Cost Containment

Services for Healthcare Insurers and TPAs
MDabroad is a leader in the TPA space in the Americas. With a local presence in the US for nearly two decades, we have earned the trust and relationships of the facilities and providers that are most commonly chosen by the international patient market. Serving expatriates and travelers globally, we have the human resources and technology to connect payers, providers and patients, enabling direct access to a large network of providers, in addition to our white glove service and 24/7 Assistance.

Our assistance service delivers a reliable member experience, powered by a rich platform of web and mobile based solutions for clients and members. MDabroad operates a Secure and Compliant Platform to transmit patient data and sensitive financial information for eligibility, GOPs, extensions, medical reports, invoicing claims settlement service. We deliver transparency and bespoke solutions for our clients to mitigate losses, drive patients to the most cost-effective networks and minimize utilization.

24/7 Assistance Services
MDabroad's assistance services are mullti-faceted. Many travelers are rarely prepared for illness while abroad for work and pleasure. Furthermore, they are unable to predict the many challenges they will face when navigating through foreign medical systems. This places travelers in a highly vulnerable position with regard to their medical well-being, both in minor and complex medical conditions. It is critical to manage health conditions appropriately and in a timely manner to minimize risk and costs while traveling abroad.

The ability to respond to these risks can make all the difference between reasonable and customary charges and grossly inflated charges. MDabroad offers comprehensive assistance Services which ensure immediate access to medical guidance and care. MDabroad can assist travelers all over the globe with an exclusive network of the most highly credentialed providers, for both outpatient and inpatient care. MDabroad offers unique packages to support the unique needs of travelers in any part of the world. Our integrated packages include travel assistance Services before, during, and upon return. We extend travel preparation Services, so they are informed of potential health risks prior to travel.

Services we provide:

Medical Assistance

• Coordination of outpatient and/or inpatient care for any medical condition
• Telemedicine
• House calls
• Dental services
• Medical evacuations & repatriations

Technical & Personal Travel Assistance

• Tracking of lost luggage and concierge services
• Cash advance
• Assistance in case of lost and/or stolen travel documentation
• Reservation of air tickets and hotels
• Transmission of urgent messages to family in case of medical or legal emergencies

Legal Referral

• Access to legal counsel whenever the traveler is being pressed with charges or was involved in an accident.
• This service also provides advocacy with the traveler’s consular authorities locally.

Cost Management

• US Claims are placed through direct agreements and Aetna Passport Health.
• On critical care cases, we deploy immediate resources, coordination of specialists and immediate response teams.
• Fraud control and auditing. Using local resources worldwide, we pay in local currency through our own staff, avoiding manipulation of pharmacy and consultation prices.

Proactive cost containment in US hospitals

• We deploy a network of hospitalists who manage care within the hospital setting on a proactive basis, as opposed to traditional case management and audit that happens after the fact.

Pharmacy

• Discount programs to our clients’ members.

Most important of all, MDabroad provides travelers with 24/7 access to a network of the world’s best providers. One call to MDabroad connects travelers to our doctors, nurses, and patient advocates.

Worldwide Network Access
MDabroad complements the in-house provider network administration areas of insurance companies and third-party administrators.

We have built up solid credit worthiness with an extensive network of strong healthcare providers, including the most renowned international patient hospitals around the world. Through our intervention, many international insurers and TPAs obtain direct access to hospitals who will not only invoice them directly (thus making it cashless for the insured), but also benefit from discounts and other preferred payment considerations that only MDabroad can provide through its rich information and vast financial resources. As such, we have emerged as the most reliable and objective healthcare provider network for the management and administration of foreign patients in many markets in the global arena.

Claims Management Services and Repricing
MDabroad offers payers meticulous case management for all inpatient cases. We ensure reasonable and customary charges, medical necessity, along with best practices for each inpatient case. Once this has been verified, we conduct exhaustive negotiations to obtain the best possible discount for our clients, through personalized negotiation, prompt payment, and other negotiation tactics. Our comprehensive claims process is supported by proprietary software platform that tracks the specific processes and needs for each Client.

Other Services for claims management include the following:

• Adjudication on our system or our clients’ system

• Proprietary software platform

• Outsourcing solutions for TPAs

• File exchange

• Medical Audits

• International arbitration

• Superior turnaround times

Funding Program
MDabroad Claims Funding (MDCF) is our unique funding program which is designed to address complicated industry concerns such as risk mitigation, cash flow, and managing the nuances of conducting business with foreign entities, MDCF is a revolutionary payment solution that was developed for healthcare insurers and TPAs that provides a highly efficient and unique pre-payment settlement option.

MDCF helps payers in the international insurance space, deal with their accounts payable in real time, maximizing prompt payment discounts while enjoying a convenient payback term. MDabroad offers a complimentary assessment to facilitate immediate implementation for this product.

Remote Online Web Access
Our cloud-based proprietary web application is available in real time 24/7, 365-days-a-year through a secure connection. Our State-of-the-art web application provides access to real-time processing, detailed information related to specific claims, processes and status updates.

Recoveries / Subrogation
MDabroad is committed to helping providers, insurance companies, and insureds to be made whole when third parties are culpable for the injuries suffered by insureds.

Our company works closely with numerous leading attorneys who focus on subrogation and lien enforcement Services where there is third party responsibility. Moreover, upon request, MDabroad can partner up injured insureds with attorneys in the jurisdiction where the accident occurred to provide counsel if the injuries stem from the fault of another. Ultimately, MDabroad consistently reviews the facts of all injuries and accidents with counsel to determine if dollars can be recovered for all interested parties.