AdClaim Services

AdClaim Pro for Indemnity

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Indemnity is healthcare scheme that emphasized more on the plan coverage limit, it provide their members with flexibility and more control over their medical options. Individuals and families who are insured by indemnity health plans may visit a physician of their choice within their specified network of hospitals, doctors, labs, and other providers with no referrals required.

The traditional indemnity plans often require up-front payment in the point of care then request for reimbursement to their payer / insurance company. With AdMedika Indemnity Claim Management, the members (policy holders / patients) can enjoy cashless treatment and the member can see their coverage details on the registration receipt. Our  AdClaim Pro  service enhance service at point of care and create convenience for members when seeking healthcare services.

EDC Receipt Sample
  • Outpatient Receipt
  • Inpatient Receipt
  • Billing Confirmation Receipt

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Indemnity Patient Workflow
  • Outpatient
  • Inpatient

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AdClaim Managed Care

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Managed Care is a health care system with administrative control of a constellation of health services, encompassing early intervention to control price, volume, delivery site and intensity of health services provided. The intention is to maximise the health of the insured, as well as the value of health benefits given, eliminate redundant facilities and services and to reduce costs. Managed care healthcare scheme use tiered referral system, starts from primary care physician who acts as a gatekeeper for secondary services, such as specialized medical care, surgery, and physical therapy.

 AdClaim Managed Care  Services unique approach combines physician-guided care with technology-driven efficiency to achieve better results for our clients. We aim to deliver quality, cost-effective healthcare by monitoring and recommending utilisation of services, as well as controlling the cost of those healthcare services. We incorporate our years of proven best practices to built highly efficient service delivery workflows that incorporate physician oversight, keep costs at minimum while raising the bar on client service and results and encourage health care providers to collaborate with our professional medical advisers.

Managed Care Patient Workflow
  • Outpatient Primary Care
  • Outpatient Secondary Care (Specialist)
  • Inpatient / Maternity

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AdClaim Plus

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AdMedika's  AdClaim Plus  is an add-on services on top of AdClaim Pro & AdClaim Managed Care Services. AdClaim Plus enables our clients to stay focused on their business strategic activities, free of infrastructure and back-office management, reduce billing that can accumulate for too long at the provider, reduce data entry costs, improve data accuracy and speed up claims payments to providers or policyholders.

With AdClaim Plus, the clients can instantly connected to more than 2,500 AdMedika's national provider network without having to do credentialing and contract with each of the providers. The client can also manage their own healthcare budget without having to use a third party service or through insurance companies.

Cooperation & Provider Network
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With AdClaim Plus, the clients can instantly connected to more than 2,500 AdMedika's national provider network without having to do credentialing and contract with each of the providers. The client can also manage their own healthcare budget without having to use a third party service or through insurance companies.

Document Flow & Claim Payment
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With AdClaim Plus, AdMedika will made claim payment directly to provider on behalf and as approval of the client. Source of fund can be in form of deposit to AdMedika, QQ (shared) bank account, or management of clients bank account.

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