Peraturan OJK Terbaru untuk Asuransi Kesehatan: POJK 36 Tahun 2025
Peraturan OJK Terbaru: Pentingnya Dewan Penasihat Medis bagi Perusahaan Asuransi Industri asuransi kesehatan memasuki era baru dengan terbitnya POJK Nomor 36 Tahun 2025 tentang Penguatan Ekosistem Asuransi Kesehatan. Regulasi ini tidak hanya mengatur produk asuransi kesehatan, tetapi juga memperkuat kapabilitas medis, tata kelola, pengelolaan biaya kesehatan, hingga kolaborasi antar pemangku kepentingan dalam ekosistem layanan kesehatan. […]
Prima Sarana Jasa: An Experienced Insurance TPA Supporting Insurance Companies
Prima Sarana Jasa: Experienced and Backed by Global Standards In the health insurance industry, service quality is determined not only by policy benefits but also by the speed, accuracy, and coordination involved throughout the administrative process. Behind a policyholder’s experience when accessing healthcare services, a Third-Party Administrator (TPA) plays an important role in ensuring that […]
How Does an Insurance TPA Work? Understanding the Healthcare Service Process from Start to Completed Claim
How Does an Insurance TPA Work? Many companies and insurance policyholders are already familiar with the term Third-Party Administrator (TPA), but how does an Insurance TPA actually work in supporting healthcare services? Many people assume that a TPA is only responsible for processing claims, but its role extends far beyond that. A TPA serves as […]
Improve Claims SLA: 7 Strategies Every Insurance Company Should Implement
Why Improving Claims SLA Is a Priority for Insurance Companies In the insurance industry, the speed of claims processing is not only a measure of operational efficiency but also a reflection of the quality of customer service. The faster and more accurately claims are processed, the higher the level of customer satisfaction and the stronger […]
ASO Insurance: A More Flexible Employee Benefits Solution for Businesses
ASO Insurance vs. Group Insurance: Which Is the Better Choice? Rising healthcare costs are prompting many companies to re-evaluate their employee benefits programs. At the same time, employee expectations for healthcare benefits continue to evolve, requiring businesses to adopt solutions that not only provide quality healthcare coverage but also help manage healthcare costs more effectively. […]
How to Choose the Right Administrative Services Only (ASO) Provider for Your Business
A Complete Guide to Choosing the Best ASO Solution for Employee Healthcare Benefits As healthcare costs continue to rise, many companies are re-evaluating their employee health benefits to balance cost control with employee satisfaction. At the same time, businesses must continue offering competitive healthcare benefits to attract and retain top talent while maintaining workforce productivity. […]
Why Is My Insurance Claim Taking So Long? 5 Common Reasons You Should Know
Why Insurance Claims Take Longer Than Expected When submitting a health insurance claim, most policyholders expect the process to be completed quickly. However, many people often ask, “Why is my insurance claim taking so long?” or “Why is my claim still being processed?” These are among the most frequently asked questions by policyholders and insurance […]
Fraud Prevention in Insurance Claims: Essential Strategies for Insurance Companies in the Digital Era
Fraud Prevention in Insurance Claims: Why It Has Become a Top Priority for Insurers Fraud prevention has become one of the most critical priorities for insurance companies. As healthcare costs continue to rise, claim volumes increase, and policyholders expect faster claim settlements, insurers must be able to identify high-risk claims without compromising the customer experience. […]
What is Claims Management? Process, Benefits, and How a Third-Party Administrator Drives Business Efficiency
Claims Management is the Key to Fast and Efficient Insurance Services Claims management is the process of handling the entire lifecycle of an insurance claim. This includes receiving the claim submission, verifying data, validating benefits, coordinating with healthcare facilities, and settling final payments. The primary goal of claims management is to ensure every claim is […]
What is an Insurance TPA? Definition, Functions, Benefits, and Its Role for Companies
What is an Insurance TPA? An Insurance TPA (Third-Party Administrator) is a company that helps manage health service administration and insurance claims on behalf of insurance providers. A TPA acts as a vital link between insurance companies, policyholders, hospitals, clinics, and healthcare providers to ensure that health benefit administration is fast, accurate, and efficient. Simply […]