Our Services
Healthcare administration beyond claims
Health-Net manages the entire healthcare administration cycle — from member enrollment and provider network management to pre-authorizations, claims adjudication, medical auditing, utilization review, and ongoing member support.
270+
Network providers
12+
Insurance partners
4,000+
Insured members
24/7
Member support
What We Offer
A full suite of administration services
Every service is delivered with clinical governance, transparency, and a focus on responsible healthcare spending.
Claims Administration
End-to-end claims lifecycle management — intake, eligibility verification, policy validation, medical review, adjudication, and reimbursement coordination.
Medical Pre-Authorization
Structured medical review for hospital admissions, surgical procedures, advanced diagnostics, specialist consultations and medical evacuations.
Provider Network Management
Contracting, credential verification, performance monitoring and quality assurance across hospitals, clinics, labs and pharmacies.
Medical Case Management
Clinical oversight and care coordination for complex conditions, chronic diseases, and high-cost care episodes.
Cost Containment & Optimization
Evidence-based treatment reviews, utilization monitoring, network optimization, and provider tariff management.
Utilization Review
Prospective, concurrent, and retrospective review evaluating whether services are appropriate, necessary, and clinically aligned.
Medical Audit Services
Evaluating medical necessity, clinical appropriateness, documentation quality, billing accuracy and policy compliance.
Provider Relations
Dedicated teams for contract management, provider onboarding, operational support, and dispute resolution.
Member Support Services
Benefit verification, provider guidance, authorization assistance and emergency assistance coordination — available 24/7.
Reporting & Analytics
Detailed reporting on claims trends, healthcare utilization, provider performance, cost analysis and risk indicators.
For Insurers
Solutions for Insurance Companies
Health-Net functions as an extension of the insurer's operational and healthcare management team — letting insurers focus on growth while we manage day-to-day healthcare administration.
- Improve operational efficiency & reduce claims administration costs
- Strengthen healthcare governance & manage provider networks
- Control medical inflation & improve customer satisfaction
- Enhanced reporting & oversight
For Providers
Solutions for Healthcare Providers
Health-Net supports healthcare providers through efficient coordination and transparent communication, building long-term partnerships.
- Faster authorization processes & clear claims pathways
- Dedicated support channels & timely issue resolution
- Clinical coordination across the care journey
- Long-term partnership opportunities
For Members
Solutions for Members
Our goal is to make healthcare easier to access and easier to navigate.
Extensive Provider Access
Access to an extensive network of more than 270 healthcare providers.
Faster Treatment Approvals
Streamlined pre-authorization to reduce delays in receiving care.
Dedicated Customer Support
A dedicated team available around the clock to assist with your needs.
Clear Benefit Guidance
Straightforward explanations of your coverage and benefits.
Care Coordination
Guidance to navigate complex healthcare decisions with confidence.
Improved Experience
An overall healthcare experience designed around your needs.
FAQ
Common questions about our services
What is a Third-Party Administrator (TPA)?
Which countries does Health-Net operate in?
How does the pre-authorization process work?
How can a healthcare provider join the Health-Net network?
URGENT AUTHORIZATION
Need urgent pre-authorization support?
Our member support team is available 24/7 to assist with urgent hospital admissions, medical evacuations, and time-sensitive authorization requests.