Frequently Asked Questions

Corporate Health Plan Sponsor FAQs

 
How do we begin?

Call us to explain what you've been noodling over in regard to healthcare cost containment. That's the best place to start. All the cards on the table, face up. (800.209.7263)

What data will you ask for?
  • Group size and profile
  • Union presence / group size
  • Expats and local nationals
  • Relevant procurement policies
  • Interest in international options - if so, where
  • Copy of past and recent 5500s
  • Predictive analytics reports
  • Past claims history
  • Lasered claims
  • Current SPD and plan docs

You probably have most of this within easy access.

How do you work?

We are corporate health travel benefits advisers. We work as fee-based consultants to help you set up your program.

Program Design and Development

  1. Generally, we come and meet with you or you come and meet with us in Denver. Your choice.
  2. We exchange a mutual NDA - yours for your data, ours for our methods and intellectual property
  3. We conduct a high level situation analysis; no two clients' needs are ever the same. If you have the data, all the better. We proceed faster and costs less.
  4. After we explain our Approval criteria, we present you with a list of Approved Providers for your perusal. These include both domestic and international suppliers
  5. You pick as many as you'd like to examine more closely and we assist you through site inspections, and executive level negotiations - as your advocate, not the agency of the providers.
  6. If you and the hospital happen to be our clients through our Master Brand, we'll offer the opportunity to act as mediator/facilitator between the parties, but we'll need mutual agreement from all parties.
  7. We supply model template contracts to make things easier, but ultimately the contract signatories are the employer or union and the provider.
  8. We have no stake in the race. We don't collect commissions for referrals to the hospitals. Approved Provider status is based solely on merit.
  9. Once your contract is executed at whatever scope you decide (single specialty, single procedure, checkups only - its all the same to us) our experts are available to tighten up your ERISA or Taft Hartley documentation and plan amendments or notices, and any beneficiary communications. Or, you can use your regular benefits adviser.
  10. At that point, one side of our firm is ready to conclude and sign off until you decide you'd like to work with us to expand your program. We certainly hope you will.

Activation of your program

  1. If you decide you would like us to administer your medical travel program the other side of the firm is activated. A separate contract is negotiated.
  2. We set up your client portal, which is role based so that your beneficiaries don't see offers or destinations that are not part of your program.
  3. We manage the end-to-end pre travel, destination care and recovery, post treatment return travel, and hometown follow up care.
  4. We monitor and measure clinical and service outcomes, patient satisfaction
  5. We prepare reports of outcomes, report back to relevant parties, and track and trend values, costs, savings and more based on whats important - to you, our client.
  6. If one of your beneficiaries would like to use the Approved Provider network for a non-covered service (self-pay) we'll make it happen as a courtesy. The providers will welcome them and the chance to earn some extra revenue and be of service. Approved Providers are located at exciting destinations in 120 countries around the world. The providers view this added opportunity to be of service as the fringe benefit of having a relationship with the patients' employer.

TPA Services and Provider Settlement

  1. Prior to departure, a TPA must be involved. You can use your existing TPA (but we prefer you use our partner).
  2. Payment arrangements between you and the provider will be spelled out in the negotiation of your contract.
  3. Many employers want a "Chinese Wall" between their medical travel program and their regular PPO arrangement for a number of reasons.
  4. We take no percentage of the TPA fees. We don't sell TPA services. We simply steer you to a firm we trust and know and they know and trust us.

 

How do you make money on this?

The old fashioned way: We bill for the consultative and case management services we provide.

What services can you provide?
  1. We can help you to identify high value, pre-inspected, Approved Providers in every specialty, in every state in the USA and in 120 countries across our globally integrated health delivery system®.
  2. We can help you with disintermediated (direct) contracts between your organization and your designated providers without middle man layers and PEPM lease fees. Across the street, across the county, across the state, across the nation or across the border. Just like Nordstrom started as a shoe store, our firm was originally a managed care contracting consultancy.
  3. We can design and implement an Executive Checkup program as a voluntary program or as a condition of employment for your senior staff and executives. We extend the program to spouses and domestic partners if you wish. The cost is the same either way. The program can be domestic, international, or both.
  4. We can assist you to locate designated providers within easy reach of your expats and employees posted away from your headquarters working in foreign countries, where perhaps care is of limited access or poor quality - or worse - nonexistent.
Tell us about your medical advisers.
  • Our USA chief medical adviser has worked in Africa and was a part of the POTUS advance party medical entourage, a former chief medical director for a large HMO at the national level, has taught family medicine at several medical schools, and has worked for the CDC. He's licensed and recognized in several countries. He has sub-specialization in tropical medicine, a Master of Public Health in addition to his Doctor of Osteopathy, and is Board Certified in Family Medicine and Primary care. He has airlift and medical evacuation and Embassy and State Department connections across the planet. And he plays golf and guitar.
  • Our Europe medical director is also our consulting epidemiologist. He's been a HMO medical director, a private practice physician and a hospital executive in Europe. He speaks several languages, holds an MBA in addition to his medical degree, and enjoys photography.
  • Our North African chief medical adviser is also a medical evacuation and airlift expert, a radiologist by training, and speaks fluent English and Arabic.
  • Our LATAM chief medical adviser is and orthopedic surgeon licensed in Mexico. He speaks German and Spanish and English.
  • Our Asian chief medical advisers are both MD/PhDs, still in active practice but with extensive managerial and medical training program involvement. One is a liver transplant specialist and the other a cardiologist. Between them, they speak Bahasa Malay, Mandarin, Cantonese, Hindi, English, Thai and Japanese.
  • Our CIS chief medical advisers are both MD/PhDs and still active in practice with specialties in physical medicine and rehabilitation. Between them they speak Russian, Ukrainian, German, English and Polish. They are leaders of national medical societies and internationally recognized for their work with rehabilitation after gruesome military and industrial accidents and injuries. They have special interests in Aquatic therapy and rehabilitation techniques.
  • We currently have an opening for a chief medical adviser in Australasia. For now that's being cross covered by our US chief who is also licensed in New Zealand.
  • Underneath all of these chiefs, we have designated experts in each country if there is a need to tap local knowledge about licenses and credentialing, training and surgical privileges.
How much will it cost us to set up a medical travel program?

