Integration of best technology with process

An ISO 9001:2008 Certified TPA

About Us

Family Health Plan (TPA) Ltd (FHPL) is pioneering as one of the best Third Party Administrators in Health Insurance sector for providing quality assistance to core groups of health care industry. FHPL is licensed by Insurance Regulatory Development Authority of India and acts as a nodal agency between the core groups of health care industry. The core groups are Insurance companies, insured members (Policy holders)) and Hospitals (healthcare service providers). FHPL ensures quality health care and bridges the gap between the sources for rendering the right service, at right time, to the right person, at a right price.

With growing number of private corporate hospitals entering the arena of health care service, there is a tremendous impact on services to health insurance policy holders. FHPL is one of leading Third Party Administrators providing quality health care services to health insurance policy holders. It helps to channelize the entire mechanism involved in the process of healthcare and insurance process.

Powered by the highly ambitious goals and continues innovation in the process and technology, FHPL channelizes the entire core groups in the health care sector to deliver safe and secure form of healthcare. FHPL dismantles the barriers involved in the whole process of assurance related to healthcare service and insurance provision. It integrates each and every group in the health care sector. It deals with great focus on arranging both national and private insurance companies to enhance the experience of the policy holder for the policy insured.

FHP has widened its horizons with 21 operational offices along with its corporate office in Hyderabad. FHPL is proud to declare the spectacular growth towards reaching 7 million members in its list.

Vision

To be the most reliable Third Party Administrator in India providing world class healthcare insurance claims services with the right blend of technology and experience.

Services

FHPL provides quality services in health care insurance sector. As a Third Party Administrator (TPA), We facilitate cashless hospitalization at pre listed health care providers like hospitals, diagnostic centers and nursing homes. FHPL ensures reimbursement claims as a part of its services in the quickest and easiest way of settlement. FHPL covers the entire spectrum of healthcare insurance policies with its wide network and linkups with insurance companies, healthcare providers and insured members.



LIAISON WITH INSURANCE COMPANY:

As a part of the services TPA services provider to health insurance companies, we offer:

  • Issuance of ID cards to individual insured and insured under group policies.
  • A Unique Health Identification (UHID) tagged details of the member will be issued for availing the services of FHPL. The UHID helps for easy access to the member information and management of the claim processing.

  • Communicating regarding the policies and claim processing requirements.
  • Speedy settlement of claimed policies
  • Timely Status and update of claims under processing, if approved or declined. (Claims Adjudication on Pre-authorization requests)
  • Capture accurate information with benefits attached to the policy of the insured. We provide Periodical Enrolment Data, Settlement Data, Management Information Systems and Relevant Analysis & Reports to regulator and insurers.



Cashless Hospitalization:

FHPL has connectivity with network of reputed hospitals both public and private. It has a list of health care providers which include Hospitals, Clinics, and Nursing homes and diagnostic centers that can offer cash less hospitalization for the registered insured members. FHPL as a leading TPA provides all its registered members with the benefits of cashless hospitalization to enhance healthcare insurance services. It connects core groups of health sector to one platform where the process runs smoothly and can safeguard the security of the insurance policies. Cashless hospitalization is like a boon for the insured.

Insured and healthcare provider as it gives less strain to each party dealing the insurance policy. We have strategic partnership with health care providers and insurance companies both private and public throughout the country. We have a wide network of connectivity with 3200 provider hospitals, 250 diagnostic centres that are dispersed across the length and breadth of the country to make the reach accessible.



CLAIMS MANAGEMENT

FHPL supports the payer entity in claims management to provide end to end world class health insurance claims processing. As a TPA, FHPL has the expertise and experience to manage the health care insurance policies covering the complete claim processing management including claims administration, premium collection, enrollment and other relative activities.

We have a team of medical doctors who can provide valuable information and support FHPL who want to claim medical expenses through medical reimbursements or benefit through cashless hospitalization. We have extensive training for our team in regard to the new schemes in insurance sector and health care policies for better management of claims processing. We strive to provide complete implementation of automated claim processing

  • Provide Claims management services including complete evaluation of all claims, data entry and adjudication.
  • Facilitating better control and monitoring of claims funding processes.
  • All information on claim forms to be captured for complete reporting of information.
  • Access to Claims, Eligibility, Enrollment, Processing as desired by the insurance company.
  • Utilization and Case Management.
  • Direct negotiation of discounts with hospitals, pharmacies and ancillary providers.



CLAIMS AUDIT SOLUTIONS:

FHPL has extensive knowledge and experience in dealing healthcare claims administration. With increasing number of corporate and private hospitals, there is a tough competition for healthcare claims administrators to scrutinize claims for safeguarding and controlling costs. FHPL has the insights to offer claims audit solutions that can provide accurate information to health insurers for claim processing.

FHPL has the expertise for efficient processing of claims and protect the interest of both insurer and insured.. FHPL claims auditing solutions helps to identify and recover excess payments to ensure and safeguard the claims policy management runs in perfect mode.

  • Healthcare Claims Auditing and Recovery Solutions
  • Comprehensive claims auditing
  • Fraud and abuse detection
  • Clinical compliance auditing

thought of the day

Customer Speaks

Read More..