Safeway TPA Services (p) Ltd is a third party service provider based at New Delhi in India. Its main objective is to assist policy holders for a hassle free claim settlement. It was established in 2004. The authorized and paid capital of the company is 1 crore as per IRDA regulation.
It provides with some key benefits to the policy holder:
It provides a photo identity card or health card to the policy holder.
Provides immediate cashless hospitalization facility at network hospitals to the insured inpatient on receipt of information and documents from the hospital.
It settles the claims within 3 days of receipt of information and documents.
It has a wide network of hospitals/ nursing homes and provides 365 days and 24hours helpline call center.
To enhance its services it also provides some key benefits to the insurer:
It forms a part of the bench of the insurance company for convincing corporate and groups regarding policy details, benefits and coverage.
It Forms a network with hospitals at pre-negotiated and discounted rates which proves to be cost effective for the insurer.
It keeps a control on cost and quality of treatment provided for application cost containing measures to bring down the claim ratio by eliminating false and exaggerated claims.
It has pooled its R&D and database with insurers and advocates use of ‘alto’ coding of diseases and creation of common cost of treatments, standards and credentials of providers.
It accepts the feedback and suggestions of insurers to categorize hospitals.
It is essentially an intermediary which has undertaken the entire administration of health plans of insurance companies. Apart from settling claims, they also process business, provides customer service and technical support. It not only interacts with doctors and hospitals to reduce claim substantially but also improves customer relationship.
When an insured is hospitalized the cashless amount is paid by this TPA. They are directly concerned with the medical institution regarding health insurance packages and the terms and conditions related to them. Any amount that is not payable under the insurance scheme is paid by the insured and later reimbursed from ‘Safeway’ just in contrast to the earlier method opted by TPAs where the insured had to first clear the hospital bills after treatment and then get it reimbursed from insurance companies through the TPAs .
Safeway’s way of working has not only made claim settlement hassle free but also trauma free for the insured.