SlideShare a Scribd company logo
Industry Understanding the responsibilities of what the administration and management of the healthcare industry represents  ,[object Object]
Organization Skills
Work Ethics
Care for OthersThe core expertise of the Enrollment Industry lies on maintaining member profiles, processing enrollment application, verifying eligibility to access an Active Coverage. Prompt service and, processing are the key functions that help to develop the Health Care Industry. 1
Market 	On your annual open enrollment time carefully research your elective provider history and turnaround claims process in order to make the right choicewhich will make a difference from the others competitors. 2
Product or Service Description As an administrator the organization should process the health care enrollment and claims without carrying insurance risk or jeopardizing the accuracy of the data.  The TPAs (third party administrators) are prominent players in the managed care industry and have the expertise and capability to administer all, or a portion of the claims process. Their services also include premium collection.  While some TPAs operate as units of insurance companies, they are often independent. However, hospitals or provider organizations desiring to set up their own health plans will often outsource certain responsibilities to TPA's. 3
Competition With more corporations outsourcing to third-party administrators to handle their enrollment, claims  with the market for the TPA services becoming ever more competitive, it's time to consider the role actuaries can play in helping TPAs provide quality service, deliver promised outcomes and provide sustained competitive advantage. Diversity of plan options and retention of policy holders is your key for success. 4
Industry Analysis 	The health care administration industry depends on the care of health-related services by professionals for the benefit of patients. To improve the effectiveness of health care services in the state and to support consumers in health care decision making, our business responsibility should be collecting, compiling, coordinating, analyzing and disseminating health related data. These data will provide accurate and timely consumers demands in order to administer and evaluate the cost of service, quality and access to healthcare. Currently there are too many options offering a private service for quality control and delivery for managing people’s confidential information, however these competitors lack of personalize services force the consumer to search for better options. 5

More Related Content

What's hot

Beacon IPA Intro 2010
Beacon IPA Intro 2010Beacon IPA Intro 2010
Beacon IPA Intro 2010Simon Prince
 
What's an IPA To Do?
What's an IPA To Do?What's an IPA To Do?
What's an IPA To Do?
Sage Growth Partners
 
Independent practice association, what you need to know
Independent practice association, what you need to knowIndependent practice association, what you need to know
Independent practice association, what you need to know
ARBYRNE
 
Will more aiims dilute brand
Will more aiims dilute brandWill more aiims dilute brand
Will more aiims dilute brandOther Mother
 
BrightStar Care Awarded for Home Care Quality by the Joint Commission
BrightStar Care Awarded for Home Care Quality by the Joint CommissionBrightStar Care Awarded for Home Care Quality by the Joint Commission
BrightStar Care Awarded for Home Care Quality by the Joint Commission
BrightStar Care
 
10th Annual Pharmaceutical Leadership Summit & Pharmaleaders Business Leaders...
10th Annual Pharmaceutical Leadership Summit & Pharmaleaders Business Leaders...10th Annual Pharmaceutical Leadership Summit & Pharmaleaders Business Leaders...
10th Annual Pharmaceutical Leadership Summit & Pharmaleaders Business Leaders...
pharmaleaders
 
Medicare’s Incident-To Guidelines Simplified
Medicare’s Incident-To Guidelines Simplified Medicare’s Incident-To Guidelines Simplified
Medicare’s Incident-To Guidelines Simplified Ashok Bagdy
 
Employee perspective needs more consideration in the workers’ comp system
Employee perspective needs more consideration in the workers’ comp systemEmployee perspective needs more consideration in the workers’ comp system
Employee perspective needs more consideration in the workers’ comp system
mosmedicalreview
 
What Are The All Payer Claims Databases (SCPDs) And What Could Be Used For?
What Are The All Payer Claims Databases (SCPDs) And What Could Be Used For?What Are The All Payer Claims Databases (SCPDs) And What Could Be Used For?
What Are The All Payer Claims Databases (SCPDs) And What Could Be Used For?
Dan Wellisch
 
Medical Stop Loss Group Captive
 Medical Stop Loss Group Captive  Medical Stop Loss Group Captive
Medical Stop Loss Group Captive
Lou Polur
 
Thinking of Starting a New Medicare Advantage Plan?
Thinking of Starting a New Medicare Advantage Plan?Thinking of Starting a New Medicare Advantage Plan?
Thinking of Starting a New Medicare Advantage Plan?
Media Logic
 
