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  Claims Administration
As a TPA, Medicare focuses on managing health benefits. Our claims administration capabilities encompass insured assistance, claim pre-certification, adjudication and settlement. We are also involved in Fund Management, Audit, Information Management, Records Inventory Management & Warehousing. 

We administer a variety of self-insured medical benefits plans for clients nationwide. Our tailored administration services provide flexibility and control to clients. We have access to health care networks nationwide and have an in-house pre-certification program for cashless treatment in these provider networks. We also provide stop-loss administration for our clients by administrating Fraud control system and real time estimating of loss reserves.
  Medical Management

Medicares' medical management team provides expertise you can count on. Our patient care managers have extensive clinical experience and are adept at managing benefit costs, while ensuring that insured receive appropriate, high-quality medical care.

We tailor managed care services to fit your individual needs in a comprehensive program that includes:
Pre-certification of hospital admissions. 
Continued stay and concurrent review 
Discharge planning 
Retrospective admission review 
Post-payment audits 
Other patient care management and review services 
Case management 
Online Real time Information to all segments including Policy Holder, Provider and Insurance Company.
  Health Care Network


Medicare is ready to meet your organization's health care needs - whether you have Insured at a single location or at multiple locations nationwide. Our approach to health care network utilizes over 4000 of the nation's hospitals, diagnostic centers and pharmacies. 

We work in concert with clients to find positive solutions to their health care plan objectives. Our strategy is to find a balance between Insured access and cost savings.