Imagine yourself not as the insurance professional that you are, but just a layperson. You’re on holiday in Greece, Thailand or Kenya, but unfortunately get sick or have an accident and need to be admitted to hospital in a strange country. There are many things to be concerned about.
Will the staff understand you, as you don’t speak Greek, Thai or Swahili? And in some cases, not even English, especially medical English. The quality of care is another important factor. Do they use clean needles, and can you have your own room? Perhaps there isn’t much of the local currency in your wallet and the credit card is maxed out.
Relatives may also need to be informed and vital medical history is with your GP. How can you make the local doctor understand? And that’s before you even consider being able to fly home and the fact your visa expires tomorrow. Even a fairly common disease or rather minor accident can lead to major stress levels.
Communicating with foreign patients
We must also take into account the perspective of your hosts, as they will have questions of their own:
• What is this foreigner talking about? I don’t understand them
• Are they going to be able to pay for their expenses?
• Where can I obtain their medical history?
Perhaps your hospital sees many foreign patients a day. That’s a load of potential stress that would be better tackled before it erupts. Different functions are required to fulfill all those needs that come with the international patient and language barriers that may emerge.
A key factor is the ability to communicate with foreign patients, assessing their needs and answering enquiries. This also applies to discussions with overseas insurers and assistance companies – understanding different systems (health/travel/social security) and specific languages used around the world. Not to mention embassies, foreign medical providers, claim and consent forms and overseas relatives. As the world gets smaller, the idea of ‘cultural translation’ is growing all the time, so having an international team is becoming even more essential.
A key factor is the ability to communicate with foreign patients, assessing their needs and answering enquiries
Team members who take care of insurance claims need to be able to communicate smoothly with both hospital staff (native language or English) and the patients and relatives (any language). Making them the single-point-of-contact for insurers is preferable as they can coordinate between patients, various third parties, and hospital physicians or departments. If they have a nursing/medical educational background, they can also assist physicians with their English medical reports. Office skills, working under pressure, and an eye for detail are all key attributes when putting such a team together.
If you want to do claims for both inpatient and outpatient departments, plus with and without guarantees of payment (GOPs), knowledge needs to be quite extensive. You must also facilitate the team with dedicated software, including a contact information database. But even then, on-the-job-training and experience are key to developing a successful unit, with happy patients and third parties.
Their job will be to become the pivoting point of all information required by the tripartite: hospital/patient/insurer.
Key tasks would be:
• To ensure they will be informed by admission and clinical staff that there’s a patient with a problem that needs investigation, along with a foreign insurance policy and treatment cost
• To provide information and evidence (passport, insurance card, flight tickets, medical report, cost estimates) to the patient’s insurance/assistance company, with a request for confirmation of coverage. This can be by phone and email, or more directly into insurance portal websites
• Field further questions (medical, financial, etc.) from insurers, which need to be relayed to hospital staff to get answers
• To request insured patients complete all required forms, which also need sending, plus inform patients and involved hospital staff about any coverage or denial thereof
• Send medical and financial updates to insurers.
If you have numerous foreign claims with so many different payers, a knowledgeable finance department is essential. With such a variety of requirements around billing and document submissions, you want to cover all bases.
Direct insurance claims and translators
With a dedicated insurance team in place and an open mind when it comes to accepting GOPs on credit from worldwide insurers, you can try to establish direct billing as much as possible, even for ‘small claims’ – as this will often be a major concern for a foreign patient.
But there’s also a multitude of other international department functions to fulfill. Depending on the patient workload and organisation, this could be the same team that deals with claims – however, that’s not always practical. Therefore, having a second, dedicated team of international coordinators should be considered, especially for those more common foreign languages. Some hospitals use native or local translators, physically present or by phone. Others operate with Google Translate, which works very well for English to another European language, but may not function quite so well for Thai, for example. The use of professional external companies for assistance by phone is another option.
A second, dedicated team of international coordinators should be considered
In my opinion, language is just one aspect of an international patient’s requirements, so my preference is a dedicated team on site, of native origin, providing the best care possible. Their job title shouldn’t be ‘translator’, as their function would be much wider than that. ‘International Coordinators’, for example, immediately implies a function beyond just language translation.
There should also be a call centre, or an easy method of contact, for all hospital staff requiring the service in a particular language. And, of course, the service should be seven days a week – daytime on site, nighttime possibly by phone.
A medical or paramedical background isn’t an absolute requirement, as you don’t require specific vernacular to explain a condition, investigation or treatment to a patient – simple language that they understand is a priority. Compassion, patience, empathy and communication skills are much more important. So many forms may need filling out, alongside email enquiries, appointments and other red tape, so ensure extensive on-the-job translation training.
Foreign patients in international hospitals have plenty to deal with, so making them feel welcome and taken care of is a priority. Teamwork is the absolute key.