TPA HEALTH
With over 30 years of experience, we offer our clients claims management and medical expense reimbursement services, both for groups and individuals, ensuring proper and optimal coverage for all parties involved. These services are crucial for ensuring that eligible individuals make the most effective and efficient use of their coverage.
Our extensive expertise is particularly pronounced in the healthcare sector, where we collaborate closely with insurers, brokers, bancassurance providers, funds, and mutuals to effectively handle the following:
- Direct management of healthcare claims, facilitated through our access to a network of preferred healthcare providers.
- Indirect management of healthcare claims, with reimbursement based on the submission of valid expense receipts.
- Oversight of dental claims, ensuring adherence to claim limits and service consistency.
Thanks to our network of over 4,000 healthcare centers and
50,000 affiliated physicians in Italy, our clients can provide their patients with direct and free access
to medical services covered by their policies. This arrangement ensures both the assurance of
receiving high-quality care and access to the most competitive rates available in the market.
All expenses incurred during periods of illness and/or injury are meticulously managed in accordance with policy conditions. Claims are promptly and meticulously processed, complying with all pertinent regulations, including those pertaining to privacy, taxation, and those mandated by the IVASS (Italian Insurance Supervisory Authority).
Our management philosophy is founded on the following principles
Our management philosophy is rooted in these fundamental principles:
- Reliability and Speed: We prioritize the swift and dependable handling of both direct and indirect claims, with an unwavering commitment to efficiency and cost-effectiveness.
- Continuous Process Enhancement: We consistently refine our processes, harnessing the power of proprietary software to facilitate ongoing improvements.
- Expert Loss Adjusters: Our team of adjusters is highly qualified
and specialized, with an extensive experience within the insurance industry. - Competitive Service Level Agreements (SLAs): We offer competitive SLAs as integral components of our contractual agreements.
- Comprehensive Reporting: We provide detailed technical, financial, and service quality reports, offering a high level of detail and real-time accessibility through dedicated platforms.
- Responsive Operations Center: Our Operations Center stands ever-ready to engage with policyholders, intermediaries, and clients, extending unwavering support at every stage of the process.
- Continual Rate Review: We perpetually update and validate discounted rates negotiated with healthcare facilities within our extensive network.
Furthermore, in addition to our core responsibilities in healthcare coverage management, AssirecreGroup proudly extends a comprehensive suite of cutting-edge integrated digital services known as Health Digital Services. For a deeper insight into these offerings, please explore https://groll.website/ippocrate-com-servizi-digitali-per-la-salute/.
It’s important to note that all informational and operational functions, along with integrated digital services, are readily accessible not only through dedicated web portals but also via dedicated apps that can be conveniently downloaded on both iOS and Android smartphones.
TPA LIFE POLICY MANAGEMENT.
All types of Life Policies, whether they are term or whole life policies, and regardless of the mechanisms that may be in place for periodic premium adjustments, require a thorough evaluation of the “health risk” by insurance companies before they are issued. This assessment takes into account various factors, including age, lifestyle habits, occupation, health condition, coverage amount, policy duration, activated benefits, and smoking status.
For several years, AssirecreGroup has been providing insurance companies with the opportunity to assess potential Life Policy applicants through its extensive network of over 4,000 healthcare centers and 50,000 affiliated physicians, offering reduced rates.
The key services typically requested during the risk assessment phase for a Life Policy include:
- Comprehensive laboratory urinalysis
- Blood tests, covering parameters such as total cholesterol, HDL, Triglycerides, Creatinine, HbA1c, AST, ALT, GGT, PRC, complete blood count with formula, and platelet count
- Stress ECG (exercise stress test on a cycle ergometer or treadmill) with full tracing conducted and reported by a cardiologist, not a sports physician
- Hepatitis B and C tests (HbsAg and HCV)
- PSA test (for men)
- HIV test
Additionally, a Medical Examination Report, available in both standard and customizable formats, is prepared by a trusted physician. This report holds significant value for the insurer as it compiles the medical history of the potential policyholder.
From an organizational standpoint, AssirecreGroup assumes full responsibility for meeting the needs of both the insurance company and the potential policyholder, providing straightforward, prompt, and dependable solutions.
Prospective Life Policyholders can request appointments for medical examinations and tests, choosing the most convenient facilities, dates, and times, either by accessing a dedicated platform or contacting AssirecreGroup’s Operations Center. Furthermore, AssirecreGroup offers comprehensive assistance and guidance to facilitate the initiation and completion of the necessary assessments.
The cost of the entire “health” risk assessment phase benefits from the discounted rates within the Assirete Network, with the possibility of bundled quotes if activities are concentrated at specific healthcare centers.
In cases where the potential policyholder bears the cost of preliminary checks, AssirecreGroup will furnish them with a complimentary Assirete Health Card (click here for more information on Easy Access ASSIRETE CARD). This card not only ensures the lowest costs during the Assessment phase but also grants preferential rates for an entire year. The ASSIRETE HEALTH CARD additionally enables policyholders to undergo personalized preventive check-ups at reduced rates, ensuring regular monitoring of their health status.