Pictured above, representatives from Mercury Healthcare International, BUPA, Custom Assurance, and a TPA in India tour Sime Darby Hospital in Malaysia.
Medical tourism hospitals often call Mercury Advisory Group to “get them into insurance networks”. Many times they are disappointed to find out that they’ve been misled on just how difficult it is to get contracts with insurers in order to receive referrals for international /medical tourism patients. Actually the two terms, international patients, and medical tourism patients are very different from the perspective of insurers. So our first order of business is to determine the discrete population to which they refer. While many American insurers will cover emergency stabilization services abroad for an accident or sudden illness, they don’t offer a medical tourism “benefit”. Therefore, if a benefit for health travel or medical tourism doesn’t exist in the policy, it is not likely that they will refer patients for elective services to a hospital outside the patient’s hometown.
What insurers care about
Insurance companies have begun to pay closer attention to which healthcare organizations, emergency services transport companies, and outpatient clinics and surgery centers hold current accreditation. In a market where competition is fierce, this is a routine focus area in their vetting process. It’s a boon to the insurer to say that “If” you become ill or injured abroad, they have a network of accredited hospitals to whom they will refer you, but again — not for medical tourism elective care.
Benchmarking you against all others
Furthermore, provider contracting personnel, often referred to as “provider relations” coordinators, generally do not have a professional work history that originates in any clinical activity. In most cases, they start their work lives as claims adjusters and customer service representatives. Therefore, many insurance company contracting personnel rarely see accreditation as more than a tick in a box on an application form. They won’t understand why you are making such a big deal about it, because to them, it’s just a tick in a box on an application form and it basically benchmarks as equal to everyone else in their network– not something special. Here’s a practical parallel to consider: When you say ” We’re accredited by the JCI or DNV, or COHSASA, or ICONTEC, think of your message being received as tantamount to “Our doctors graduated from medical school and have a license and everything!”
