Cutting edge TPA software manages all claims, guaranteeing accuracy, efficiency, and cost-effectiveness through an automated system. The software provides for the generation of crucial reports, claims management, coverage status, outstanding claims, claim paid status and claims queries. CONNEX Assistance’s aim is to provide these services with speed, quality, and cost effectiveness that meet the standards of our clients’ operations, while making the process hassle free for client’s customers. We are dedicated to maintaining transparency in all stages of a claim and keeping open channels of communication with clients.
Our 24 hour call center is made available to our clients and their customers and our staff is prepared to deliver any required reports or documentation required by insurers and policy holders. We also provide a member guide detailing the policy and the available medical network.
We see each claim through from beginning to end. Each claim undergoes a medical audit by our staff of medical professionals to ensure proper implementation of the beneficiary’s policy. Our TPA software processes which claim, applying all rules and conditions of the plan, while we keep open direct channels of communication to resolve any outstanding cases or rejected claims. The software also regulates all accounting until the final settlement. We also handle all billing and collection of all payments, as well as providing risk carriers with claims reports and any other required documentation.
CONNEX Assistance records each benefits plan, including multiple classes for each policy, and the beneficiaries to whom the plans correspond. Accordingly, we issue membership ID cards and membership guides to each risk carrier. We also handle all addition and deletion endorsements, provide clearance forms for those members deleted from the policy, and implement the terms of reinsurance treaties.
If required, CONNEX Assistance is ready to assist insurers in designing benefit plans to meet the conditions of the customer’s region of residence. Our TPA software allows us to design benefits plans and related services according to the required medical services to ensure efficient handling of treatment.
The greatest advantage provided by CONNEX Assistance TPA services is our extensive and established network of over 2,000 medical service providers in Egypt all with proven track records that meet our operating standards.