Gesa Assistance HealthCare Management Services
G E S A with 10 years of experience in handling health claims services within local Indonesian market, will provide the expertise in administration services to handle the Health Care Program.
Our functions contributes to lowering the cost of client medical coverage by managing the benefits closely. We carefully review to payment claims, and maintenance of provider network.
Our Case Management staffs representative for intake of the authorization requests and has medical team to review the request and make a decision for approval or denial based on medical necessity.
One of our functions is to pay claims. Automation of the claims process is becoming more common. We are operate lines to answer questions and help with calls about claims. Our focus has shifted to faster turnaround times, accuracy in payment and denying or reducing billing, if non medical necessary.
Our provider network consists of health professionals and facilities that provide services to the beneficiaries. We are responsible to provider recruitment, contracting and credentialing in the network.
At our provider networks allow beneficiaries to access in-network benefits. Arrangements with contracted providers stipulated that they cannot charge over a certain amount for their services. The purposed is to keep the cost of benefits according to medical needs.