Link Lebanon TPA - Services

Our Services:

Comprehensive Claims Auditing and Adjudication: Our meticulous audits on health insurance claims involve precise application of policy terms, international medical standards, and agreed-upon tariffs with medical providers. These rigorous assessments safeguard the integrity of each claim, facilitating efficiency and accurate adjudication.
Fraud and Abuse Control: With a commitment to combating fraud and abuse, we implement stringent control measures, meticulously examining each case to ensure compliance with industry norms and policies.
Partner Management : Acting as a liaison between insurance companies and medical providers, we foster strong relationships, managing claims efficiently on behalf of our partners, including mutual funds, self-funded management schemes, and large groups.
Pharmacy Benefits Management(PBM): Our PBM solution utilizes advanced tools and a cutting-edge engine to oversee acute and chronic prescriptions, assessing their necessity based on the member's medical background. Expert medical oversight guides the administration of formularies, incorporating e-prescribing and e-dispensing for streamlined and efficient member service.
Actuarial and Statistical Services: Through a proficient team of dedicated actuaries, LINK offers a range of actuarial and statistical services, encompassing product design, reinsurance account management, rating adjustments, underwriting tools, and guidelines. Additionally, we provide reinsurance support through our partners in the region, loss-reducing treaties, actuarial monitoring, health-related studies, and bulletins.
Automated Healthcare Manegement: Leveraging cutting-edge tools and expertise, we proficiently oversee healthcare provider networks and streamline health insurance claims. From pre-approval of admission to claims adjudication and payment settlement, our seamless process facilitated by an e-claims portal ensures swift and accurate online claims processing. Our automated software, enriched by over 64 million combinations of medical rules, can respond to any pre-approval request within seconds.
Customer Service Enhancement: Specialized call centers equipped with dedicated desks cater to policy and network information, complaint handling, IT assistance, and health information support, ensuring enhanced customer services.
LINK Conciegerie:We provide exceptional service and personalized attention tailored specifically for our VIP clients.

Comprehensive Claims Auditing:

ICD and CPT Expertise: Our automated software Medconcept meticulously examines health insurance claims, ensuring accurate application and validation of ICD and CPT codes to ascertain precise billing and diagnosis alignment while combining them with age and gender.
Fraud Detection and Prevention: Leveraging sophisticated analytics and extensive experience, we employ stringent measures to detect and prevent fraudulent claims, protecting the financial interests of our valued clients.

Advanced Data Analytics and Reporting:

Insightful Analysis: Our proficient data analytics team generates comprehensive reports with granular analysis, providing actionable insights to insurance companies for informed decision-making.
Performance Metrics Evaluation: We meticulously measure and report on critical performance indicators, empowering our clients to continuously refine their claims management strategies.

Collaboration with medical Providers:

Relationship Management: We have cultivated strong relationships with medical providers, facilitating a streamlined process to approve health claims for insured individuals with contracted insurance companies.
Authorization and Approval: Through these partnerships, we expedite the approval process for health claims, ensuring prompt and efficient settlement for insured individuals.

Why Choose LINK:

Unparalleled Industry Expertise: Our team comprises industry veterans with extensive experience in healthcare claims management, audit procedures, and the precise application of ICD and CPT codes.
Cutting-Edge Technological Integration: Utilizing state-of-the-art technology and advanced analytics tools, we ensure precision, efficiency, and effectiveness in validating claims.
Customized Solutions for Client Needs: Understanding the unique requirements of our clients, we deliver tailor-made solutions that specifically address their challenges and align with their strategic objectives.
Ethical and Transparent Practices: LINK operates with the utmost integrity, upholding ethical standards to foster trust, transparency, and confidentiality in all auditing practices.

Compliance and Regularly Details:

The company operates in compliance with all applicable laws, regulations, and industry standards governing the insurance and healthcare sectors in Lebanon.