Total Care Saudi would be, I believe, an excellent choice of a TPA service provider as it prides itself on being a leader in its field and constantly strives to deliver the best in quality healthcare management and support to its clients. We hold ourselves to the highest standards of ethics, professionalism and service. We are dynamic, innovative and committed to passing on the benefits of a rigorous and constant process of research and development to better service our clients. I, on behalf of the team at Total Care Saudi, would like to thank you for taking the time to read this and, thus, allowing Total Care Saudi (TCS) to present its capabilities and services in the field of Health Care Management Solutions as a Third Party Administrator.
Total Care Saudi (TCS) is a leading Third Party Administrator (TPA) dually licensed and accredited by the Saudi Arabian Monetary Agency (SAMA) and the Council of Cooperative Health Insurance (CCHI). The founding shareholders had been previously involved in the insurance and TPA markets both in KSA and the region. Their experience highlighted the need for a new and dynamic provider of TPA services with a personalized customer oriented approach. Recognizing the difficulties facing the healthcare industry and it’s constantly expanding needs, the founders set out to create a company which could offer professional claims handling and administrative services within a broader framework of transparency, efficiency and sound advice. The outcome was TCS, whose approach, reflected herein, is one of cooperation and assistance rather than prescription.
TCS your partner in integrated healthcare management solution.
- Over 5 million claims handled every year.
- Over 2.8 million lives managed on a daily basis.
- Contracts with over 2500 HealthCare Providers in KSA in addition to a worldwide network in over 170 countries.
- Over 150 employees (including Medical Doctors and Registered Nurses) are allocated to follow up and ensure quality service for insured members and client insurance companies.
TCS gives access to providers all over KSA and the Middle East through its network of Affiliated TPAs.
- SAMA License (license date 03/2010).
- CCHI Accreditation (accreditation date 04/2010).
- CCHI Accreditation & SAMA License Renewed (03/2013).
- Register of Commerce No 2051040769 - Khobar - KSA.
- Licensed by the Saudi Arabian General Investment Authority as a Third Party Administrator with license number 1/665.
- Company officially registered in 2009 and was incorporated as a Limited Liability Company with paid up capital of 3,000,000 SR.
• Abdullah Abdul Mohsen Al-Khodari Sons Company – 30% of all shares held.
• Mr. Mohammad Jamal Ali Dinnawi – 25% of all shares held.
• Mr. Abdulatif Azmi Abdulhadi – 15% of all shares held.
Board of Managers
TCS's board is currently composed of the following members:
• Mr. Rizk El Khoury – CEO – Partner
• Mr. Fawaz Al Khodari – Partner (representing A.A.M. Al-Khodari Sons Company)
• Mr. Abdulatif Azmi Abdulhadi – Partner
- Since its creation, TCS has taken, as its foundation, the delivery of quality management services, and the addition of value through enhanced business intelligence reporting and assistance. Our offering therefore is based upon certain tenets we believe to be fundamental to sound and cost effective operations between TCS and its clients. These tenets include but not limited to:
- We believe all stakeholders should have access to all information relevant to their sphere of operations. You should be made aware at all times of TCS’s intentions, goals, and procedures. TCS ensures that its operations are structured in a manner to benefit all stakeholders, including the company, the providers, and last, but certainly not least, the insured Members.
- TCS’s approach is based on working together on a regular process over the period of the agreement to optimize production, coverage conditions, and services. TCS will seek an active role in key decision making related to network composition & negotiations, claim coverage trends & the impact of product design and financing on the above.
- Sustainability and Balance
- We believe that a good relationship is one that lasts. TCS at all times is committed to an ongoing process of improvement in the quality of services available, and accordingly, welcomes and relies upon feedback of its clients and stakeholders on a regular basis. In addition, TCS commits to maintain and promote its clients’ identity, and not that of itself, at all times.
- Access to funds
- We believe that a TPA should not have any access to funds and all financial dealings should be directly between you and the healthcare providers (i.e. the payment of claims, rebates, and savings). This aims to maintain transparency of dealings as TCS is a real Third Party who is hired to protect your best interests and preserve the managed members as well. Being a part of the financial relation will hinder this role and subject the TPA to temptations that disrupts its mission of optimum cost containment.
- We are committed to incorporating technology into our operations to increase efficiency and enhance decision making processes. We are further committed to an ongoing process of research and development and to passing on the benefits of this process to our clients.
- Sound Portfolio Management
- Keeping the balance between preserving insured members satisfaction while managing costs and utilization helps our clients insurance companies grow. We at TCS adhere to a strict philosophy of cost control, tempered by our clients' market strategy and needs. Over the past few years, we have successfully managed both utilization and reduced costs for our clients, despite the increasing pressures of inflation. We are committed to thorough cost control at point of entry and throughout patients' stay in hospital through diligent auditing as well as to passing on the benefits of our efforts to our clients.
- Long Term Partnerships
- A health insurance policy might be only for one year, or more for that matter, but the relationship you build with your stakeholders may last a lifetime. You need a partner that will be there, helping you grow. We believe our operations should benefit all parties concerned. To strengthen the partnerships we build with you, we are committed to a comprehensive development program for our services, systems and processes which we pass on directly to you. We also look to involve our clients directly in our development, integrating their feedback into the way we improve and grow our business.