Customized Medical
Case Management

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 accurately and efficiently determine whether appropriate treatment protocols are being used, and ensure your patients aren’t receiving unnecessary care.

Our medical case management methods shorten admissions, lowering costs before our negotiation team even begins to negotiate your 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.

Owned by Us. Staffed by us. And Operated by us.

Nothing else could ensure the quality of service demanded by our clients. All incoming calls are handled by our experienced multilingual primary assessment team 24/7/365. We also monitor service levels in real time and constantly adjust our queues as necessary to ensure optimal response time.

Because negotiation isn’t easy, many competitors shy away from offering negotiated settlements.

Medical case management is a collaborative process with U.S. providers that covers four key areas:

1. 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.
2. Risk Assessment: We evaluate any co-morbidities, decreasing the risk of readmission, and controlling total LOS.
3. Utilization Review: Global Excel ensures resource utilization and interventions are medically necessary, and within policy limitations and intent.
4. Safe Discharge Planning: It starts when your patient is admitted (to minimize excessive length-of-stay), and it focuses on appropriate post-hospitalisation consultations, investigations and treatments.

Other case management services include:

• Coordinated medical escort, either by commercial flight or air ambulance
• Local transportation arrangements
• Repatriation of remains
• Accommodation and ticketing reservations

If you prefer to do your own case management but would occasionally like additional support handling large cases in the U.S., Global Excel offers GEM Clinical^TM and GEM Clinical Express^TM:

• Available only for inpatient cases in the United States
• Both products allow you to retain all contact with your patient, and all decision-making power / approval for services provided by U.S. facilities
• Global Excel gathers the necessary medical information and shares this with you, along with our own medical recommendations regarding 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

Our directional tool provides you with:

• 24 / 7 access to the most current network provider listing in a user-friendly format
• Help quickly locating network physicians, hospitals, pharmacies and ancillary facilities
• The option to search for providers by address, name or automated quick search
• Accurate mapping and directions to specific provider addresses
• The option to download and print or email customized directories