Healthcare Start Ups and their Impact
Healthcare Start Ups and their ImpactHealthcare Start Ups and their Impact
Healthcare Start Ups and their Impact
Kumar Rohan
 
Healthcare Reform Proving To Be A Calendar Challenge - John Baresky, #baresky
Healthcare Reform Proving To Be A Calendar Challenge - John Baresky, #bareskyHealthcare Reform Proving To Be A Calendar Challenge - John Baresky, #baresky
Healthcare Reform Proving To Be A Calendar Challenge - John Baresky, #baresky
Bare Sky Marketing Healthcare Content Writing Services
 
About The Alliance
About The AllianceAbout The Alliance
About The AllianceThe Alliance
 
Blue Cross Blue Shield and BUPA Partnership - 2014 - A Global Healthcare Deve...
Blue Cross Blue Shield and BUPA Partnership - 2014 - A Global Healthcare Deve...Blue Cross Blue Shield and BUPA Partnership - 2014 - A Global Healthcare Deve...
Blue Cross Blue Shield and BUPA Partnership - 2014 - A Global Healthcare Deve...
Bare Sky Marketing Healthcare Content Writing Services
 
What is mips and how it affects my
What is mips and how it affects myWhat is mips and how it affects my
What is mips and how it affects my
alicecarlos1
 
Workers’ compensation program - the texas model
Workers’ compensation program  - the texas modelWorkers’ compensation program  - the texas model
Workers’ compensation program - the texas model
mosmedicalreview
 

What's hot (20)

Beacon IPA Intro 2010
Beacon IPA Intro 2010Beacon IPA Intro 2010
Beacon IPA Intro 2010
 
What's an IPA To Do?
What's an IPA To Do?What's an IPA To Do?
What's an IPA To Do?
 
Independent practice association, what you need to know
Independent practice association, what you need to knowIndependent practice association, what you need to know
Independent practice association, what you need to know
 
Will more aiims dilute brand
Will more aiims dilute brandWill more aiims dilute brand
Will more aiims dilute brand
 
BrightStar Care Awarded for Home Care Quality by the Joint Commission
BrightStar Care Awarded for Home Care Quality by the Joint CommissionBrightStar Care Awarded for Home Care Quality by the Joint Commission
BrightStar Care Awarded for Home Care Quality by the Joint Commission
 
10th Annual Pharmaceutical Leadership Summit & Pharmaleaders Business Leaders...
10th Annual Pharmaceutical Leadership Summit & Pharmaleaders Business Leaders...10th Annual Pharmaceutical Leadership Summit & Pharmaleaders Business Leaders...
10th Annual Pharmaceutical Leadership Summit & Pharmaleaders Business Leaders...
 
Medicare’s Incident-To Guidelines Simplified
Medicare’s Incident-To Guidelines Simplified Medicare’s Incident-To Guidelines Simplified
Medicare’s Incident-To Guidelines Simplified
 
Meritus 2015 Broker Handbook VNT LR
Meritus 2015 Broker Handbook VNT LRMeritus 2015 Broker Handbook VNT LR
Meritus 2015 Broker Handbook VNT LR
 
Employee perspective needs more consideration in the workers’ comp system
Employee perspective needs more consideration in the workers’ comp systemEmployee perspective needs more consideration in the workers’ comp system
Employee perspective needs more consideration in the workers’ comp system
 
What Are The All Payer Claims Databases (SCPDs) And What Could Be Used For?
What Are The All Payer Claims Databases (SCPDs) And What Could Be Used For?What Are The All Payer Claims Databases (SCPDs) And What Could Be Used For?
What Are The All Payer Claims Databases (SCPDs) And What Could Be Used For?
 
SearchforBenefits
SearchforBenefitsSearchforBenefits
SearchforBenefits
 
resume #2 (1)
resume #2 (1)resume #2 (1)
resume #2 (1)
 
Medical Stop Loss Group Captive
 Medical Stop Loss Group Captive  Medical Stop Loss Group Captive
Medical Stop Loss Group Captive
 
Thinking of Starting a New Medicare Advantage Plan?
Thinking of Starting a New Medicare Advantage Plan?Thinking of Starting a New Medicare Advantage Plan?
Thinking of Starting a New Medicare Advantage Plan?
 
