Who we are
Founded in 1998, Total Care Network (TCN) is a managed care provider to insurance companies and healthcare organizations, offering integrated services intended to optimize the cost of health benefits and improve the quality of care.
Since May 2016, TCN’s main shareholder is Expert Opinion, Greece’s leading medico-legal reporting agency, which has also undertaken the company’s management.
TCN’s mission is to ensure high-quality healthcare services to policyholders as well as optimised healthcare costs to the insurance companies.
Gatekeeping system / Utilization management / Healthcare provider network management / Claims processing, auditing and adjustment / Pre-insurance assessment / Medical telephone interview
We have the resources and capabilities
to meet your needs.
Gatekeeping system
TCN delivers high-end managed care services,
by the interaction of several distinct sections within the company.
Medical Call Centre
Operating on a 24 / 7 basis, the Medical Call Centre is staffed by competent and experienced physicians who promptly respond to inquiries concerning medical advice or prospective treatments and, depending on eligibility and policy coverage, decide on referrals to health providers from TCN’s network of affiliated private medical offices, diagnostic centres, hospitals and clinics.
Coordinating Centre
Available during business days, the Coordinating Centre is an integral part of TCN’s gatekeeping system, ensuring quality healthcare service level for policyholders at optimised cost for the insurers. Staffed with highly efficient personnel trained in managed care, the Coordinating Centre reviews policy terms and implements utilization management tools, including case assessment by TCN medical reviewers on admission and, if warranted, during hospital stay.
Healthcare Providers Network
TCN has assembled a nationwide network of healthcare providers spanning all medical specialties. It comprises affiliated physicians, diagnostic centres and private hospitals and clinics, admitting policyholders at a predefined preferred pricelist. The healthcare providers network is continuously evaluated and expanded, ensuring high quality and cost effective health care for beneficiaries.
Services overview
TCN provides sector-leading integrated services, modular and fully scalable,
to insurers and healthcare providers.
Managed care
TCN implements a variety of techniques intended to optimize the cost of providing health services and improve the quality of care, to the benefit of patients, healthcare providers and insurers.
- Utilization management, including pre-certification, discharge planning, concurrent clinical reviews, and clinical case appeals
- Utilization review, fraud & abuse containment
- Prospective and retrospective medical review
- Healthcare provider network management
Third-party administration
As a third-party administrator, TCN is a prominent player in the healthcare industry, having the expertise and capability to administer all parts of the claims process.
- Hospital and outpatient claims processing, auditing and adjustment
- Process optimisation consulting
Health risk assessment
Health risk assessment of insurance policy applicants is pivotal in the underwriting process and TCN’s expertise guarantees optimal procedures to fulfil the task.
- Medical underwriting support and pre-insurance assessment
- Medical telephone interview service
- Quality control – Data analysis and performance reporting
Quality policy
ISO Certification
TCN is committed to the continuous improvement of the quality of services, adhering to certified procedures for managing each and every case and evaluating employees and partners.
The company has received ISO 9001:2008 certification of its Quality Management System, highlighting its commitment to maintain the highest level of functioning and provision of services.
The management of TCN’s medical and personal digital data complies with the security provisions of ISO 27001:2005 quality standard, proof of the company’s strong commitment to integrate its hardware, software and procedures in a comprehensive Information Security Management System.
Specialized software
TCN operates on a web-based medical case management platform that allows 360o visibility of the progress of each and every case by all stakeholders, including medical reviewers, insurance companies and health providers.
In addition, our bespoke TPA software implements data mining and predictive modelling algorithms, to provide a treasure of epidemiological, financial and comparative statistics.