Global Excel | Customized Medical Case Management
Global Excel is a worldwide premium medical cost containment company, providing services to a broad range of market segments. Our partners trust our expertise in controlling healthcare costs for the management of their claims dollars as well as our ability to provide a superior member experience.
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SERVICES TO FIT YOUR NEEDS
Our case management services are just like all our other services – flexible and tailored to the needs of the client. Our clients decide how little or how much they want us to be involved. They know they can rely on a focused and empathetic team of professionals who are dedicated to achieving the highest degree of customer satisfaction.
Our dedicated in-house team approaches medical case management using the same criteria employed by U.S. health care providers — by referring to the evidence-based Milliman Care Guidelines.
Milliman Care Guidelines are universally recognized in the U.S. and enable our case management team to discuss patient care with providers using a common set of criteria. As a result, they can determine with efficiency and accuracy if appropriate treatment protocols are being used and ensure that patients aren’t receiving unnecessary care.
Our methods of medical case management have been proven to shorten admissions, thereby lowering medical costs before our negotiation team even begins to negotiate the bills.
This team acts as the point of contact for client members and their families.
In the event of a medical emergency, these multilingual and empathetic individuals do everything there is to do, from understanding policy details and how to interpret them, to pre-approving doctor’s visits and, in the most unfortunate of cases, arranging repatriation services.
Negotiation is not easy and because of that many of our competitors shy away from offering negotiated settlements.
Medical case management is a collaborative process with U.S. providers that covers four key areas:
- Medical Review: Global Excel’s physicians and nurses work closely with treating professionals to validate the appropriateness of admissions, interventions and length-of-stay (LOS) for each case.
- Risk Assessment: Global Excel evaluates any co-morbidities so as to decrease the risk of readmission and control total LOS.
- Utilisation Review: Global Excel ensures that resource utilisation and interventions are medically indicated and within policy limitations and intent.
- Safe Discharge Planning: It starts when the patient is admitted (to minimise excessive length-of-stay) and it focuses on appropriate post-hospitalisation consultations, investigations and treatments.
Other case management services include:
- Medical escorted by commercial flight or air ambulance repatriation coordination
- Local transportation arrangements
- Repatriation of remains
- Accommodation and ticketing reservations
In the event that a client prefers to do case management themselves but, on occasion, would like additional support handling large cases in the United States, Global Excel offers GEM Clinical™ and GEM Clinical Xpress™:
- Available only for inpatient cases in the United States;
- Both products allow our clients to retain all contact with the patient, as well as all decision making power/approval with regards to services provided by U.S. facilities;
- Global Excel gathers the necessary medical information and shares this with our clients, along with our own medical recommendations pertaining to continued treatment, FTF (fit-to-fly), alternative treatment options and (when applicable) cost-benefit analyses comparing optional care scenarios.
- Industry-approved care guidelines are relied upon to effectively oversee care and avoid overtreatment.
Global Excel’s directional tool provides clients with:
- 24/7 access to the most current network provider listing in a user-friendly format;
- A tool that helps quickly locate network physicians, hospitals, pharmacies and ancillary facilities;
- The option to search for providers by address, name or automated quick search;
- A tool offering accurate mapping and directions to specific provider addresses;
- The option to download and print or email customized directories.
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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.