Healthcare Start Ups and their Impact
Healthcare Start Ups and their ImpactHealthcare Start Ups and their Impact
Healthcare Start Ups and their Impact
 
Healthcare Reform Proving To Be A Calendar Challenge - John Baresky, #baresky
Healthcare Reform Proving To Be A Calendar Challenge - John Baresky, #bareskyHealthcare Reform Proving To Be A Calendar Challenge - John Baresky, #baresky
Healthcare Reform Proving To Be A Calendar Challenge - John Baresky, #baresky
 
About The Alliance
About The AllianceAbout The Alliance
About The Alliance
 
Blue Cross Blue Shield and BUPA Partnership - 2014 - A Global Healthcare Deve...
Blue Cross Blue Shield and BUPA Partnership - 2014 - A Global Healthcare Deve...Blue Cross Blue Shield and BUPA Partnership - 2014 - A Global Healthcare Deve...
Blue Cross Blue Shield and BUPA Partnership - 2014 - A Global Healthcare Deve...
 
What is mips and how it affects my
What is mips and how it affects myWhat is mips and how it affects my
What is mips and how it affects my
 
Workers’ compensation program - the texas model
Workers’ compensation program  - the texas modelWorkers’ compensation program  - the texas model
Workers’ compensation program - the texas model
 

Viewers also liked

Research Ethics 20th Nov 09 Arec
Research Ethics 20th Nov 09 ArecResearch Ethics 20th Nov 09 Arec
Research Ethics 20th Nov 09 Arec
Colin_Standfield
 
Healthcare Communication and Management in the Changing World
Healthcare Communication and Management in the Changing WorldHealthcare Communication and Management in the Changing World
Healthcare Communication and Management in the Changing WorldSusan "Suzanne" Ewert
 
Com theroy exam 2
Com theroy exam 2Com theroy exam 2
Com theroy exam 2jasonsirmon
 
Ethics for Introduction to Health Care
Ethics for Introduction to Health CareEthics for Introduction to Health Care
Ethics for Introduction to Health Care
RHSHealthScience
 
Morals and ethics
Morals and ethicsMorals and ethics
Morals and ethics
Paul Irving
 
PHI 204 - Ethical Issues in Health Care: Virtue Ethics, Feminist Ethics
PHI 204 - Ethical Issues in Health Care: Virtue Ethics, Feminist EthicsPHI 204 - Ethical Issues in Health Care: Virtue Ethics, Feminist Ethics
PHI 204 - Ethical Issues in Health Care: Virtue Ethics, Feminist Ethicsdotcom YOGA
 
Ethics in Healthcare
Ethics in HealthcareEthics in Healthcare
Ethics in Healthcare
Swarupa Rani Sahu
 
Copyright and Ethics In Digital Age
Copyright and Ethics In Digital AgeCopyright and Ethics In Digital Age
Copyright and Ethics In Digital Age
Kathy Gill
 
Ethics lesson 4
Ethics lesson 4Ethics lesson 4
Ethics lesson 4Sampath
 
1.04 ethics in healthcare
1.04 ethics in healthcare1.04 ethics in healthcare
1.04 ethics in healthcare
melodiekernahan
 
Ethical Boundaries
Ethical BoundariesEthical Boundaries
Ethical Boundariespayneje
 
Ethics in the workplace
Ethics in the workplaceEthics in the workplace
Ethics in the workplace
CG Hylton Inc.
 
BIOETHICS, a bridge between the facts and moral behaviour.
BIOETHICS, a bridge between the facts and moral behaviour.BIOETHICS, a bridge between the facts and moral behaviour.
BIOETHICS, a bridge between the facts and moral behaviour.
UAS,GKVK<BANGALORE
 
Ethical theories NURSING ETHICS
Ethical theories NURSING ETHICSEthical theories NURSING ETHICS
Ethical theories NURSING ETHICS
PIR BUX JOKHIO
 
Ethics Review
Ethics ReviewEthics Review
Ethics Review
Ian Carmichael
 
Ethics of health care introduction
Ethics of health care  introductionEthics of health care  introduction
Ethics of health care introductionbholmes
 
Role presentation ethical decision making-final
Role presentation ethical decision making-finalRole presentation ethical decision making-final
Role presentation ethical decision making-finalKatelyn Taylor
 

Viewers also liked (20)

Research Ethics 20th Nov 09 Arec
Research Ethics 20th Nov 09 ArecResearch Ethics 20th Nov 09 Arec
Research Ethics 20th Nov 09 Arec
 
Controversy 5
Controversy 5Controversy 5
Controversy 5
 
Healthcare Communication and Management in the Changing World
Healthcare Communication and Management in the Changing WorldHealthcare Communication and Management in the Changing World
Healthcare Communication and Management in the Changing World
 
