AdMedika Claim Management

AdMedika Claim Management

eclaim admedika AdMedika’s Claim Management Services called e-Claim , are conceptualized on the fact that paper-based medical claims process proved inefficient, lacks transparency and prone to abuse and fraud. Our proven methods and procedures of claim administration simplify and standardize healthcare information, reduce cost, enhance service at point of care and create convenience for members (policy holders / patients) when seeking healthcare services. This service will enable our clients to focus on strategic activities of their organization, relieving them from infrastructure cost and back office management, reduce provider billing aging, reduce data entry cost, improves data accuracy and accelerate claim payment to the providers and/or policy holder.

Our experienced claim professionals utilize AdCPS (AdMedika Claims Processing Systems) technology. This state-of-the-art, on-line, real-time system provides instant claim and eligibility information and able to process even the most complex transactions efficiently.

We strive to process claims with 100% accuracy and with the fastest time possible. When speed, accuracy and cost are critical, our solution alleviates the pressure.

Healthcare Scheme

AdMedika Claim Management Services are able to accommodate both Indemnity & Managed Care healthcare scheme. And with our flexible processing system, we are able to customize our service to handle Hybrid healthcare scheme which is a fusion between Indemnity & Managed Care

admedika scheme

Why AdMedika Claim Management ?

  • 24/7 Contact Center
  • 24/7 Case Monitoring
  • 24/7 Medical advisers
  • Real-time eligibility
  • Largest healthcare network providers
  • Standardized healthcare information
  • Minimizing claim excess
  • Minimizing fraud & abuses
  • Improves data accuracy
  • Cost Containment
  • Real-time & Online system
  • Online web system
  • Accelerate claim payment
  • Membership data administration
  • Advanced security and confidentiality of data
  • Reliable Data Center
  • Comprehensive reporting
  • Increase productivity & service quality
claim management

AdMedika Service Layer

AdMedika Convergence - Digital Innovation

Fully utilized Telkom Health Information Exchange (HIE) as a Digital Hub to deliver Paperless Claim service, Automatic Payment Gateway, e-health applications and to integrate with Jaminan Kesehatan Nasional (JKN).


AdMedika Nationwide Backbone

The core of AdMedika Claim Management Services, utilizing AdMedika Claim Processing System (AdCPS) with worldwide coverage data center to deliver cashless, online & real-time service.



AdMedika Access

The gateway of AdMedika Claim Management Services. Thousands of EDC network infrastructure are placed on healthcare providers accross the nation and neighboring countries. EDC types includes fixed line, IP Based, GPRS and web service.

AdMedika Service Layer

AdMedika Service Market

Work With AdMedika

Corporations or state-owned enterprises (BUMN/BUMD) that have its own Healthcare Foundation & Private Insurance, Self-Insured and JAMKESDA can cooperate directly with AdMedika.

Corporations or state-owned enterprises (BUMN/BUMD) that do not have Healthcare Foundation can cooperate with AdMedika as a Third Party through a Private Insurance company.

AdMedika Claim Management Services are flexible and can be tailor made to your requirements.
If your company or institutions do not match above criteria, please SENT US A MESSAGE and we will collaborate with you to find the best solution for your healthcare administration needs.

Claim Management Service Type

Partial Service
  • Member Data administration
  • Realtime Eligibility
  • EDC Network
  • X
  • Online Monitoring Web Access
  • 24/7 Contact Center
  • 24/7 Case Monitoring
  • Customer Care
  • Reporting
  • Admin Payment (Optional)
  • SMS Notification
  • AdMedika Valuecard
Technology Only
  • Member Data administration
  • Realtime Eligibility
  • EDC Network
  • X
  • Online Monitoring Web Access
  • X
  • X
  • X
  • Reporting
  • X
  • X
  • AdMedika Valuecard

Finding The Best Solution

AdMedika Claim Management Service has a wide range of types, schemes and service level that would provide the best solution for every type of healthcare insurance. The services are flexible and can be tailor made to fit your specific requirements. Here are a quick guide on how to find your best Claim Management solution.

  • Service Type

    Choose the Claim Management Service Type that suits your requirements. Full Service / ASO, Partial Service or Technology.

  • Service Scheme

    Choose the Healthcare Scheme that fits you best. Indemnity, Managed Care or Hybrid.

  • Service Level

    Choose your Claim Management Service Level that suits your requirements. Standard, Premium Gold or Premium Platinum

  • Customize

    AdMedika Claim Management Services can be tailor made. Inform us for any customization that best fits your requirements.

PT. Administrasi Medika
Telkom Gambir, Gedung C, Jl. Medan Merdeka Selatan No. 12, Jakarta Pusat 10110 - Indonesia
021 3483 1100   021 3483 0101   Contact Us   Find on map
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