Ministry of Health hires
third party administrators
To manage in-house
hospitalization of patients
GlobeMed, Best Assistance, and Total Care – third party administrators (TPAs) of medical services – won a tender requested by the Ministry of Health to manage patients hospitalized at its expense.
Five companies participated in the tender, including NEXtCARE and MediVisa.
The Ministry will notify the three TPAs in a month from now of the contract’s final value, and the hospitals in which they will manage the claims.
While the winners’ remit will include private hospitals, they are unaware if public hospitals will also be included. There are presently around 119 private hospitals and 25 public hospitals.
“Everyone without insurance or social security resorts to the Ministry of Health to pay part of the hospitalization expenses,” said Walid Hallassou, General Manager of GlobeMed.
TPAs charge on average eight to ten percent of the value of claims. “The Ministry itself will continue to negotiate the rates with the hospitals, but the approval will be issued by us. We will control the file and send it to the Ministry,” said Hallasou.
The Ministry, which has been managing these services internally through its own doctors, believes that in partnership with the private sector, it is better able to contain costs.
The claims covered by the Ministry are in-patient treatment and surgeries. “Each company will handle a number of hospitals, depending on size and the number of cases,” said Jida Halabi, Quality Control Manager at Total Care.
All five companies participated in a six-month trial period. “We were the last, with only two months before the Ministry ended the trial,” she said.
Third party administrators estimate that medical claims are expected to reach around 80,000 per year.
Reported by Yassmine Alieh
Date Posted: Jun 21, 2016