Com theroy exam 2
Com theroy exam 2Com theroy exam 2
Com theroy exam 2
 
Ethics for Introduction to Health Care
Ethics for Introduction to Health CareEthics for Introduction to Health Care
Ethics for Introduction to Health Care
 
Morals and ethics
Morals and ethicsMorals and ethics
Morals and ethics
 
PHI 204 - Ethical Issues in Health Care: Virtue Ethics, Feminist Ethics
PHI 204 - Ethical Issues in Health Care: Virtue Ethics, Feminist EthicsPHI 204 - Ethical Issues in Health Care: Virtue Ethics, Feminist Ethics
PHI 204 - Ethical Issues in Health Care: Virtue Ethics, Feminist Ethics
 
Codes Of Ethics
Codes Of EthicsCodes Of Ethics
Codes Of Ethics
 
Ethics in Healthcare
Ethics in HealthcareEthics in Healthcare
Ethics in Healthcare
 
Copyright and Ethics In Digital Age
Copyright and Ethics In Digital AgeCopyright and Ethics In Digital Age
Copyright and Ethics In Digital Age
 
Ethics lesson 4
Ethics lesson 4Ethics lesson 4
Ethics lesson 4
 
Bio ethic
Bio ethicBio ethic
Bio ethic
 
1.04 ethics in healthcare
1.04 ethics in healthcare1.04 ethics in healthcare
1.04 ethics in healthcare
 
Ethical Boundaries
Ethical BoundariesEthical Boundaries
Ethical Boundaries
 
Ethics in the workplace
Ethics in the workplaceEthics in the workplace
Ethics in the workplace
 
BIOETHICS, a bridge between the facts and moral behaviour.
BIOETHICS, a bridge between the facts and moral behaviour.BIOETHICS, a bridge between the facts and moral behaviour.
BIOETHICS, a bridge between the facts and moral behaviour.
 
Ethical theories NURSING ETHICS
Ethical theories NURSING ETHICSEthical theories NURSING ETHICS
Ethical theories NURSING ETHICS
 
Ethics Review
Ethics ReviewEthics Review
Ethics Review
 
Ethics of health care introduction
Ethics of health care  introductionEthics of health care  introduction
Ethics of health care introduction
 
Role presentation ethical decision making-final
Role presentation ethical decision making-finalRole presentation ethical decision making-final
Role presentation ethical decision making-final
 

Similar to Presentation w2

Network Development In The Managed Care Organization
Network Development In The Managed Care OrganizationNetwork Development In The Managed Care Organization
Network Development In The Managed Care Organization
Gina Alfaro
 
Digital Health Strategies: What Matters to Payers?
Digital Health Strategies: What Matters to Payers?Digital Health Strategies: What Matters to Payers?
Digital Health Strategies: What Matters to Payers?
Susan Philip
 
Digital Health Strategies: What Matters to Payers?
Digital Health Strategies: What Matters to Payers?Digital Health Strategies: What Matters to Payers?
Digital Health Strategies: What Matters to Payers?
Susan Philip
 
Understanding State Efforts to Implement Exchanges
Understanding State Efforts to Implement ExchangesUnderstanding State Efforts to Implement Exchanges
Understanding State Efforts to Implement Exchanges
AcademyHealth
 
D1 1020 related paper a booster shot for health and wellness exec report v4
D1 1020 related paper a booster shot for health and wellness exec report v4D1 1020 related paper a booster shot for health and wellness exec report v4
D1 1020 related paper a booster shot for health and wellness exec report v4
Dr. Wilfred Lin (Ph.D.)
 
Running Head HEALTH CARE MARKETING ORGANIZATIONHEALTH CARE MAR.docx
Running Head HEALTH CARE MARKETING ORGANIZATIONHEALTH CARE MAR.docxRunning Head HEALTH CARE MARKETING ORGANIZATIONHEALTH CARE MAR.docx
Running Head HEALTH CARE MARKETING ORGANIZATIONHEALTH CARE MAR.docx
cowinhelen
 
Mastering Pharmacy Medical Billing + Claims Submission
Mastering Pharmacy Medical Billing + Claims SubmissionMastering Pharmacy Medical Billing + Claims Submission
Mastering Pharmacy Medical Billing + Claims Submission
kendall100
 
Broker Article
Broker ArticleBroker Article
Broker Article
jeffmarks
 
Kindly respond to this discussion 250 2.docx
Kindly respond to this discussion 250 2.docxKindly respond to this discussion 250 2.docx
Kindly respond to this discussion 250 2.docx
write22
 
