Inova Care Indonesia Profile

CARE ASIA
Become a Network Provider
January 2020 Ó Inova International

All Rights Reserved  Confidential & Proprietary
The Inova Care Network
The cornerstone of Inova’s success is the quality of its medical and Networks
dental provider networks.
• Medical
For nearly two decades Inova Solutions has been a pioneer in • Dental
developing innovative products and services that bring value and
patient volume to our provider network. • Ancillary
• Telemedicine
We welcome you to join our provider network and become part of
a growing international healthcare network of providers that is
committed to improving how healthcare services are accessed
worldwide.
Ó Inova International
All Rights Reserved  Confidential & Proprietary2
Introduction to Inova Care Asia
• Parent company (Inova International) established in 2002
• Sister company to:

- Inova Care USA
- Inova Benefit Solutions
- Inova Cyber Security
- Inova Digital Technologies
- Skygen USA
• All solutions are designed to help our business partners:

- Increase revenue
- Improve access to healthcare services
- Differentiate their product and service offerings
About Inova International
Claims Managed
since 2002 Areas of Specialization
> 4.5 million
• Market research
Care
Customer Care
Coordinated • Product development
cases since 2002
since 2002
> 2.5 million • Third Party Administration
> 700k cases
• Cost containment
• Value-added services
Call Average Claims • Technology solutions
Abandonment Turnaround =
Rate = 2.95% 2.25 days • Distribution development
Where We Are
• China
• Indonesia
• India (in process)
• Italy
• Japan
• Korea
• Malaysia
• Mexico
• Myanmar
• Philippines
• Singapore
• Thailand
• Turkey
• United States
• Vietnam
5
Product / Service Development Experience
Our solutions have resulted in record growth and profitability for our clients:
• Individual and group medical ǀ dental programs
• Managed health care plans
• Limited medical supplementary plans
• Hybrid high limit critical illness and cancer plans
• Hybrid hospital income protection plans
• Personal accident
• Individual and corporate wellness programs
• Disease state management solutions
• Cross border health care programs
• Hybrid medical second opinion services
Why Join the Inova Care Network
• Participation in new and innovative health and dental benefit programs.
• Increased patient volume
• Direct, fast payment for covered services

< 10 business days for clean claims
• Efficient web claims process
• VIP appointment scheduling coordination services for Inova’s members
Ó Inova International 7
How to Join the Inova Care Network
Joining our Network is Easy:
• At anytime you may apply to join the Inova network online
at www.inova.network.
• The Inova provider relations team will send you all

documents required to join our network.
• Simply sign the provider agreement and the provider

relations team will confirm your status.
• Inova Care will regularly update you about the new

benefit programs we support.
What Makes Inova Care Unique
• Fully integrated web-based technology
• Provider network contracting model
• International quality and utilization management guidelines
• Transaction efficiency
• Product development capabilities
• Web portal tool for members, providers and payers
• Online, real-time management reporting
• Modular service model
Operational Workflows
10 Ó Inova International
Outpatient Medical & Dental Workflow
Show Card – provider check eligibility via calling the toll-free number +65 6222 3157
or by emailing the singapore@inovacare.com and request for Letter of Guarantee of
member if active.
e-Card – provider checks the eligibility at the bottom of the e-card. If additional
verification is needed, provider may call Inova Care hotline.
ÓInternal Use Only

Inova International
Inpatient Workflow
Member presents insurance e-card & Provider check eligibility via calling the designated hotline no (local Inova Care issue Authorization Letter based on
valid government issued ID card to hotline) or by emailing providermm@inovacare.com and request for member’s eligibility and Room & Board
provider for obtaining treatment Letter of Guarantee if the member is active. benefits to confirm admission.
Hospital admission and treatments Inova Care performs concurrent review during Provider fill in claim form with treatments code/
commence Member hospitalization Physician attending’s report/Final expenses
(IPD)and send all documents to Inova Care
Member to pay excess amount

Inova Care issue GL for the approved final (if there are non-coverable Provider sends all required information Inova process and settle payment to
medical expenses (IPD) items/benefit) to hospital to Inova for claim process. Provider.
Medical Claim Documentation Requirements
M
F OR
LE
MP
SA
Medical History Medical Report e.g. Laboratory, X-ray or Scan Results and Prescription
Medical Claim Form
Medical Invoice with Patient’s Copy of Passport or National ID Card

Signature
Sample Letter of Guarantee
14
Sample Claim Submission Checklist
CLINIC OR HOSPITAL NAME:
MEMBER NAME:
MEMBER ID:
DOCUMENTS NEEDED
 CONSENT FROM MEMBER OR MEMBER’S SIGNATURE
 AUTHORIZATION LETTER FROM INOVA CARE (FOR CASHLESS)
 MEMBER ID CARD / MEMBER GOVERNMENT ID CARD
 DULY ACCOMPLISHED CLAIM FORM
 ORIGINAL ITEMIZED RECEIPT / INVOICE
 COPY OF DRUG/MEDICATION PRESCRIPTIONS (IF APPLICABLE)
 OPY OF LABORATORY AND OTHER DIAGNOSTIC TEST RESULTS (FOR AVAILED AND AS SUPPORTING DOCUMENTS FOR
COMPLICATED TREATMENTS)
 CLAIM FORM INFORMATION
 DIAGNOSIS
 CODED TREATMENTS / PROCEDURES
 X-RAY COPIES (FOR AVAILED AND AS SUPPORTING DOCUMENTS FOR COMPLICATED TREATMENTS)
 MEMBER'S SIGNATURE
 ATTENDING PHYSICIAN'S SIGNATURE
 CLINIC’S STAMP
15
Sample Member ID Card
Sample
Member ID
Physical
Card
16
Sample Virtual ID Card
Alternative to traditional Show Card

 Mobile app digitization of physical ID card
 Simplified Distribution of ID Cards
 Digital Fulfillment Process
 Electronic Eligibility Verification
 Customer Service Access
Digital ID card with photo for fraud control
17
Member Eligibility Verification
Digital Member Eligibility Check
Unlike physical card, the Digital Card has capability to determine member eligibility and status of the
membership which is important for products with monthly premium collection.
Active Membership Inactive Membership Card is Offline

The application has connected with The application has connected with Member’s device does not have
Inova Care core system via internet Inova Care core system via internet internet connectivity or there is other
and validated status of the and validated status of the technical reason and the member
membership and premium payment, membership and premium payment, eligibility cannot be determined.
and member is currently active and member is currently inactive Providers needs to follow traditional
offline process.
18
Inova’s Current & Past International Clients
19
THANK YOU
Contact Us 4851 Tamiami Trail, Suite 200

Naples, Florida 3410
International
info@inovasolutions.net
20 Ó Inova International

Inova Care Indonesia Profile

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CARE ASIA

Become a Network Provider

January 2020 Ó Inova International

• Sister company to:

• All solutions are designed to help our business partners:

• Increased patient volume

• Direct, fast payment for covered services

• Efficient web claims process

• VIP appointment scheduling coordination services for Inova’s members

• The Inova provider relations team will send you all

• Simply sign the provider agreement and the provider

• Inova Care will regularly update you about the new

ÓInternal Use Only

Member to pay excess amount

Medical Invoice with Patient’s Copy of Passport or National ID Card

Alternative to traditional Show Card

Digital ID card with photo for fraud control

Active Membership Inactive Membership Card is Offline

Contact Us 4851 Tamiami Trail, Suite 200

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