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 Web page contains only a brief summary of current benefits, conditions, limitations and exclusions, and is subject to all the terms and conditions of the full Certificate of Insurance. The complete Certificate of Insurance with all terms, conditions and exclusions will be included in the fulfillment kit sent to approved applicants. These plans are amended, modified or replaced from time to time, and IMG reserves the right to issue the most current Certificate of Insurance for this insurance plan in the event this Web page, application, and/or brochure has expired, is modified, or is replaced with a newer version. Samples of current Certificate wordings are available upon request.