White Paper - Building Your ACO and Healthcare IT’s Role
White Paper - Building Your ACO and Healthcare IT’s RoleWhite Paper - Building Your ACO and Healthcare IT’s Role
White Paper - Building Your ACO and Healthcare IT’s Role
NextGen Healthcare
 
Managed Care.docx
Managed Care.docxManaged Care.docx
Managed Care.docx
4934bk
 
Why A Healthcare System Is An Organization Of People,...
Why A Healthcare System Is An Organization Of People,...Why A Healthcare System Is An Organization Of People,...
Why A Healthcare System Is An Organization Of People,...
Rachel Davis
 
4 75.docx
4 75.docx4 75.docx
4 75.docx
write5
 
Privacy and Security What types of health care data are protected u.pdf
Privacy and Security What types of health care data are protected u.pdfPrivacy and Security What types of health care data are protected u.pdf
Privacy and Security What types of health care data are protected u.pdf
badshetoms
 

Similar to Presentation w2 (16)

Network Development In The Managed Care Organization
Network Development In The Managed Care OrganizationNetwork Development In The Managed Care Organization
Network Development In The Managed Care Organization
 
industry-in-focus
industry-in-focusindustry-in-focus
industry-in-focus
 
Digital Health Strategies: What Matters to Payers?
Digital Health Strategies: What Matters to Payers?Digital Health Strategies: What Matters to Payers?
Digital Health Strategies: What Matters to Payers?
 
Digital Health Strategies: What Matters to Payers?
Digital Health Strategies: What Matters to Payers?Digital Health Strategies: What Matters to Payers?
Digital Health Strategies: What Matters to Payers?
 
Understanding State Efforts to Implement Exchanges
Understanding State Efforts to Implement ExchangesUnderstanding State Efforts to Implement Exchanges
Understanding State Efforts to Implement Exchanges
 
Top5Challengessm
Top5ChallengessmTop5Challengessm
Top5Challengessm
 
D1 1020 related paper a booster shot for health and wellness exec report v4
D1 1020 related paper a booster shot for health and wellness exec report v4D1 1020 related paper a booster shot for health and wellness exec report v4
D1 1020 related paper a booster shot for health and wellness exec report v4
 
Running Head HEALTH CARE MARKETING ORGANIZATIONHEALTH CARE MAR.docx
Running Head HEALTH CARE MARKETING ORGANIZATIONHEALTH CARE MAR.docxRunning Head HEALTH CARE MARKETING ORGANIZATIONHEALTH CARE MAR.docx
Running Head HEALTH CARE MARKETING ORGANIZATIONHEALTH CARE MAR.docx
 
Mastering Pharmacy Medical Billing + Claims Submission
Mastering Pharmacy Medical Billing + Claims SubmissionMastering Pharmacy Medical Billing + Claims Submission
Mastering Pharmacy Medical Billing + Claims Submission
 
Broker Article
Broker ArticleBroker Article
Broker Article
 
Kindly respond to this discussion 250 2.docx
Kindly respond to this discussion 250 2.docxKindly respond to this discussion 250 2.docx
Kindly respond to this discussion 250 2.docx
 
White Paper - Building Your ACO and Healthcare IT’s Role
White Paper - Building Your ACO and Healthcare IT’s RoleWhite Paper - Building Your ACO and Healthcare IT’s Role
White Paper - Building Your ACO and Healthcare IT’s Role
 
Managed Care.docx
Managed Care.docxManaged Care.docx
Managed Care.docx
 
Why A Healthcare System Is An Organization Of People,...
Why A Healthcare System Is An Organization Of People,...Why A Healthcare System Is An Organization Of People,...
Why A Healthcare System Is An Organization Of People,...
 
4 75.docx
4 75.docx4 75.docx
4 75.docx
 
Privacy and Security What types of health care data are protected u.pdf
Privacy and Security What types of health care data are protected u.pdfPrivacy and Security What types of health care data are protected u.pdf
Privacy and Security What types of health care data are protected u.pdf
 

Recently uploaded

India Orthopedic Devices Market: Unlocking Growth Secrets, Trends and Develop...
India Orthopedic Devices Market: Unlocking Growth Secrets, Trends and Develop...India Orthopedic Devices Market: Unlocking Growth Secrets, Trends and Develop...
India Orthopedic Devices Market: Unlocking Growth Secrets, Trends and Develop...
Kumar Satyam
 
