OUR MODUS OPERANDI

COMPLAINT RESOLUTION
» All members have access to the Emergency lines manned by THT medical personnel.
» THT medical personnel are empowered to resolve medical issues with providers.
» Enrollment Officers deal with eligibility issues.
» The Medical Managers report all complaints to Medical Directors daily.
» Promptness of necessary care is the watchword of THT.

RISK MANAGEMENT
» All beneficiaries are registered.
» Photo-ID & Numbers issued to each beneficiary.
» Each Beneficiary chooses a provider on network
» All Primary Care to be Accessed at chosen Provider
» Access to Network Providers only except in Medical Emergency.
» Providers capitated for primary & secondary care only.
» Specialist consultations and procedures paid by HMO following due notification in case of emergency or due
   authorization for non-urgent care.
» Providers educated on Evidence Based Medical Guidelines through mandatory Continuing Medical Education.
» Utilization review of provider services by THT Medical Department.
» Medical Exclusions on pre-paid premium clearly listed