Latest OJK Regulation for Health Insurance: POJK 36/2025
Latest OJK Regulation: The Importance of the Medical Advisory Board for Insurance Companies The health insurance industry is entering a new era with the issuance of Financial Services Authority Regulation (POJK) No. 36 of 2025 concerning the Strengthening of the Health Insurance Ecosystem. This regulation not only governs health insurance products but also strengthens medical […]
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 […]
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 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 […]
Claims Cost Control: A Must-Have Strategy for Insurance Companies
Why Has Claims Cost Control Become an Insurance Industry Priority? Claims cost control has emerged as a primary focus for health insurance companies. Amidst rising healthcare costs, insurers are no longer just expected to pay claims quickly; they must also ensure that every claim is managed efficiently, accurately, and sustainably. This challenge is further highlighted […]
How TPAs Support Insurance Companies Like Prudential
How TPAs Support Insurance Companies Like Prudential Amid Rising Claims Costs Indonesia’s health insurance industry is becoming increasingly dynamic. As public awareness of health protection continues to grow, business sustainability is being challenged by rising medical costs. A report from the Global Asia Insurance Partnership highlights medical inflation as the most significant risk across Asia, […]
The Role of TPAs for Insurance Companies Like Prudential: A Strategic Partner in Claims Management
Why Are TPAs Important for Insurance Companies Like Prudential? In today’s increasingly complex health insurance industry, insurance companies are expected to deliver fast, accurate, and transparent services to policyholders. This becomes even more crucial for well-known insurers such as Prudential. Prudential Insurance itself partnered with Global Excel Indonesia to support a more efficient and optimized […]