Planning

Leveraging on the use of information technology, Esorse provides  back office administration to  third party administrators and insurance agents/brokers in delivering comprehensive and consumer-driven benefit solutions. Our main goal is to help design a plan that will maximize the health coverage of the members while minimizing the health care costs of the plan sponsors.

Billing

As an advocate of helping plan sponsors control health care costs, we are providing options and flexibility in the way Plan Sponsors fund their programs. Periodic contributions may be withdrawn through pre-authorized payment or through cheque. To help administer funds, invoices and notifications are sent prior to each withdrawal.

Claims Entry & Adjudication

Claims are electronically submitted to and adjudicated by Esorse Corporation. Members enjoy the convenience of presenting their Health Benefit Cards to affiliated providers and dental offices to purchase prescription drugs and dental services.

Another breakthrough in claims management is the availability of secured portals where members, providers and third party administrators may input claims that are adjudicated in real-time. This significantly cuts down the processing time and turn-around time.

Members who are comfortable with the traditional way of submitting paper claims may still continue to do so.

Claims Payment

One significant phase of the whole process is the turn-around time in paying claims. And at Esorse, we pride ourselves in assuring our members that eligible claims are processed and paid within 48 business hours.

Methods of payment are pre-determined by members and providers, with the option to have cheques generated or funds deposited directly to respective bank accounts. And now, with our partnership with VISA®, payments can be received in seconds! Another first and definitely an unrivaled feature to minimize out-of-pocket expenses.

Electronic Explanation of Benefits (EOBs) are sent to members while monthly statements of accounts are emailed to providers. All of this information is also made available via the secured portals of Esorse Corporation. This is in conjunction with our commitment of keeping everyone well-informed of day-to-day transactions.

Customer Service

We provide superior support to our clients and providers. Our Customer Service Representatives are available to respond to your calls, emails or faxes. We also have a hotline exclusively for French-speaking members and providers.