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Third Party Administration

This is a medical outsourcing service, which involves recruitment of providers (hospitals); processing and payment of hospital bills; a service hereto to that would have been provided by the employer. This system loosens up administrative time for employers to focus on their core services. There are no limits to medical care except as set by the employers. Anchor HMO will administer the healthcare funds by negotiating tariff with the hospitals and also pay the hospitals accordingly. Anchor HMO charges an administrative fee for the service provided.

Third Party Administration  
Scope of coverage – The scope of coverage is unlimited and is designed to meet the organization’s requirement and budget. Service Delivery – Subscribers will have access to additional services such as 24hr customer care, emergency ambulance and medical assistance services.
Reduced Healthcare Cost – Anchor HMO reimburses the health care provider for services provided at a pre-negotiated rate. Quality Management – Anchor HMO will ensure high quality care delivery by accrediting and monitoring contracted health providers. A second opinion will be required for non-emergency medical procedures.
Reduced administrative burden – We take on the responsibility for administering medical benefits and payments. Nationwide Emergency Coverage – Subscribers are guaranteed access to our nationwide emergency care coverage.
Utilization Reports – We shall provide an annual analysis of the scheme’s operations and performance as well as periodic reports on payments, expenses and utilization trends. Funding and Payments – The administrator develops and administers a revolving medical claims fund (deposit) which allows for cash flow advantage. The TPA system eliminates the issue of premiums but embraces payments for only genuine medical services rendered.
Flexibility – The subscribing organisation sets the financial, dependents and health care provider limits according to the company’s condition of service.