Customer Service
Medivisa customer service gives adherents a good understanding of the tasks, responsibilities and skills involved at Medivisa with a complete interaction by providing all information needed to their enquiries, concerns & requests. Medivisa customer service center carefully listen and attend to our customers’ needs and desires. We are constantly on the lookout for opportunities to improve our customer service in order to avoid any stagnation.
Medivisa’s customer service representative main concern is to respond promptly to the customers complains by any mode .Thanks to our customer service dedicated team who works 24/7 with full authority & technical support to resolve all emergency issues after working hours & during holidays.
The key of this outstanding service is due to the bridge build between all support team to reach to our mission “customer satisfaction “. The support team consists of:
* Dedicated Delegates with 24/7 availability to handle emergency cases & issues
* 24/7 dedicated network team for on call assistance at all contracted hospitals reachable through their mobile devices & linked on real-time to Medivisa server.
* On-calldelegates that handle emergency claims at any time of the day or night.
* Rotation during official holidays: We believe that the delegate presence on all official holidays in all contracted hospitals will keep our service not interrupted & outstanding
Actual purpose of case management is provision of best healthcare facility to our insured members as well as making sure of quality treatment with cost effective outcome.
More.
Case Management
Medivisa is having a team of professionals for managing cases from different operational departments which includes customer support center as well as medical preauthorization department.
Actual purpose of case management is provision of best healthcare facility to our insured members as well as making sure of quality treatment with cost effective outcome.
Usually chronic or complicated cases are managed by our professional team according to standard operating procedures, sometimes when required referred from pre-authorization department to customer support center which in turn finds the best and suitable healthcare provider to refer these cases where quality of treatment is granted in addition cost effectiveness is also achieved.
When required case managers follow-up directly with healthcare providers concerning progress of the patient.
Also our professional team members’ guide and advice concerning chronic or complicated cases with follow up of the treatment progress and obtaining feedbacks from insured members concerning treatment related issues.
Pre-Authorizations
Pre-authorization also known as medical approvals is considered one of the core functions of any claims management organization. Medivisa’s pre-authorization department has professional and qualified medical doctors who reply to all approval requests which are received from different assigned providers network from all over Lebanon.
All received pre-authorization requests are handled professionally by our team, department head and his assistant make sure that requests are replied in agreed KPI time to avoid any unnecessary delay.
Medivisa pre-authorization team consists of a variety of specialists and consultants in order to deal professionally with all kind of medical cases within accepted time boundaries..
Daily In-hospital visit by our delegates
Our delegates visit all admitted patients upon admission to ensure that they are getting the proper service and attend to any request that might need. Additionally our delegates review the medical file of admitted patients on daily basis and follow-up closely with the treating physician and medical team .
By this action our team always keep an eye on quality of services provided to our valuable clients as well as to control healthcare providers from providing unnecessary services to our insured members which can lead to abuse of medical insurance service and ultimately increased premium.
Medivisa has a medical steering committee whose members meet frequently to discuss and review important as well as complicated cases and share experience.
Claims Adjudication
Invoices related to patients are audited medically and technically, unnecessary services will be questioned to the healthcare provider to justify rendering them. The aim of this 2nd line of defense is to serve our vision by providing the perfect healthcare service within accepted cost effectiveness to preserve the benefit coverage limits for our insured members.
Claims processing is the technical review of claims after claims medical adjudication, also in all claims details are entered in the system based on medical adjudication as well as policy terms and conditions, also contractual agreements are verified with healthcare providers and number of supporting reports justifying treatment whether available or missing.
Once technical verification completed full data of those claims registered in claims management system of Medivisa.
Healthcare Providers Relations
This department ‘s main task is to ensure that MediVisa’s clients enjoys the widest network of healthcare providers and best medical services at preferential tariffs.
Medivisa’s professional team also provide complete support and guidance to healthcare providers and assisting them from claims submission till payment release, major responsibilities of the medivisa team is to resolve healthcare providers issues related to claims adjudication , processing, technical support related to I.T system, medical as well as technical reconciliation , solving providers queries through customer care and support centers.
In case of conflict of any healthcare providers with insurance firms, medivisa’s professionals provide full supporting data to both parties to solve any unclear or outstanding issues.
Statistical And Technical Support
Medivisa has a statistical department with professionals who keep track internally of all daily operational activities and provide updated daily reports to Medivisa’s management to keep track of daily work.
Operational departments which are usually followed on daily basis by statistical team includes pre-authorizations department, claims management department, call center as well as customer support.
Al Medivisa’s operational departments follow strict KPIs and statistical department provide daily reports concerning KPIs related to each department.
Also statistical department provide produce all required reports concerning high cost illnesses, frequency of visits, providers cost inflation, service utilization, loss ratio calculation and any other service requested by out TPA clients.
Medivisa can provide its valuable clients any kind of specially tailored technical reports which can be requested from the statistics department providing required study parameters.
The contact details are on the back of your card Assistance Company.