The Thai Life Insurance Association is collaborating with the Ministry of Public Health to upgrade services that aim to provide patient care according to international standards and ensure accurate and prompt claims processing.
In collaboration, the organisations organised a recent training course aim is to drive Thailand’s healthcare system towards value-based healthcare, emphasising appropriateness, safety and maximum benefit for policyholders.
Some areas covered in the session included:
- Transparent protection of rights: Ensuring patients receive necessary treatment, in accordance with medical indications and standards, and ensuring medical expense claims are submitted correctly and in line with the policy's terms of coverage.
- Faster claim approval and reduced upfront payments: Accurate coordination and documentation preparation system from the outset minimises the need for retrospective requests for additional information. This may result in faster and smoother claims processing on the day of discharge or pre-authorisation of eligibility before surgery.
- Understanding policy limitations: Helping patients understand universal limitations or exclusions insurance does not cover, such as genetic diseases, cosmetic surgery, or minor illnesses that can be treated with outpatient care, so patients can confidently plan expenses and treatment.
- Enhancing quality of care: Shifting from claims reviews to a becoming a partner for patients, thus reducing the risk of unnecessary treatments or diagnoses (overuse) and preventing hospital-acquired complications.
- Efficient resource management: Allocate patient care levels appropriately, whether for outpatients, day surgery, or inpatients, thus reducing unnecessary hospital stays and alleviating bed constraints.
- Simplified workflows: Clear and systematic medical records to reduce redundancy in documentation reworks, thus enabling hospitals to receive accurate, complete and timely payments for medical expenses from insurance companies.