ITIC APAC assessment: Is traditional medical assistance sufficient?


“Traditionally,” John began, “support was primarily call center focused – we had to respond to calls quickly, minimize dropped calls and focus on first call resolution. Metrics were paramount – RFPs focused on phone service factors like call abandonment. What was missing was something to do with customer experience. Medical assistance, in reality, was often limited to “traveling to the nearest emergency room”, and the emphasis was on statistics rather than member satisfaction, with ultimate success measured in percentages. savings. This approach had to change due to several factors:

  • Healthcare inflation around the world, especially in the United States
  • Changing consumer demands (such as telemedicine, mental health and maternity management)
  • Very different quality-cost ratios.

To counter the effects of the above and meet the challenge of providing assistance to today’s discerning traveler, medical assistance must prevent, mitigate and contain costs. “If we can avoid a claim if we can refer a patient to a provider, we’re much better able to prevent costs from occurring,” John said.

However, the real assistance is not just in the medical assistance services – there is so much more to do. Services could include security assistance, conducting high-risk evacuations, assistance obtaining local legal representation, and cashless access to treatment. On cashless access to treatment, John highlighted two products – Fast Track and Express Discharge, both of which allow clients to exit within 30 minutes of treatment without putting their hand in their pocket.

“Today,” John concluded, “support is all-inclusive. It is proactive and begins before the claim occurs; it coordinates seamlessly with medical case and cost management initiatives; and it improves the member’s journey while reducing net paid claims costs. Real support isn’t just about digital versus human touch, he added, or direct management, networks, negotiations and contracts. It’s about creating the right solution for you and your members.


Comments are closed.