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International Medical Care

Quality, communication and prompt payment

International Medical Care
3 Oct 2022 | Charlotte Estipular
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lga Assistance discusses the nuances of cost containment in the UAE, and how its approach is guided by local regulation and in-depth understanding of customer needs and cultural variations

The Covid crisis reinforced cognizance that the scale and pace of healthcare and insurance – and therefore cost containment – reinvention is required, especially in the healthcare vertical. A significant surge in healthcare costs has been just one of the major consequences of the Covid-19 pandemic. The crisis has shaken healthcare systems to the core, and meant that a lot of organizations have had to adopt new ways of working that have profoundly affected the medical and travel assistance landscape to address rising healthcare costs.

Assistance companies across the United Arab Emirates (UAE) have continuously been reinventing the travel and medical assistance industry by making daring moves, challenging the status quo, and responding to global shifts as well as clients’ evolving needs. Several of these moves involve the adoption of new technologies, and working more closely and effectively with hospital partners to fix prices and ensure transparent billing processes. For lga Assistance, these efforts form the core of our three pillars of cost containment – LGA HPASS, Cash and Go Program, and Outpatient Fixed Tariff Cost.

LGA Healthcare Provider Auto-selection System

This digital solution system aims to reap major benefits in various ways.  The concept is to minimize costs without compromising the quality that the patients would receive – the goal of every assistance and cost containment company. This promotes friendly competition between our key provider partners and promotes high quality and value for the payer. The Provider Cost and Quality ranking in our system would depend on the type of provider, patient’s location, category of the provider, financial benefits, and monthly performance evaluation concluded by LGA Operations Team and of course, our patients.

The Covid crisis reinforced cognizance that the scale and pace of healthcare and insurance – and therefore cost containment – reinvention is required

Providers have given attention to this strategy and in our experience, we have found that it has driven them not to be complacent, especially when competition in the industry is fierce, and this information to get tighter on quality assurance has been disseminated to our insurance counterparts. The rates per CPT code in the LGA HPASS system are based on the local rate and are pre-filled by the provider during the credentialing process with LGA Assistance, and can only be amended once both parties agree to re-negotiate. Their contract with LGA Assistance prohibits the providers from using the commercial rate to ensure the costs to payers are with in usual and customary rates. The LGA HPASSS has led insurance companies to auto-select the best provider for their clients based on the requirements. LGA Assistance envisions this system could be used not only through B2B landscape, but also through B2B2C perspective.

Cash and Go Program

LGA Assistance continues to integrate efficient and effective practices into all of its developments to address issues concerning provider billing mistakes, combined with the skyrocketing cost of healthcare services. The Cash and Go Program is the stage in the healthcare provision pathway that enables us to save more and pay less. Aside from the proactive discount that we could get and the savings that we have reached with the help of LGA HPASS, the Cash and Go Program allows insurers reach the maximum saving value. This occurs when the insurers opt to pay within seven calendar days from the patient’s discharge. Provider partners offer additional percentage reduction on the total invoice value that could reach up to 10-20 per cent and the total saving could reach 49.7 per cent.

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Outpatient Fixed Tariff Cost

In the commitment to provide adequate support to manage costs and reach the maximum saving, LGA Assistance is one of the proponents offering the Outpatient Fixed Tariff Campaign. Researchers found that outpatient fixed-rate contracts correlate with lower healthcare costs. During the Covid-19 pandemic, we have witnessed how healthcare costs were being driven up, especially for outpatient procedures. LGA Assistance is partnered with the best medical providers across the Gulf Cooperative Council region, which grant us packages with very competitive prices. Insurers, especially those that sell low- cost policies, saw particular benefits from this programme.

Researchers found that outpatient fixed-rate contracts correlate with lower healthcare costs

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Multi-pronged approach delivers tangible results

During the crisis, we have strengthened our digital solution, process enhancements and transformation in the assistance vertical. I am proud to say that LGA Assistance was able to respond with incredible resilience and adaptability, and proud that our relationships with our core partners remain as strong as ever. Our bias for proactive approach to cost containment and medical assistance is the real game changer. LGA Assistance will always be committed to providing best customer journey in the right place, at the right time, with the right cost.

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ITIJ 261

October 2022
 Issue

In this issue:

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Charlotte Estipular

Charlotte is the Business Development Manager of LGA Assistance Group and leads the organization across all its geographies. Charlotte has more than decade of experience in the industry. Her key responsibility is to reinforce the brand across strategic areas. Her core strength is driving integrated campaigns across geographies and empower corporate culture within the LGA Assistance Group. She is obsessed with operational excellence to ensure that LGA Assistance Group remains to be the number one vendor of choice.

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