When evaluating potential providers, true value is really a combination of the quality of treatment and the associated costs. In our industry, consideration for both quality and costs is virtually non-existent when evaluating a provider. For many years, Global Excel routinely encountered hospitals with some of the lowest quality ratings billing some of the highest charges in the country.
Our FairChex tool was developed to combine both these factors together, essentially aligning a facility’s quality with its charges. The data used is completely objective – provider quality information is updated routinely from CareChex, an independent third party quality analysis firm, and the financial data is sourced from the U.S. government. FairChex allows us to compare any number of potential U.S. providers, including providers that may have been ‘recommended’ to the insured.
Global Excel is the only cost containment partner that routinely uses a cost-quality tool for pre-admission analysis. Once an appropriate provider has been identified and selected by the insurer/insured, Global Excel will then pre-negotiate the financial arrangements with that provider.
Our GEMClinical tool is the ideal solution to help international assistance companies and insurers manage their difficult inpatient cases occurring in the USA. GEMClinical allows our corporate client to retain all contact with the patient, as well as all decision making power with regards to the medical treatment provided by U.S. facilities. Global Excel gathers the necessary medical information from the provider, summarizes it and shares it with our corporate client in a structured report. We reference industry-approved care guidelines to assist our client with effectively overseeing care and avoiding overtreatment.
Our doctors and nurses have an intimate understanding of how the U.S. system works and we use that expertise to provide our own medical recommendations pertaining to continued treatment, fit-to-fly, alternative treatment options and (when applicable) cost-benefit analyses comparing optional care scenarios. Our medical team is always available to answer any questions our clients may have.
There is no question that the earlier you can intervene in a case, the greater your potential for controlling the ultimate costs. But in circumstances where the patient has already been discharged and that hospital has already billed the insurer, Global Excel’s ‘blended approach’ to cost containment can be applied very effectively. Our expert negotiators will examine the bills and benchmark the charges against objective cost data. We communicate the various options back to the insurer and allow them to make the final choice on how to proceed. The key thing is that the client has the ultimate control – our job is to outline the opportunities, provide advice and then to execute the client’s final decision.
Global Excel also offers the complete range of claim administration services. From bill scanning and triage through to bill editing, adjudication and payment. All these tasks are wrapped in a comprehensive Quality Assurance program that assures consistent and accurate processing. Our Online Portal allows you to follow the entire process from beginning to end. Transparent reporting is key – if you don’t know how your claims dollars are being spent, how can you adjust your strategy to compensate?
The success and the growth of our company are directly linked to the dedication and expertise of the more than 600 employees who are part of our team. These talented individuals offer a complete range of services to more than 360 clients worldwide, consistently offering them a superior customer experience. Interested in joining our team? Visit our careers section to learn more about the career opportunities available at Global Excel.