We hate to sound cliche' but "it depends". Talk to us and we can give you a no obligation estimate. It may be far less than you might guess. Much of the cost is dependent on the scale of what you want to build. We try to first determine if you have enough cases that will create enough in savings at a minimum savings of $15,000 per case to warrant having a program in the first place. Our goal is to help you realize savings, not spend money on consulting.

How long will it take to set us up?

We hate to sound like a broken record, but "it depends". Talk to us and we can give you a no obligation estimate. It may be much quicker than you might guess. Much of the time required is dependent on the scale of what you want to build and how fast you can give us the time to review and approve choices.

If you are in a pinch and need a case managed right away, let's get your plan member taken care of and then work out your program design without added stress. We usually work on those little emergencies on the basis of a retainer and a fee agreement. We can get things going in a matter of days - or hours if necessary.

That's the beauty of having our globally integrated health delivery system® and Approved Providers pretty much everywhere.

Will you work with our benefits consultants?

Our approach is broker/consultant agnostic.  From that perspective, it has been really good for our broker/consultant partners in the market, where we serve mutual clients and prospects. We don’t intend to be a threat; we want to work with them of behalf of clients.

When a new client comes to us and they want a pre-packaged health and wellness travel benefit administration solution and they’re not interested in staying with their current broker or they are actively looking for a new broker, we can bring strategic partners to the table. But, most of what we have experienced with our clients and our prospects is they have brokers and consultants and advisers that they trust and they want to keep. They like the fact that we will work with their current brokers. The vast majority remain with their current broker. Many developed these relationships over decades and wish to keep their current broker/ consultant and work with us for their health and wellness travel case management, network development, and medical travel TPA services only.

We focus on providing a corporate medical travel benefit administration experience that is fully integrated with the broader human capital experience at each company. We don't supply cookie-cutter solutions and we offer choices in the USA and 120 countries unlike any other firm in the business.  We don't believe in a pre-packaged medical travel benefit program for all employers like our competitors. We prefer to customize a solution that will save you money and that your plan participants will use.

That being said, there are a few brokers and consultants who have been difficult to work with. Some have taken advantage of us and one converted our intellectual property. Let's just say, "We don't forget." and leave it at that.

How small is too small?

I own a small business with fewer than 20 employees. Will you help us?

Do you have a self-funded health plan? A catastrophic plan and a HSA or HRA? Talk with us. Let's first see what you need. If we can help. We will.

Why is Specialized Travel Planning Important?

There are many advantages to working with our specialized medical travel planners. For one thing, the team is a collaboration of clinical care coordinators working with experienced travel agency professionals.

But there's more to the specialized travel planning than meets the eye:

Accountability

A travel agent’s job is on the line with every trip. At Mercury Health TRavel, the team has a manager and a client to answer to —and they are a real person clients can speak with to work things out.

Specialized Training and Experience

Our specialized medical travel agents have been doing the job for years and know all the ins and outs. Despite popular myths, many plan participants live in rural areas where healthcare is scarce. They may have never traveled on a plane before. Medical travel is always stressful. Instead of deciding where to go and what type of ticket to purchase, your plan participants can speak to someone who does this for a living and knows what they’re talking about.

Value for money

A travel agent with access to special unpublished discount rates can ensure that your travel dollars are stretched as far as possible without sacrificing quality, safety, or cutting corners that can leave a traveler stranded due to a misconnection or flight interruption.

Full itinerary support

Our specialized travel planners give clear cut instructions, set expectations, and provide details of plans and appointments for each day. They make the choices to keep your plan participant on time, informed, and plan services and use suppliers that you've already approved.

Budgeting

A medical travel planner will help map out exactly how much the planned and covered expenses will cost, to reduce surprises.

Insurance

Mercury Health Travel's specialized travel planners provide peace of mind in a number of ways, from guaranteeing that the hotel has been inspected to our standards, is appropriate for the medical traveler, to actually advising on which insurance policies are needed, from trip cancellation to medical emergencies. They also insure that medical travelers will have the correct travel documents, so they don’t end up missing their plane or run into complications at immigration desks. And when things do go wrong, travel agents have the resources and the contacts to get your plan participants to the head of the line.

