TPA Service
Insmart is an independent claim settlement enterprise (TPA). We currently manage insurance programs for millions of clients participating in health insurance of 26 domestic and foreign insurance companies.
TPA
Insmart is an independent claim settlement enterprise (TPA). We currently manage insurance programs for millions of clients participating in health insurance of 26 domestic and foreign insurance companies.
Insmart provides comprehensive claim management services for health insurance products from the beginning to the end in product development, together with after-sales service and customer care.
Reimbursement Service
Insmart receives claim files and settlement based on the terms and conditions of healthcare insurance contract that signed between the insured and the insurer.
Reimbursement process:
1.Receive claim files from insured
2. Digitize data
3. Evaluate claim files. Require supplemental documents (if necessary)
4. Send Notification and make payment
Direct Billing Service
Insured of voluntary healthcare insurance will be able to use direct billing service at medical providers of insurers’ direct billing system. With this service, the coverage costs will be guaranteed by insurers and paid directly to medical providers, insured only need to pay the rest, which are not covered by the contract.
Domestic direct billing network
Network panel with over 350 state-owned and private medical providers; covering 57 provinces, cities and all economic regions across the country.
Profiles of all medical providers are carefully assessed to guarantee the reputation and service quality.
Apart from direct billing service, Insmart also achieves commitments with medical partners in supporting appraisal of medical files, which is an important step in reimbursement process.
Overseas direct billing network
Insmart cooperates with more than 120 medical providers in 9 countries (Australia, Singapore, Malaysia, Thailand, Cambodia, China, Hong Kong, Taiwan, India).
All medical providers have been certified by prestigious international organizations for quality standards in medical treatment and examination.
