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“Traditionally,” began John, “assistance was primarily focused on the call centre – we had to answer calls quickly, minimise dropped calls, and focus on first-call resolution. Metrics were everything – requests for proposals were focused on telephone service factors like call abandonment. The thing that was missing was anything to do with the customer experience.” Medical assistance, in reality, was often limited to ‘go to the nearest emergency room’, and the focus was on statistics instead of member satisfaction, with the ultimate success being measured on a percentage of savings. This approach had to change due to several factors:
- Healthcare inflation around the world, particularly in the US
- Changing consumer demands (such as telemedicine, mental health and maternity management)
- Cost-quality ratios differing significantly.
To counter the effects of the above and rise to the challenge of providing assistance to today’s savvy traveller, medical assistance needs to prevent, mitigate and contain costs. “If we can get out in front of a claim if we can steer a patient to a provider, we’re much better able to prevent costs from occurring,” said John.
True assistance though, lies not just in medical assistance services – there is so much more to do. Services could include offering security assistance, performing high-risk evacuations, assistance in securing local legal representation, and cashless access to treatment. On the topic of cashless access to treatment, John highlighted two products – Fast Track and Express Discharge, both of which allow clients to be discharged within 30 minutes of treatment without putting their hand in their pocket.
“Today,” John concluded, “assistance is all inclusive. It’s proactive and starts before the claim happens; it coordinates seamlessly with medical case and cost management initiatives; and it enhances the member’s journey while reducing net paid claims costs.” Real assistance is not just about the digital-first vs the human touch, he added, or about direction, networks, negotiations and direct contracts. It’s about creating the right solution for you and your members.