Are you or your organization responsible for managing healthcare claims for a specific beneficiary population? If so, chances are that at some point you’ve experienced frustration with segmented, incomplete, or non-auditable vendor invoicing.
It’s not easy to integrate the numerous aspects of your clients’ total care experiences into single, streamlined claims – nor is it effortless to capture and manage data that are sufficiently refined to serve as a predictive body of evidence for your funders’ future planning. But fortunately, Agile Global Health has already tackled these challenges for you. And we’re here to share what we’ve learned.
“Our claims process captures cost transparently and in real time throughout the patient treatment experience, which also frequently includes an international travel component,” said David Spisak, Agile’s Director of Revenue Cycle Management (RCM). “Our global team inputs and tracks 360-degree updates to a patient’s profile to help us manage their experience comprehensively…our single portal, for everything from a new prescription or diagnostic test results to patient praise for their guesthouse accommodations or a relative’s request for assistance with a financial transfer, enables integrated, timely relationship management.” And at the end of a client’s medical journey, it’s from this complete record of service transactions that our system generates an invoice for the funder.
“What the funder or third-party claims manager wants to know is whether our procurement costs are justified,” said Morgan Darwin, Agile Global Health Chief Executive Officer. “The complexity of capturing cost from multiple jurisdictions, multiple currencies, and presenting this information to the funder in a way that quickly assures them they’re buying value…providing clarity to understanding that complexity, that is what Agile has mastered.”
Agile Global Health hired new RCM staff to build and launch its integrated, auditable claims model throughout 2016 and 2017, and the process has already proven successful. “Our reputation for best-in-industry claims management support for services that flow through us is rapidly developing both our procurement and sales operations,” said Mr. Darwin. “The new model has already enabled us to expand client operations in the Gulf, notably in the United Arab Emirates, but also in neighboring nations in which we’ll soon have active agreements. It has also propelled us forward in India, where we’ve developed a preferred tier of partners from among our broader network in order to satisfy the major demand we’ve encountered for this kind of streamlined claims management from the provider side.”
Want to learn more? Our claims management approach may be able to help your organization serve clients more thoroughly and effectively, while also maximizing your investment in their care. Contact us today for a consultation about your needs.
Agile Global Health
Agile Global Health (operating as A&K Global Health in select countries) is an Agile Health Systems company and a worldwide leader in realizing transparent, affordable, effective and innovative solutions to complex healthcare delivery challenges. We listen to local and national healthcare leaders in every country where we work, and then support their vision to improve their national health system’s accessibility, quality, and clinical outcomes. For patients, we connect you with the right care for your needs, from facilitating quality local and regional treatment to coordinating international medical travel; for healthcare funders and providers, we optimize your organizational impact by introducing transparency, control and customization to the medical, financial and experiential aspects of your clients’ medical journey. Contact us today to learn how we can support you.