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Want to have Intellicare as your healthcare provider? Click HERE
Third Party Administration (TPA)

INTELLICARE THIRD PARTY ADMINISTRATION HEALTH PLAN

Under Intellicare’s TPA Program, corporate clients deposit on behalf of their enrolled members an agreed amount of money called a Health Fund. This fund is administered and exclusively used by Intellicare for payment of healthcare services and benefits that have been availed of via Intellicare’s network of affiliated and accredited healthcare providers. Under this arrangement, therefore, clients only pay for what is utilized.

The Health Fund is then replenished regularly by clients to ensure that in no case shall the fund be less than the agreed amount (usually three months worth of utilization costs). In exchange for administrative services rendered, Intellicare charges against the health fund its Administrative Fees, Network Access Fees, and other medical collectibles on services/benefits which are not covered by or in excess of the agreed limits.

Thus, clients are relieved of financial pressures under the TPA program. Instead of paying a fixed periodic premium, clients only pay for what has been actually utilized by their employees. At the same time, clients are able to enjoy Intellicare’s volume discounts on medical fees/charges in view of the latter’s large collective base of enrolled members. But over and above these benefits, clients are afforded equal access to Intellicare’s top-rate, countrywide infrastructure for an effective and efficient healthcare delivery at no extra cost.

INTELLICARE SERVICE CAPABILITY

  1. Intellicare cards processed in 15 working days
    • As part of the Network Access Fee, every member of the company will be provided with Intellicare cards. This will enable members to have access to more than 1,000 accredited hospitals, clinics and diagnostic centers nationwide and to almost 15,000 affiliated medical practitioners.
    • Intellicare cards are produced in-house for faster processing. Also, for easy identification, the member's photo will be on the card.
  2. Account Officer to assist during transition
    • For smooth transition, an Account Officer will be assigned at the client’s office for assistance and coordination in the form of the "Help Desk". This will be daily during the first month of transition and weekly thereof or until full transitional requirements have been achieved.
    • Product Orientation will be done at the start of the contract period for proper availment procedures.
  3. Comprehensive Utilization Report
    • Client is provided on a quarterly basis (or as needed) a copy of their Utilization Report. This is broken down to summarize the company’s top illnesses, hospitals and clinics utilized, and members who have utilized the card. This is properly explained and reviewed with clients on a quarterly basis. Following the analysis, Intellicare makes recommendations to the client as to how they may help manage their employees through healthcare programs.
  4. Cash Book for easy monitoring of funds
    • TPA clients will receive a Cash Book, a document that monitors the movement of the client’s Health Fund on a regular basis for easy reference. It indicates the running balance of their Health Fund beside the actual utilization. Attachments of all original documents are forwarded to the client at regular intervals.
  5. Intellicare TPA Department
    • For proper monitoring and servicing of all our TPA clients, Intellicare has set up a TPA Department solely to handle the requirements of our clients.
    • Intellicare is currently servicing more than 150 corporate accounts purely on the TPA program.

How can we get a quotation and enroll in the TPA Program?

  • As of the moment, Intellicare only accepts requests for proposals for CORPORATE ACCOUNTS. Should you wish have Intellicare as your healthcare provider, click HERE