24-Hour Customer Service Call Center
Manned by nurses to handle medical questions and service inquiries

Hospital Liaison Officers
Nurses that look into member's concerns during confinement

Physician Coordinators
General Practitioners are assigned to each affiliated hospital and oversee patients overall medical care

Handles various concerns and play a pro-active role in ensuring customer satisfaction


QUALITY ASSURANCE MECHANISMS
- Clinical practice guidelines
- Evidence-based medicine
- Clinic service surveys
- In-patient service evaluation
- Immediate feedback to providers and members on any medical servicing concerns
- Monitoring of utilization metrics
- Wellness programs


UTILIZATION MANAGEMENT AND COST CONTAINMENT MECHANISMS
- Pre-admission or pre-utilization certification
- Concurrent review of health services rendered to a confined patient
- Post-review of in-patient utilization
- Peer review of physician's practice patterns and outcomes