ADV Angola is a company specialised in health benefit plan management for Health Insurance Companies, Public Systems and medium and large-size Companies.
We also provide Clinical Management in the areas like workplace accidents, car accidents, personal accident insurance and life insurance, undertaking all clinical procedure management evaluation and personal injury evaluation.
We have a vast specialised and multi-disciplinary team (which includes, among others, doctors, nurses, specialised healthcare professionals and technicians and actuaries) which enables us to provide, together with our clients, an integrated and complete management of personal/patient insurance coverage under our management.
We also provide services in the areas of Accidents in the Workplace, Motor Vehicle Accident Insurance, Personal Accident Insurance and Life Insurance, undertaking all clinical procedure management evaluation and personal injury evaluation.
If you are already working with us, we’d like to invite you to discover how our range of services has developed. If you are not yet a Client or Partner of ADV Angola, find out more about our activity.
Management and Monitoring of clinical cases under our care:
- Accident/Health Expenses Insurance Settlemen
- Payment of expenses in line with healthcare benefit plan coverage, whether through a network of conventional service suppliers, or insured clients/patients, controlling and checking respective invoices/receipts.
- Providing extracts of benefits for insured clients/patients and health care service providers.
- Configuration, implementation and monitoring of parameters and indicators of use.
- Clinical management
- Face-to-face accompaniment and management of clinical cases under our care.
- Analysing requests subject to pre-authorisation and issuance of respective terms of responsibility.
- Discussing best clinical practices with the network of healthcare service providers.
- Call center
- Round-the-clock call service 7 days a week for insurance policy holders/patients and healthcare service providers for any inquiry:
- Telephone eligibility procedures;
- Expenses processing;
- Pre-authorisations and issuance of terms of responsibility;
- Satisfaction surveys on quality of service within the network of service providers;
- Others;
- Client Website
- Providing insurance policy holders/patients with a specialised website (adapted to the image of each insurer), containing various information such as the demographic data of policy holders/patients, the coverage policy contracted, the records of expenses paid, claims requests and respective replies issued, amongst other important and relevant information.
- Management information
- Regular meetings with the client management team for partnership accompaniment;
- Ongoing measuring and analysis of different performance indicators;
- Regular delivery of management reports on the different activities under ADV Angola management (complaints, telephone assistance, payments, terms of responsability, etc.);
- Regularly carrying out and presenting results obtained from satisfaction surveys to insurance policy holders and service providers;
- Providing relevant management information on the Angolan market, helping clients make strategic decisions.
- Management of network of service providers
- Fulfilling contracts with healthcare providers taking into account the needs of the network in geographical terms and the development of the policyholder/patient portfolio under management;
- Negotiation and management of contracted fee tariffs;
- Carrying out market analysis processes (private and convention) so as to ensure competitive pricing models;
- Accreditation of the network of service providers taking into account the availability of a network of assured health insurance providers offering high standards of quality;
- Carrying out ongoing training sessions with the network of agreed service providers.
- Materials/support content in accordance with the institutional image of each client
- Production of materials and support content necessary for managing healthcare coverage policy plans, namely:
- Cards accessing the network of service providers;
- Newsletter;
- Provision of promotional materials to the network of service providers.
Bodily Injury Management:
- Work, car, life and personal accident insurances
- Management of clinical and personal accident procedures resulting from accidents within the scope of work, car, life and personal accident insurance. Personal accident management encompasses, among other things, the following service
- The proactive management of accidents, ensuring a thorough evaluation of evidence of causal link, and if so determined, later channelling of patients to speciality appointments and complementary diagnostic exams with agreed service providers;
- Definition and control of treatment plans, ensuring a thorough evaluation process of temporary and permanent disability;
- Providing an information system adapted to personal injury management and developed according to best market practices;
- Evaluating state of health through expert clinical exams carried out by a team of medical specialists;
- Clinical support to insurers in all administrative processes and in processes of a legal nature.