Allianz Worldwide Care understands that excessive or inappropriate medical treatment can be potentially detrimental to patients as well as costly for individual clients and employers alike. For this reason, the company has put a range of processes and checks in place to ensure that the cost of medical care is managed appropriately. Below are just some of the cost containment measures that we have implemented:
a) Medical Services and Claims team
Individuals within the
Medical Services and Claims teams are allocated to specific geographical territories, allowing them to develop stronger relationships with the medical providers in those regions. This experience places them in a good position to review and challenge the in-patient treatment path and tariffs proposed by medical providers, ensuring that the proposed treatment is appropriate, necessary and that costs are in line with the usual and customary charges for the region.
b) Treatment Guarantee process
Treatment Guarantee is the prior notification to Allianz Worldwide Care of certain proposed treatments and benefits e.g. submission of a Treatment Guarantee Form is required in advance of any in-patient treatment, medical evacuation, oncology treatment, rehabilitation or routine maternity. Each Treatment Guarantee gives us the opportunity to ensure that treatment is appropriate as well as the chance to negotiate additional savings.
c) Network management strategy
Allianz Worldwide Care is not restricted to any exclusive
medical provider network arrangements. This strategy allows us to harness the combination of networks and the most appropriate means of access, to best meet the needs of each corporate client in terms of cost containment and customer service. It also means that insured members are free to select their preferred medical providers (subject to the wishes of our corporate clients in the case of employees).
d) Provider Affairs team
We recognise that strong medical provider relationships are essential to the ongoing delivery of effective cost containment and efficient customer service. For this reason, Allianz Worldwide Care has a Provider Affairs team which is in regular contact with our medical partners across the globe. Territory visits are often made by the Provider Affairs team in order to reinforce these important relationships and to supplement contact made by telephone.
e) Development of new partnerships
StandbyMD™
(US)
Our partnership with StandbyMD™ was established to help contain the cost of medical claims for corporate clients with employees who are either based in or traveling within the US, by avoiding non-essential visits to Emergency Rooms. It is estimated that 33% of visits to hospital emergency rooms are semi-urgent/non-emergency, each costing up to US$3,000, compared to StandbyMD’s cost of US$200 - US$500.
The StandbyMD™ service offers fast access to a qualified physician at night/weekends or when traveling. Services include 24hr a day telephone consultation, in-room physician visits, replacement of lost/forgotten prescription refills and express ER triage and hospital admittance when necessary.
f) Claims Reports
Our large corporate clients are provided with regular claims reports e.g. claims by benefit, by country, by size, by insured type/age/sex and by insured population. This allows clients to monitor (and forecast) group scheme claims performance. Separate reports which detail any high claims are also made available to Group Scheme Managers. Our claims reports can be scheduled to issue automatically, at regular intervals, to the client contact person, without the need for manual intervention.