CADAVER AS OUR FIRST TEACHER anatomt in your.pptx
CADAVER AS OUR FIRST TEACHER anatomt in your.pptxCADAVER AS OUR FIRST TEACHER anatomt in your.pptx
CADAVER AS OUR FIRST TEACHER anatomt in your.pptx
fakeloginn69
 
RMD24 | Retail media: hoe zet je dit in als je geen AH of Unilever bent? Heid...
RMD24 | Retail media: hoe zet je dit in als je geen AH of Unilever bent? Heid...RMD24 | Retail media: hoe zet je dit in als je geen AH of Unilever bent? Heid...
RMD24 | Retail media: hoe zet je dit in als je geen AH of Unilever bent? Heid...
BBPMedia1
 
Affordable Stationery Printing Services in Jaipur | Navpack n Print
Affordable Stationery Printing Services in Jaipur | Navpack n PrintAffordable Stationery Printing Services in Jaipur | Navpack n Print
Affordable Stationery Printing Services in Jaipur | Navpack n Print
Navpack & Print
 
BeMetals Presentation_May_22_2024 .pdf
BeMetals Presentation_May_22_2024   .pdfBeMetals Presentation_May_22_2024   .pdf
BeMetals Presentation_May_22_2024 .pdf
DerekIwanaka1
 
Discover the innovative and creative projects that highlight my journey throu...
Discover the innovative and creative projects that highlight my journey throu...Discover the innovative and creative projects that highlight my journey throu...
Discover the innovative and creative projects that highlight my journey throu...
dylandmeas
 
Cracking the Workplace Discipline Code Main.pptx
Cracking the Workplace Discipline Code Main.pptxCracking the Workplace Discipline Code Main.pptx
Cracking the Workplace Discipline Code Main.pptx
Workforce Group
 
Exploring Patterns of Connection with Social Dreaming
Exploring Patterns of Connection with Social DreamingExploring Patterns of Connection with Social Dreaming
Exploring Patterns of Connection with Social Dreaming
Nicola Wreford-Howard
 
The Parable of the Pipeline a book every new businessman or business student ...
The Parable of the Pipeline a book every new businessman or business student ...The Parable of the Pipeline a book every new businessman or business student ...
The Parable of the Pipeline a book every new businessman or business student ...
awaisafdar
 
Attending a job Interview for B1 and B2 Englsih learners
Attending a job Interview for B1 and B2 Englsih learnersAttending a job Interview for B1 and B2 Englsih learners
Attending a job Interview for B1 and B2 Englsih learners
Erika906060
 
April 2024 Nostalgia Products Newsletter
April 2024 Nostalgia Products NewsletterApril 2024 Nostalgia Products Newsletter
April 2024 Nostalgia Products Newsletter
NathanBaughman3
 
20240425_ TJ Communications Credentials_compressed.pdf
20240425_ TJ Communications Credentials_compressed.pdf20240425_ TJ Communications Credentials_compressed.pdf
20240425_ TJ Communications Credentials_compressed.pdf
tjcomstrang
 
Maksym Vyshnivetskyi: PMO Quality Management (UA)
Maksym Vyshnivetskyi: PMO Quality Management (UA)Maksym Vyshnivetskyi: PMO Quality Management (UA)
Maksym Vyshnivetskyi: PMO Quality Management (UA)
Lviv Startup Club
 
Premium MEAN Stack Development Solutions for Modern Businesses
Premium MEAN Stack Development Solutions for Modern BusinessesPremium MEAN Stack Development Solutions for Modern Businesses
Premium MEAN Stack Development Solutions for Modern Businesses
SynapseIndia
 
RMD24 | Debunking the non-endemic revenue myth Marvin Vacquier Droop | First ...
RMD24 | Debunking the non-endemic revenue myth Marvin Vacquier Droop | First ...RMD24 | Debunking the non-endemic revenue myth Marvin Vacquier Droop | First ...
RMD24 | Debunking the non-endemic revenue myth Marvin Vacquier Droop | First ...
BBPMedia1
 
Filing Your Delaware Franchise Tax A Detailed Guide
Filing Your Delaware Franchise Tax A Detailed GuideFiling Your Delaware Franchise Tax A Detailed Guide
Filing Your Delaware Franchise Tax A Detailed Guide
YourLegal Accounting
 
一比一原版加拿大渥太华大学毕业证(uottawa毕业证书)如何办理
一比一原版加拿大渥太华大学毕业证(uottawa毕业证书)如何办理一比一原版加拿大渥太华大学毕业证(uottawa毕业证书)如何办理
一比一原版加拿大渥太华大学毕业证(uottawa毕业证书)如何办理
taqyed
 
