Healthcare Administration

TMA and Ewave deliver end-to-end healthcare administration with tools for pre-authorization, insurance and claims management, provider coordination, CRM, and real-time data repositories. Simplify operations. Improve accuracy.

Streamlined, Integrated, Reliable

TMA supports healthcare organizations with a fully integrated administration platform powered by Ewave. From insurance verification and claims adjudication to service provider coordination and customer relationship management, this system simplifies complex back-office processes, reduces administrative overhead, and ensures real-time data consistency across your entire healthcare network.

EWAVE Pre-Authorization SystemEligibility Validation at Every Step

Ensuring patients receive the right services under the correct insurance terms is fundamental. Ewave’s pre-authorization system verifies eligibility at every point of interaction—whether through an external hospital, laboratory, or within the Ewave platform’s EMR, portal, or scheduling modules. This preemptive approach strengthens patient trust and allows staff to focus on care, not bureaucracy.

Prevent service delays by validating insurance terms before care begins

Make verified eligibility data available across systems via secure API integrations

Minimize disputes and administrative work by automating eligibility checks

Health Insurance Management

Flexible Setup for Any Policy Structure

Insurance products today must handle varying benefit plans, multiple price lists, and complex provider networks. The insurance management module offers robust functionality for insurers and care providers to:

Build and manage insurance plans, co-payments, deductibles, coinsurance, and capitation models

Easily manage contracts, issue insurance cards, and integrate billing processes

Set and track premium collections across groups and individuals

EWAVE Health Insurance ManagementBenefits at a glance

Everything is centralized in one platform, supported by a user-friendly interface that allows your team to perform advanced tasks like policy creation and service mapping with just a few clicks—without relying on external consultants.
Each configured plan feeds directly into the claims management system to ensure seamless adjudication based on rules and services associated with the plan.

Claims Management

Automated, Accurate, Efficient

Processing claims manually increases error rates and delays payments. Ewave’s claims management module allows your organization to handle both digital and manual submissions with speed and accuracy.

EWAVE Claims ManagementBenefits at a glance

Team members with access privileges can update adjudication logic through an intuitive interface—no technical background needed. This flexibility reduces backlog and improves financial oversight across departments.

Automatic claims adjudication based on pre-configured workflows, policy rules, and service agreements

Integrated back-office view for accessing service provider contracts, price lists, and customer policies

Tools for managing litigation, negotiation, payment notifications, and policy validation

Insureds Management

Centralized Customer and Employer Handling

Managing customer data is critical for accurate billing, policy management, and communications. Ewave’s insureds management module collects, updates, and centralizes all relevant information including:

Demographics and family tree (for policy concatenation)

Associated physicians and policy rules

Plan details, employer relationships, and eligibility tracking

EWAVE Insureds ManagementBenefits at a glance

New customers can be onboarded using a customizable enrollment wizard that reflects your internal workflow. Employers benefit from bulk contract management, group pricing, and insurance card issuance. A built-in CRM module tracks service requests, communication history, and documents—all with role-based access for compliance.
Eligibility and insured data can be accessed by other systems across the platform (EMR, online portals, scheduling, payment systems) via robust APIs.

Service Providers Management

Full Visibility and Contract Alignment

Maintaining up-to-date information for all contracted providers is essential to accurate billing and claims adjudication. The service providers module allows you to manage:

EWAVE Service Providers ManagementBenefits at a glance

The system supports real-time integration with patient portals and mobile apps, allowing users to search for available providers. Once configured, any provider changes are immediately reflected across the entire platform.
Claims submitted are automatically validated against the provider’s agreement—ensuring accurate reimbursement and faster turnaround.

Any provider type (clinics, labs, hospitals, physician networks)

Custom service agreements with pricing tailored by insurance group or specialty

Specialty and location configurations

Repositories Management

Real-Time Data Consistency Across Systems

The repositories management module is the foundation of synchronized information across the healthcare ecosystem. It serves as a central location for managing key datasets, including:

Member profiles

Drug baskets

Service provider details

Coding systems (e.g., ICD)

EWAVE Repositories ManagementBenefits at a glance

Any changes—such as a member update, new code addition, or pricing change—are immediately propagated to all connected systems. Whether a physician is submitting a claim through the EMR, or a patient is paying their premium online, the data used is accurate and current.
Repositories are available via secure APIs for use by external stakeholders including labs, pharmacies, and affiliated providers, ensuring reliable data exchange across the care network.

Why Choose TMA and Ewave for Healthcare Administration?

Whether managing thousands of patients or dozens of contracts, TMA’s implementation of Ewave’s administrative modules allows organizations to keep everything aligned and accessible from a single interface.