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Our Services

Managing Benefit Options

We manage the registration and parameterization of the various products offered by the medical aid plans and the entities that own the medical and medication care systems under our administration.

Credit
Control

We have an internal credit control team especially dedicated to ensure that contractual terms with clients are met, especially with regard to the issue of financial liabilities to the plan.

Subscription Management

We have technological tools that allow both the direct registration of members and dependents, as well as the remote and centralized management of this process, depending on the parameters determined for this purpose. The process is done at three levels (member, client and Affinity).

Renovation Management

Coordinate and manage the processes of renewal of benefits each year, according to the benefit cycle of each health plan.

Management of medical care costs payments

Through means and partnerships integrated in the process, we have mechanisms that facilitate the payment of medical care costs of our clients inside and outside the network of contracted providers, providing convenience and maintaining relationships with providers. We have means of payment that facilitate the payment of medical expenses in real time inside or outside the network.

Relationship management with providers

In addition to the day-to-day management of the relationship with providers, including but not limited to reconciliation processes, management of daily work protocols for member service, we also organize lectures, trainings and workshops aimed at the different types of contracted providers.

Emergency Services

We activate means of evacuation and transport in cases of emergency that need specialized means for this purpose. We assure specialized personnel and means for emergency response within high standards of care.

Emergency services provide:

  • Special means of evacuation;
  • Qualified and specialized personnel;
  • Response 24/2

Logistics

We support the members under our administration in organizing and coordinating all the resources necessary to guarantee medical assistance outside their place of origin. This support includes:

  • Booking trips;
  • Obtaining travel visas;
  • Organization of flight tickets;
  • Booking places for accommodation;
  • Availability of translators;
  • Availability of local transportation;
  • Destination mobility management;
  • Food management;
  • Financial needs management.

Health Care Management Programs

In accordance with the guidelines and benefits of the plans under our administration, we initiated processes and protocols to mobilize, enroll and refer members to various health care management programs (chronic diseases, maternity and other programs offered by the plan).

Invoicing
Management

We manage the entire billing process for customer contributions, issuing all the supporting documentation for the process, from pro-form invoices, debit and credit notes, detailed listing for reconciliation and other supporting documentation.

Exclusion
Management

We have set the exclusion rules applicable to each product offered by the medical aid or medical care system under our administration to identify uncovered items in a timely manner.

Contracting the network of providers

We have a team dedicated to the identification and contracting of service providers inside and outside the country, according to the needs of the client. In addition to contracting, we negotiate and manage rates with providers.

Pre-authorization Management

We coordinate and manage the pre-authorization processes, within the protocols established by the medical aid.

Management of expenses with medical and medical care

We ensure, the due treatment (processing) of the medical expenses of the members, whether inside or outside the network. We have means that allow the treatment of expenses directly in our systems or, depending on the preference of the client, remotely from experienced and qualified personnel for the purpose. The medical expense is treated and meticulously in order to avoid errors, fraud or omissions in this process.

Contracting the network of providers

We have a team dedicated to the identification and contracting of service providers inside and outside the country, according to the needs of the client. In addition to contracting, we negotiate and manage rates with providers.

Invoice audit

Through our team of doctors, we investigate the relevance, adequacy and reliability of data on medical and pharmaceutical bills provided to members. This process includes checking the items to ensure they are free from anomalies and inconsistencies ensuring that they conform to:

  • The diagnosis;
  • The quality and quantities recommended;
  • The agreed prices or within the market price standard;
  • Zero anomalies and incongruities.

Procurement

We support members under our management in locating and purchasing all kinds of medical services and applications. Among others, we assist our clients with:

  • The location of health professionals or providers;
  • The negotiation of prices and payment methods;
  • The creation of acquisition plans;
  • The acquisition and availability of medical services and applications

Opening Hours

Monday - Friday: 8.30 - 18.30
Saturday: 09.30 - 14.30
Sunday: CLOSED

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