Total Care Saudi
Total Care Saudi is a Third Party Administrator providing health insurance claims management, provider network administration, and reinsurance reporting to insurance companies in Saudi Arabia. The firm manages 2.8 million lives daily and processes over 5 million claims annually.
- Company typePrivate
- Founded2009
- HeadquartersAl Khobar, Saudi Arabia
- Headcount101–250
- GTM typeB2B
- OfferingServices
What Total Care Saudi does
Total Care Saudi (TCS) is a Third Party Administrator (TPA) headquartered in Al Khobar, Kingdom of Saudi Arabia, incorporated in 2009 as a limited liability company with paid-up capital of 3,000,000 SAR. The company administers health insurance portfolios on behalf of insurance companies operating in the Saudi market, managing claims processing, provider network administration, technical underwriting advisory, and reinsurance reporting. TCS handles over 5 million claims annually, administers coverage for over 2.8 million lives on a daily basis, and maintains contracts with more than 2,500 healthcare providers across Saudi Arabia plus a worldwide network spanning 170+ countries. The company holds SAMA licensing and CCHI accreditation, both originally obtained in 2010 and renewed in 2013, which constitute mandatory regulatory clearances for TPA operations in KSA.
TCS operates an integrated IT platform that supports medical underwriting, claims management, policy administration, and reporting through rule-driven automation. Proprietary technical components include Automated Provider Price Recognition (validating provider billing against contracted rates), an Automated Coverage Rules Engine, a Medical Claims Auditing System, and P.A.S.S. pre-authorization form management. Service delivery is supported by seven role-based online portals (for Healthcare Providers, Insured Members, Policy Holders, Group Policy Holders, Insurance Companies, Brokers, and Reinsurance) plus a mobile application for insured members. The platform applies process automation to claims auditing, anomaly detection for fraud and abuse control, and predictive analytics for risk assessment and actuarial analysis.
The business model is structured as managed services TPA engagements with insurance company clients, with revenue tied to managed lives and claims volume. TCS employs a direct enterprise sales motion targeting insurance company decision-makers, supplemented by a 24/7 call center for claim approvals and member support. In November 2025, TCS announced a strategic alliance with Keralty Group to develop a proactive population health management model aligned with Saudi Vision 2030, marking the company's first material move beyond reactive claims administration.
Total Care Saudi firmographics
Firmographics- Name
- Total Care Saudi
- Legal name
- Total Care Saudi TPA LLC
- Website
- https://tcs-ksa.com
- Company type
- Private
- Founded year
- 2009
- Operating status
- Operating
- Headcount range
- 101–250 employees
- Short description
- Total Care Saudi is a Third Party Administrator providing health insurance claims management, provider network administration, and reinsurance reporting to insurance companies in Saudi Arabia. The firm manages 2.8 million lives daily and processes over 5 million claims annually.
- Ownership category
- akta.pro rank
Total Care Saudi industry classification
Industry- Product category
- Healthcare Insurance Third Party Administration
- NAICS
- Pharmacy Benefit Management and Other Third Party Administration of Insurance and Pension Funds (524292), Health Care and Social Assistance (62)
- SIC
- Hospital & Medical Service Plans (6324), Insurance Agents, Brokers & Service (6411)
- akta.pro primary industry
- Medicare Plan Administration & Third-Party Services (TPA/BPO, Enrollment, Billing) (FSAIAGAI)
- akta.pro secondary industry
- Individual Health Insurance Administration (TPA/ASO) (FSAIAEAK)
Keywords
Where Total Care Saudi is headquartered
LocationHeadquarters
- HQ city
- Al Khobar
- HQ country
- Saudi Arabia
- HQ region
- Middle East
Offices1 record
Markets served
Total Care Saudi business model
Business model- GTM type
- B2B
- Offering type
- Services
- Cost components
- Personnel, Operations, Technology or R&D, Marketing or Sales, Infrastructure, Others
Revenue model
- Third Party Administrator Services: TCS operates as a Third Party Administrator (TPA) providing claims management, provider network management, and insurance technology services to insurance companies in Saudi Arabia. Services are provided on a managed services basis with fees based on managed lives and claims volume.
Go-to-market motion3 records
Distribution channels3 records
Marketing channels4 records
Total Care Saudi product offering
Product offeringCore offering
Total Care Saudi (TCS) is a Third Party Administrator (TPA) for healthcare insurance, delivering end-to-end health insurance administration services to insurance companies in Saudi Arabia. Its offering spans claims handling, preferred provider network set-up and management, technical advisory, actuarial and pricing services, product design, reinsurance reporting, and IT solutions for insurers, supported by a proprietary integrated platform and 24/7 multilingual call center.
Product overview
Total Care Saudi (TCS) operates as a Third Party Administrator (TPA) providing healthcare insurance and risk management services in the Kingdom of Saudi Arabia. The company offers a unified platform approach centered on its comprehensive IT system for medical underwriting, claims, policy management, and reporting. The core product is the Health Care Insurance & Health Care Benefits Management Services, supported by integrated service modules including Technical Management and Advice, Preferred Providers Network Set-up and Management, Claim Handling, and Reinsurance Reporting. Value-added services encompass Insurance IT Solutions & Integration, Product Design, Actuarial Reporting, Pricing Review, and General Insurance Consultancies. The company provides multiple stakeholder-specific web portals for Healthcare Providers, Insured Members, Policy Holders, Group Policy Holders, Insurance Companies, Brokers, and Reinsurance, along with a mobile application for insured members. TCS leverages technology-driven processes for automated claims auditing, fraud detection, and real-time monitoring across its network of over 2,500 healthcare providers.
