MP+ International Insurance

Medical Management

The ability to access quality health care is of paramount importance when a medical emergency arises abroad. From routine medical care to complex case management, from check-ups to emergency medical evacuations, IMG is there to offer our expertise in cost containment and a unique blend of valuable services including:

International Utilization Management

Utilization Management is the process of determining whether the services delivered or scheduled to be delivered to a patient are medically necessary and appropriate. By using established national medical guidelines, evaluation is provided for the medical necessity for hospitalizations and out-patient services and the appropriateness of the overall treatment plan.

The key to successfully managing rising health care costs is early identification of catastrophic cases, and then taking action to manage those cases. Precertification is used as a key tool for this early identification of a patient’s entry into the health care system. This allows our medical staff to be proactive in working with both the patient and the providers assuring delivery of health care in the most appropriate and cost-effective manner.

Prior to receiving treatment, members will need to precertify the following procedures to avoid a reduction in benefits:

  • In-patient treatment
  • „„ Surgery or surgical procedure
  • „„ Care in an extended care facility
  • „„ Home nursing care
  • „„ Durable medical equipment
  • „„ Artificial limbs
  • „„ All transplants

International Comprehensive Care Management

Our medical staff will help coordinate care for your members who have highly complex cases requiring detailed management. These services may include assisting with:

  • Concurrent review and monitoring of medical services for medical necessity
  • Coordination of the hospitalization and any necessary post-discharge care
  • Transition of patient to a U.S.-based care manager upon return to the U.S.

Medical Claim Review

If your members have received a hospital bill, there is a reasonable bet that they have been overcharged. As was reported in theWall Street Journal, Weekend Investor, 80% of all hospital bills contain errors (February, 2011). Of these errors, 85% are in favor of the hospital. Most claim administrators have invested significant amounts of money incorporating claims auditing software in the claims system. IMG takes the claim review process one step further by examining the details behind documents submitted by the medical provider. Our auditors review all medical records to assure that all the services billed were actually delivered and delivered in the quantities billed.

Our goal is to assure that your members only pay for the services that were actually rendered.

This invitation to inquire allows eligible applicants an opportunity to inquire further about the insurance offered and is limited to a brief description of any loss for which benefits may be payable. Benefits are offered as described in the insurance contract. Benefits are subject to all deductibles, coinsurance, provisions, terms, conditions, limitations, and exclusions in the insurance contract. The contract does contain a pre-existing condition exclusion and does not cover losses or expenses related to a pre-existing condition.