Safeway Medi Claim & Card Status Track

Organization : Safeway TPA Services
Service Name : Know Your Claim & Card Status

Claim Status : http://www.safewaytpa.in/claimstatus.aspx
Card Status: http://www.safewaytpa.in/frmcardstatus.aspx

Know Your Claim Status :

Enter the UHID, Policy Number or Claim ID & Submit.

Related :  Paramount TPA Policy & Claim Status : www.statusin.in/18708.html

Know Your Card Status :
Select or Enter the Corporate Name & Insured Name.

Claims Management :
** Our claims management software is the heart of our claims control and underwriting profitability system. Our well trained claims processors and supervising medical professionals review incoming claims from hospitals and individuals. For hospitalizations pre-authorization is required to determine eligibility of coverage and the reasonableness of planned treatment and expenses.

** No pre-authorization is required for the insured who is taking treatment in Non Network Hospitals but incoming claims are reviewed and entered into the claims software systems database using standard ICN-10 codes identifying diagnosis and treatment. Claims are adjudicated and an Explanation of Benefits (EOB) sent to the client explaining the payment or denial of benefits. Payments are made to the individual or hospital on behalf of the underwriter.

** Data entered into the claims management software system then become a very valuable database which our actuaries can manipulate to detect trends, either positive or negative in a timely fashion so that hospital providers who are overcharging or over utilizing through unnecessary tests and procedures can be identified at an early date and corrective action taken.

** It similarly allows us to track which Corporate Groups are over utilizing benefits so that HR departments can be involved at an early stage to discourage employees from abusing their benefits and head off the necessity of high premium increases. This is highly appreciated by corporate clients and underwriters.

Role of TPA:
** TPAs are essentially insurance intermediaries, which undertake the entire administration of health plans for insurance companies. Apart from settling claims, TPAs also process business, offer customer service and technical support. The idea behind hiring TPAs is to reduce the high claim ratios by eliminating fraud cases.

** While TPAs’ network with hospitals and interaction with doctors is expected to reduce claims substantially, insurers also wish to improve customer relationship through their TPAs. The entry of TPAs would also mean cashless health care delivery to policy holders, along with trauma support and other advisory services.

** A cashless scheme under a TPA is a customized health insurance scheme generally devised as a Group Health insurance scheme and put in place by a Third Party Administrator ( TPA ). Here when the insured is hospitalized he/she need not pay for Medical Expenses incurred are settled by the TPA directly with the concerned medical institution as per the terms and conditions of the health insurance package.

** This is quite unlike the original TPA policy, which was basically a reimbursement scheme where the insured, when hospitalized, pays the medical institution, submits the claim to the insurance company and gets reimbursed as per the terms and conditions of the policy.