Seeking Recommendations for Reliable Third-Party Health Service Administrators for Our Organization

Aish_Pathak
Dear all, please let me know some good third-party administrators for health services for our organization. You can email me at [Email Removed For Privacy Reasons].

Best Regards,
Aishvarya Pathak
deepakmendiratta
Thank you, Giridhar! Jumping in a bit late into the conversation. Aishvarya, what is the size of your company and the profile of your health insurance cover? I can then perhaps suggest the options that you can possibly look at for solutions.

Regards,
Deepak
Cite Contribution
Thank you, Giridhar and Deepak, for your help. I appreciate the assistance offered. Please share some deciding factors that Aishwarya should keep in mind while choosing a service provider. Your guidance would help every member reading this thread.

Thanking you in anticipation of your support.
deepakmendiratta
Dear Aishwarya,

The efficiency of the TPA is a function of, amongst others, the insurer that you decide on. Quite often, two issues work simultaneously:
(a) The insurers' internal processes for releasing claim funds to the TPA after the processing is done. Few insurers have an electronic transfer of funds directly to the TPA, such as United India Insurance, while others conduct an audit and manual clearance of funds before they reach the TPA and then the employee.
(b) The efficiency of the TPA. Some of the better TPAs that I know are regional in nature. When I say this, I mean that while they may be present across the country in terms of offices, the centralized/decentralized mode of operations, the quality of manpower, etc., you will observe wide variations.

Another equally important factor when opting for Mediclaim/health insurance is the quality of the Broker/Intermediary that you choose. Their job is not only to get you good quotes from insurance companies but also to ensure that the claims servicing is smooth. Health insurance policies may have many grey areas where the claim may be processed against the interests of the employee, while there can be another way within the policy terms. It is the job of the intermediary (consultant/Broker) to ensure that the interpretation is presented/done in favor of the employee. Moreover, you should select a partner who provides great value addition in terms of technology that extends to your employee.

Broadly, you can check PHS and Medi Assist as prospective partners; they are considered quite strong in servicing group health insurance covers.

Do let me know if you need any further assistance.

Regards,
Deepak
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