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Medical Third Party Administration | Mondial Assistance

Medical Third Party Administration

Keeping One Step Ahead

NEXtCARE, our health management division of Mondial Assistance, specializes in providing complete health insurance management and third party administration services. It combines unmatched flexibility, leading software solution and customized management services for insurers, corporate and individuals.

We are recognized by our customers as providers of quality services; we will continuously work on improving our services, and continued focus on customer's changing needs, and on-going reviews of our customer service approach.

Mondial Assistance Malaysia - medical third party

24 Hour Call Centre

Operates 24-hour, 7 days a week Call Centre, specialised in handling queries from Panel Providers and Members and provide centralised point for any question or requirements ranging from medical referral to benefit and coverage queries.

Mondial Assistance-Panel Clinic Listing 110814.pdf

Pre-certification, Concurrent and Retrospective Review

Our centralised Claims Centre provides pre-certification and micro-management for each inpatient admission as well as for relevant outpatient and emergency cases. This ensures that patients are treated in the most medically appropriate and cost-effective manner.

Impartial Claims Decisions

We ensures that members are given balanced and fair decisions related to their claims coverage and payment. Decisions are based on eligibility of the beneficiary and the terms and conditions of the policy.

Claims Processing

We specialised in detailed capture of medical bills related to medical services rendered to members covered under the terms and conditions guaranteed by the insurers or corporate.
Mondial Assistance Malaysia - Impartial claims

International Guidelines

International standards such as the World Health Organization's International Classification of Diseases, the Current Procedure Terminology and other ancillary services nomenclatures and structures are some of the standards we use for claims administration.

Information System

Our information system "TATSH" delivers a cost-effective electronic solution to healthcare schemes, streamlining processing and ensuring competitiveness and effectiveness. Relying on internet communication technology, all players are trained and connected to TATSH in order to communicate, exchange information and perform transactions on-line with ultimate efficiency.