Enterprise Excellence is Inclusive Excellence.pdf
Enterprise Excellence is Inclusive Excellence.pdfEnterprise Excellence is Inclusive Excellence.pdf
Enterprise Excellence is Inclusive Excellence.pdf
KaiNexus
 
Pitch Deck Teardown: RAW Dating App's $3M Angel deck
Pitch Deck Teardown: RAW Dating App's $3M Angel deckPitch Deck Teardown: RAW Dating App's $3M Angel deck
Pitch Deck Teardown: RAW Dating App's $3M Angel deck
HajeJanKamps
 
anas about venice for grade 6f about venice
anas about venice for grade 6f about veniceanas about venice for grade 6f about venice
anas about venice for grade 6f about venice
anasabutalha2013
 

Recently uploaded (20)

India Orthopedic Devices Market: Unlocking Growth Secrets, Trends and Develop...
India Orthopedic Devices Market: Unlocking Growth Secrets, Trends and Develop...India Orthopedic Devices Market: Unlocking Growth Secrets, Trends and Develop...
India Orthopedic Devices Market: Unlocking Growth Secrets, Trends and Develop...
 
CADAVER AS OUR FIRST TEACHER anatomt in your.pptx
CADAVER AS OUR FIRST TEACHER anatomt in your.pptxCADAVER AS OUR FIRST TEACHER anatomt in your.pptx
CADAVER AS OUR FIRST TEACHER anatomt in your.pptx
 
RMD24 | Retail media: hoe zet je dit in als je geen AH of Unilever bent? Heid...
RMD24 | Retail media: hoe zet je dit in als je geen AH of Unilever bent? Heid...RMD24 | Retail media: hoe zet je dit in als je geen AH of Unilever bent? Heid...
RMD24 | Retail media: hoe zet je dit in als je geen AH of Unilever bent? Heid...
 
Affordable Stationery Printing Services in Jaipur | Navpack n Print
Affordable Stationery Printing Services in Jaipur | Navpack n PrintAffordable Stationery Printing Services in Jaipur | Navpack n Print
Affordable Stationery Printing Services in Jaipur | Navpack n Print
 
BeMetals Presentation_May_22_2024 .pdf
BeMetals Presentation_May_22_2024   .pdfBeMetals Presentation_May_22_2024   .pdf
BeMetals Presentation_May_22_2024 .pdf
 
Discover the innovative and creative projects that highlight my journey throu...
Discover the innovative and creative projects that highlight my journey throu...Discover the innovative and creative projects that highlight my journey throu...
Discover the innovative and creative projects that highlight my journey throu...
 
Cracking the Workplace Discipline Code Main.pptx
Cracking the Workplace Discipline Code Main.pptxCracking the Workplace Discipline Code Main.pptx
Cracking the Workplace Discipline Code Main.pptx
 
Exploring Patterns of Connection with Social Dreaming
Exploring Patterns of Connection with Social DreamingExploring Patterns of Connection with Social Dreaming
Exploring Patterns of Connection with Social Dreaming
 
The Parable of the Pipeline a book every new businessman or business student ...
The Parable of the Pipeline a book every new businessman or business student ...The Parable of the Pipeline a book every new businessman or business student ...
The Parable of the Pipeline a book every new businessman or business student ...
 
Attending a job Interview for B1 and B2 Englsih learners
Attending a job Interview for B1 and B2 Englsih learnersAttending a job Interview for B1 and B2 Englsih learners
Attending a job Interview for B1 and B2 Englsih learners
 
April 2024 Nostalgia Products Newsletter
April 2024 Nostalgia Products NewsletterApril 2024 Nostalgia Products Newsletter
April 2024 Nostalgia Products Newsletter
 
20240425_ TJ Communications Credentials_compressed.pdf
20240425_ TJ Communications Credentials_compressed.pdf20240425_ TJ Communications Credentials_compressed.pdf
20240425_ TJ Communications Credentials_compressed.pdf
 
Maksym Vyshnivetskyi: PMO Quality Management (UA)
Maksym Vyshnivetskyi: PMO Quality Management (UA)Maksym Vyshnivetskyi: PMO Quality Management (UA)
Maksym Vyshnivetskyi: PMO Quality Management (UA)
 
Premium MEAN Stack Development Solutions for Modern Businesses
Premium MEAN Stack Development Solutions for Modern BusinessesPremium MEAN Stack Development Solutions for Modern Businesses
Premium MEAN Stack Development Solutions for Modern Businesses
 
RMD24 | Debunking the non-endemic revenue myth Marvin Vacquier Droop | First ...
RMD24 | Debunking the non-endemic revenue myth Marvin Vacquier Droop | First ...RMD24 | Debunking the non-endemic revenue myth Marvin Vacquier Droop | First ...
RMD24 | Debunking the non-endemic revenue myth Marvin Vacquier Droop | First ...
 