Differentiator
Problem solved
Functional benefit
Quantifiable outcome
- Over 5 million claims handled yearly
- +3 more outcomes
Companies that use Total Care Saudi
Customer profileNamed customers5 records
Segments3 records
Ideal customer profiles2 records
Total Care Saudi technology and API
TechnologyTechnology focussed No
API detail
- Has API
- No
- API docs
- API detail
Core technology
AI maturity
App detail
AI capability4 records
Feature5 records
Total Care Saudi partnerships and signals
Strategic signalPartnerships
One partnership is on record.
- Keralty GroupcoreStrategic alliance to develop a new healthcare model aligned with Saudi Vision 2030. The collaboration aims to shift healthcare focus from reactive disease management to proactive population health management, utilizing innovative products and risk segmentation. The alliance was announced in Riyadh and represents TCS's entry into population health management services.
Scale indicators7 records
Recent moves5 records
Expansion highlights5 records
Total Care Saudi competitors and assessment
Company assessmentDirect peers
- Crawford & Company: World's largest independent claims management provider offering TPA-style services to insurers and self-insured employers, including healthcare claims administration that overlaps with TCS's core offering.
- NextCare: MENA-headquartered Third Party Administrator providing health insurance management, medical claims processing, and provider network services to insurers and policyholders across the Middle East.
- MedNet: MENA-focused healthcare TPA and managed care services provider offering claims administration, provider networks, and utilization management to insurers across the region, mirroring TCS's core offering.
- GlobeMed: Lebanon-based leading Third Party Administrator across the MENA region, providing health insurance management, claims processing, and provider network services directly comparable to TCS's model in the Gulf.
- Sedgwick: Global claims management and TPA firm serving insurance carriers, employers, and government entities with healthcare, disability, and absence management services, competing for similar enterprise TPA contracts.
Broad incumbents
- Cigna Global Health Benefits: Global health services company providing TPA functions, claims administration, and provider network management to insurance carriers and employers, including corporate health benefits programs in the Middle East.
- AXA Partners: Global assistance and TPA division of AXA providing claims management, provider networks, and health insurance administration services to insurers worldwide, including in MENA markets where TCS competes.
Others
- Bupa Arabia: Saudi Arabia's largest specialized health insurer and a key TCS client/counterparty; operates an in-house TPA function that represents both a customer relationship and competitive threat to TCS's external TPA model.
- Tawuniya (Company for Cooperative Insurance): Major Saudi cooperative health insurer that uses TPAs for portions of its portfolio while maintaining in-house capabilities; represents both a customer and a potential long-term insourcing threat to TCS's business.
Regional players
- NAS (National Health Insurance Company) Administration Services: Qatar-based health insurer and administrator operating a comparable TPA model for the Qatari market, representing the same regulatory and cultural context as TCS but in an adjacent Gulf geography.
Market position
Strengths5 records
Weaknesses5 records
Competitive moat5 records
Key risks6 records
Key highlights7 records
Customer concentration
Total Care Saudi social profiles
Digital presenceTotal Care Saudi compliance and trust
Trust signalCompliance3 records
Total Care Saudi financial estimates
Financial estimateRevenue estimate
Valuation estimate
Total Care Saudi leadership team
Management profileNumber of profiles
Profiles6 records
Total Care Saudi funding detail
Funding detailFunding overview
Funding rounds
Investors
Funding detail is available on the Subscription and Enterprise plan.Contact sales →
Total Care Saudi M&A and investment
M&A and investmentM&A
Investments
M&A and investment is available on the Subscription and Enterprise plan.Contact sales →
Frequently asked questions about Total Care Saudi
What does Total Care Saudi do?
Total Care Saudi (TCS) is a Third Party Administrator (TPA) for healthcare insurance, delivering end-to-end health insurance administration services to insurance companies in Saudi Arabia. Its offering spans claims handling, preferred provider network set-up and management, technical advisory, actuarial and pricing services, product design, reinsurance reporting, and IT solutions for insurers, supported by a proprietary integrated platform and 24/7 multilingual call center.
Is Total Care Saudi a public or private company?
Total Care Saudi is a private company. It is classified as unknown and is currently operating.
When was Total Care Saudi founded?
Total Care Saudi was founded in 2009. It employs 101 to 250 people.
Where is Total Care Saudi based?
Total Care Saudi is headquartered in Al Khobar, Saudi Arabia, in the Middle East region.
How does Total Care Saudi make money?
One revenue line is on record: third Party Administrator Services.
Who are Total Care Saudi's main competitors?
Direct peers on record are Crawford & Company, NextCare, MedNet, GlobeMed and Sedgwick. Broad incumbents are Cigna Global Health Benefits and AXA Partners. Others are Bupa Arabia and Tawuniya (Company for Cooperative Insurance). NAS (National Health Insurance Company) Administration Services is listed as a regional player.
Does Total Care Saudi have an API?
No public API is recorded for Total Care Saudi.
What industry is Total Care Saudi in?
Total Care Saudi's product category is Healthcare Insurance Third Party Administration. Its primary akta.pro industry code is FSAIAGAI, Medicare Plan Administration & Third-Party Services (TPA/BPO, Enrollment, Billing), with a secondary code of FSAIAEAK, Individual Health Insurance Administration (TPA/ASO). Its NAICS code is 524292 and its SIC code is 6324.