Why is TPA Insurance Company necessary?

Posted by Aafiya Ae on July 13th, 2019

Unknown to most of us, there is a bigger team working behind the process of Heath Insurance that helps us get stress- and hassle-free claims. Health insurance policies are bought to ease some of the burden off our shoulders in times of an emergency. Apart from that it also helps financially along with giving a major peace of mind. The benefits of a health insurance policy aren’t required to be mentioned. However, we often find ourselves at a clueless position when it comes to claim!

AAFIYA, as one of the leading TPA Insurance Company in UAE manages solutions to health insurance companies. It acts as an intermediary between the insurance company and policyholder and ensures smooth and cashless claims and reimbursement claims are settlement. In requirement of medical treatment for the policyholder, the client gets in touch with the TPA of the insurance company. It lets the client know about the nearest network hospital and guide him or her in the claim process. At the time of discharge from the hospital, whole of the medical bills are sent to the TPA Insurance Company for payment. AAFIYA clears them after scrutinizing them against the pre-negotiated rates. Once the documents and bills are approved, the expenses are settled directly or reimbursed by it.

The question “why AAFIYA?” must be there in one’s mind but it is the wide range of services that has made it the leading TPA Insurance Company.

• Claim settlement
• Processing cashless claims
• Wide network of hospitals and pharmaceuticals
• Online pre-authorization with hospital
• Tracking claims
• 24x7 assistance

When consulted with the clients, they were found to be satisfied with the services and the most admired one being its command over the healthcare Data analytics. In healthcare industry, prediction is essential and most useful as the knowledge acquired by studying relevant data can be transformed into action. The timely action and strive to intervene is the key to harnessing the power of past and real-time data. Importantly, to have the best use of such data, both the predictor and the intervention must be integrated in a way within the same system related to the workflow where the trend takes place.