Filing Your Delaware Franchise Tax A Detailed Guide
Filing Your Delaware Franchise Tax A Detailed GuideFiling Your Delaware Franchise Tax A Detailed Guide
Filing Your Delaware Franchise Tax A Detailed Guide
 
一比一原版加拿大渥太华大学毕业证(uottawa毕业证书)如何办理
一比一原版加拿大渥太华大学毕业证(uottawa毕业证书)如何办理一比一原版加拿大渥太华大学毕业证(uottawa毕业证书)如何办理
一比一原版加拿大渥太华大学毕业证(uottawa毕业证书)如何办理
 
Enterprise Excellence is Inclusive Excellence.pdf
Enterprise Excellence is Inclusive Excellence.pdfEnterprise Excellence is Inclusive Excellence.pdf
Enterprise Excellence is Inclusive Excellence.pdf
 
Pitch Deck Teardown: RAW Dating App's $3M Angel deck
Pitch Deck Teardown: RAW Dating App's $3M Angel deckPitch Deck Teardown: RAW Dating App's $3M Angel deck
Pitch Deck Teardown: RAW Dating App's $3M Angel deck
 
anas about venice for grade 6f about venice
anas about venice for grade 6f about veniceanas about venice for grade 6f about venice
anas about venice for grade 6f about venice
 

Presentation w2

  • 1.
  • 4. Care for OthersThe core expertise of the Enrollment Industry lies on maintaining member profiles, processing enrollment application, verifying eligibility to access an Active Coverage. Prompt service and, processing are the key functions that help to develop the Health Care Industry. 1
  • 5. Market On your annual open enrollment time carefully research your elective provider history and turnaround claims process in order to make the right choicewhich will make a difference from the others competitors. 2
  • 6. Product or Service Description As an administrator the organization should process the health care enrollment and claims without carrying insurance risk or jeopardizing the accuracy of the data. The TPAs (third party administrators) are prominent players in the managed care industry and have the expertise and capability to administer all, or a portion of the claims process. Their services also include premium collection. While some TPAs operate as units of insurance companies, they are often independent. However, hospitals or provider organizations desiring to set up their own health plans will often outsource certain responsibilities to TPA's. 3
  • 7. Competition With more corporations outsourcing to third-party administrators to handle their enrollment, claims with the market for the TPA services becoming ever more competitive, it's time to consider the role actuaries can play in helping TPAs provide quality service, deliver promised outcomes and provide sustained competitive advantage. Diversity of plan options and retention of policy holders is your key for success. 4
  • 8. Industry Analysis The health care administration industry depends on the care of health-related services by professionals for the benefit of patients. To improve the effectiveness of health care services in the state and to support consumers in health care decision making, our business responsibility should be collecting, compiling, coordinating, analyzing and disseminating health related data. These data will provide accurate and timely consumers demands in order to administer and evaluate the cost of service, quality and access to healthcare. Currently there are too many options offering a private service for quality control and delivery for managing people’s confidential information, however these competitors lack of personalize services force the consumer to search for better options. 5
  • 9. Statistics and Target Market The demands for Health Care Administrators for the Bilingual Market represent: Job opportunities for minorities Healthcare options at an affordable rate Better Health and Education for Hispanic And Asian Communities as they learned the state Coverage policies and guidelines. TARGET 6
  • 10. Top 3 Competitors: Nowadays in the Health Care Administrators Industry there are three reputable competitors: Hewitt: A global human resources outsourcing and consulting firm founded in 1940. They represent millions of participants and is approaching $300 billion in assets. (http://www.hewittcoleman.com/) Trion: Supports the communities in which it operates, its employees work and its clients thrive helping hundreds of charities, non profits and organizations achieve their mission. (http://www.trion.com/services/fsa-compliance-focus/default.aspx) Kelly Services: Offers the most qualified, accomplished healthcare professionals at all levels from case managers, to medical technicians, to therapists and everything in between. (http://www.kellyservices.com/web/global/services/en/pages/index.html) 7