports

As a value added service, we can generate a corporate profile with “easy to understand” graphical charts. You’ll be able to view reports on

  • Disease patterns
    • Expenditures by diagnoses
    • Profiles of diagnoses by age group or gender
    • Claims by clinics or individuals
    • Reports of individuals with high frequency of visits
    • Medical leave use and more

And now your company can take charge of its medical expenses while eliminating administrative hassles involved with managing benefits, when you experience the convenience provided.