Frequently Asked Questions

What is TPA ?

TPA or Third Party Administrator is a company or party who provide service on behalf of another company to administer certain functions which are not their core business. In the Health Insurance sector a Third Party Administrator give service to the policy holder of an Insurance Company by providing services that include issuance of membership identity, facilitating outpatient treatment, facilitating In-Patient Treatment and claim administration that defined under the scope of his/her health insurance policy contract.

What is AdMedika ?

Admedika is a health insurance TPA that use EDC terminals to capture claims information at clinics/hospitals and a powerful backend system to process the claims. This integrated system provide comprehensive service to administer, monitor and process health insurance claims online and realtime.

When was AdMedika established ?

AdMedika was established on August 2002

How many member does AdMedika servicing ?

Please see our Fact & Figures page for quick statistics of AdMedika.

What do you mean by healthcare provider network ?

A hospital and or clinic which has an agreement with AdMedika to provide cashless treatment.

How many healthcare provider network of AdMedika ?

Please see our Fact & Figures page for quick statistics of AdMedika.

What are the core service provided by AdMedika ?

Since its establishment in 2002, AdMedika's core service is Business Process Outsourcing in Healthcare industry which is commonly called Third Party Administrator (TPA) that managed Health Insurance claims.

What is the differences between AdMedika and other TPA ?

Please see our Benefit & Comparison page for more details.

What should I do to obtain AdMedika services ?

If you are already a health insurance policy holder from any of the Insurance companies in Indonesia, then please contact your agent or divisional office who has issued the policy to you. If you are not having any policy, then contact your agent or the insurance company which has had a cooporation with AdMedika.

Which are the insurance companies having cooperation with AdMedika ?

Most of insurance companies in Indonesia which provide Health Insurance products, already cooperated with AdMedika. Other than Insurance companies, AdMedika also servicing State-own-companies (BUMN), Self-Managed-Healthcare companies and other TPA's. Please see see our Our Clients page for more details.

What should I do if I lost my membership card while I need a medical treatment ?

You should contact your insurance agent or divisional office who issued the policy to you, or contact our call center for futher clarification.

How does AdMedika's call center work ?

First, any phone call will be monitor by our system, upon knowing your card number we will retrieve all relevant information about the member from our database. Which makes our call center officer to identify the member easily. Our Call Center representatives are always ready to serve our members 24/7.

How does cashless healthcare works ?

Each person covered under health insurance policy which had been cooperated with AdMedika will be issued an electronic card. Whenever there is a need for outpatient treatment and or hospitalisation the policy holder should give the card to the admission counter, the admission staff will swipe the card to the EDC terminal, after 30 seconds the EDC terminal will issue a letter of authorization which is indicate the name of the patient and the entitlement. The hospital and clinic will then start treatment.

What are the points must note while getting hospitalisation under cashless access ?

  1. Show your healthcard and ID at the provider's registration counter
  2. Fill up the Hospitalisation form provided by healthcare provider
  3. In case the amount approved is less than the medical expense – you have to pay for the cost differences. In Addition to the above, you will also have to pay expenses of telephone charges, non medically items, etc.
  4. If you wish to know more on expenses that is not covered by your policy please contact the call center number that are printed in your healthcard

How can i obtain more information on AdMedika ?

You can browse through our website or contact our friendly, in-house costumer service team through calls, emails or online chat about your inquiries, and we will help you resolve it quickly and effectively. click here to go to our contact page.

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