Interview: Sumit Gaurav, Roy Medical Assistance

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What is your experience in the international healthcare industry and what advantage does your work experience bring to the world of medical assistance?

When I worked in the international health sector in the past, I was aware that most international policyholders faced difficulties in finding the appropriate medical services, as most hospitals refused cashless treatments due to the stoppage. or late payment from major insurance companies. Many insurance companies were unresponsive to attempts to communicate. I thought, this is the right time; service providers need an international TPA company to facilitate and coordinate with patients, insurance companies and the hospitals themselves. Thus, Roy Medical Assistance (RMA) was founded in 2016 as an international TPA to meet the needs of customers by providing a 24/7/365 alarm center. Our efficient team has managed to build an extensive network by entering into agreements with many leading hospitals in Asia to provide assistance services to tourists, expatriates, students, diplomats and any other international visitors in need of assistance. Our team personally visits vendors across Asia to establish a relationship with service providers and insurance companies, and acts in accordance with the agreements we make with them. RMA has been in this business for over six years, and our hospital claims settlement ratio is 99%. To date, RMA works with over 5,000 hospitals in 16 countries such as India, Nepal, China, Hong Kong, Vietnam, Indonesia, Thailand, Singapore, Cambodia, Maldives, UAE Arab States, Turkey, Sri Lanka, the Philippines, Myanmar and Azerbaijan, with direct billing agreements in place that allow hospitals to provide cashless outpatient and inpatient treatment.

What prompted you to launch RMA?

Before 2016, I saw many international patients facing the problem of getting cashless treatment in hospitals, and many hospitals in Asia and the Middle East were heavily indebted. Hospital management was not structured or willing to accept payment guarantee documents from insurers in foreign countries. We have discussed this issue with hospital management teams and assured them that we will coordinate the claims process, acting as a local guarantor with a local office. After many years of waiting, they agreed – but with lots of terms and conditions attached.

What can international insurance companies gain from working with RMA?

As a local guarantor, most of the hospitals in our network accept our direct billing agreement, which offers many advantages to policyholders: • Access to a hospital within a radius of 2 to 5 km around the patient: As we know, all patients want a good hospital with the best facilities near their home, workplace or hotel. • From a single company, international insurance companies can be connected to more than 5,000 hospitals in 16 countries. We have our own medical team in our support center who assist the patient and deliver the medical reports in such a way that the international insurance company understands the treatment protocol and the charges in order to approve any further treatment without delay. We have our own claims and payment team who can verify benefits and pay the provider without waiting for a guarantee from the insurance company. We provide all necessary support and logistical services to our international insurance company partners. Whenever customers need medical assistance in remote areas, we provide instant payment transfer method, so that insured customer get cashless benefits. RMA ensures customer satisfaction by working closely with hospitals, and our representatives communicate frequently with the patient to provide them with all the support they need.

What are the biggest challenges you have faced when setting up your medical network in Asia, and how do these challenges differ in different countries?

We had many problems setting up a medical network in Asia, especially when we first spoke to hospitals over the phone, it was the first time they had heard of RMA. Naturally, the hospitals initially disagreed with our terms and conditions. Our team had to travel to countries to meet hospital management staff and introduce the RMA team. After continuous follow-up with hospital management teams regarding direct billing arrangements, and after performing due diligence checks on RMA by finding information about us from other hospitals and clinics already in our network, they agreed our terms and conditions. The process took about two to three years. We have found that in some countries – Singapore, Thailand, Vietnam, China and the United Arab Emirates – hospital management prefers to work with a local office in their own country to ensure smooth coordination of patients and in terms of payment, as they do not are not in favor of granting credit facilities to international insurance and assistance companies outside Asia.

Are there any particularly challenging cases you’ve handled recently that exemplify your company’s service offerings and talent?

Recently we received a call from Maldives (Thulusdhoo Island) at 1am. The case involved a Colombian tourist who suffered a cerebral hemorrhage at 12:30 a.m. Thulusdhoo is a very small island; there are two or three hotels, and nothing else. We contacted the local doctor and sent him to the island by speedboat at 2 am local time. They provided first aid and waited for the transfer to Male, 200 km from this island by speedboat. Early in the morning, we sent a seaplane to Thulusdhoo Island with our medical team on board and evacuated the patient to our network hospital in Male. After two days, the patient was referred to a higher level of care in India. We organized a critical care air ambulance with life support to transfer the patient to New Delhi, India. After 20 days, she recovered and was discharged from the hospital. However, she still had to return home to Colombia and we arranged for her ticket and all necessary medical support, including a medical escort for the 26-hour trip. The patient returned comfortably to her country of origin and the mission was a success.

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