Resources

At the touch of Mercury Health Travel's planners’ fingertips they have resources a general traveler simply does not. Planning travel to access healthcare or return requires much more than an Internet connection and an online discount travel agency website.

Exclusivity

Mercury Health Travel planners know the destinations and have high enough volumes to warrant exclusive unpublished rates not available to the general public. Through our partners, we also often get freebies for our clients and their plan participants that range from extra amenities and upgrades to discounts of up to 60% on international upgraded fares.

Leverage

When hotel sites and online travel agency sites report no availability, they are only reporting availability on their assigned sell blocks.  Mercury Health Travel planners and travel agents spent years developing long-term relationships, and travel suppliers understand how important their repeat business is. Travel agents have leverage with most hotel companies and resorts, and they are more likely to get what they want than a single consumer booking online or by telephone, and especially booking through an online discount travel site.

In short, our specialized medical travel planners save time and hassles and aggravation—and often, money as well.

How reliable and transparent are the prices you quote?

First we don't quote prices. We help you negotiate prices directly with the hospitals, clinics, doctors and dentists. Therefore, rates are 100% transparent and reliable. You have them in writing and they are enforceable by you.  We simply help facilitate the contracting, site visits, and will help with supplied provider contracting templates you can use.

Once you've negotiated those prices, terms and conditions, we'll introduce you to the nation's only TPA that can manage bundled, set fees without raising an eyebrow. When everything is ready for documentation, we'll help you draft and prepare your plan wrap documents and set up all case management and a user portal for your plan beneficiaries.

Is mental healthcare and substance abuse /eating disorder recovery available?

Absolutely. Mental healthcare and substance abuse /eating disorder recovery services are no different than cancer treatment, a stomach ache or a migraine headache or a concussion. In the USA, the Mental Health Parity laws require identical coverage, but your leased provider network may not include the places you want to use. No worry, there's a workaround and we're ready and able to help.

Need a quick intervention and admission arranged, but worried about all the client administration paperwork to set up your account? Call us. We won't stand on ceremony or delay access to care on account of paperwork. We can mobilize on a moment's notice if necessary. 800-209.7263.

 

Can you help us develop a limited expense HRA to save our employees on HDHPs out of pocket cash?

Of course. Call us and we'll direct you to our specialist for this kind of arrangement.

800.209.7263.

How many Americans currently travel abroad for the purpose of obtaining healthcare?

According to a recent report by Visa and Oxford Economics that analyzed billions of the credit card company's transactions by spending category, about 14 million people each year travel abroad in search of more affordable medical care. They spend roughly $45.5 billion for it, The authors calculated that the market will grow by 25 percent annually to reach to some $3 trillion by 2025, and estimate 3 percent to 4 percent of the world's population will become medical travelers.  According to Maria Todd, CEO of Mercury Healthcare International, she states, "I don't know what data they studied or how they interpreted it. The authors and publishers were called out for overstating the statistics and projections much the same way Paul Keckley, formerly with Deloitte had to restate his estimates, twice. Therefore I read it and acknowledge it but don't count on it for strategic planning and advise I provide to clients. Honestly, those numbers don't directly correlate to what happens in corporate medical travel benefits administration because they are consumer expenditures, and could include hotel massages, facelifts, and cosmetic surgery procedures that simply aren't relevant to corporate America's health benefit programs.

Todd says that the numbers proposed by Visa and Oxford don't appear to take into account spending on "medically necessary" covered and approved procedures paid for by employers, unions, and association health benefit plans paid by ERISA and other trust account dollars. Nor does it  - take into account the company paid travel to get to the treatment destination or stay in a hotel paid for under package deals paid by the same employers, unions, and association health benefit plans or the handful of insurers that are experimenting with medical travel for a few test cases. Therefore, when a journalist uses these numbers to "lead with their lead" and the data is non-sequitur to the topic of a story about corporate medical tourism benefits, the rest of the information presented is of questionalbe accuracy and value to a benefits manager.

What are the growth and trend projections for medical tourism?

The Visa and Oxford researchers say they believe medical tourism is primed for accelerated growth as more of . . . older travelers [65 and older] seek new treatments, as well as lower cost or higher-quality care not available in their home country."  There again, Todd explains that the statement doesn't really relate to corporate medical tourism benefits because the 65 and older crowd is more likely a Medicare crowd, and no longer on the participant rolls of most American company benefit plans for active employees and dependents. So the number is taken out of context when applied to corporate medical tourism benefits.

"The truth is", as Todd explains, "We really don't have that number because there is no requirement to report where purchases are transacted and there is no means to verify the accuracy of any data." "We also know," she continues, "from interactions with our clients, that many employers curious or beta testing medical tourism at the corporate benefit level don't want their program made public and make great efforts to keep interest, utilization and outcomes on the down low." The reason for this is because there is considerable fear by both workers and benefits managers and those considering the addition of a medical travel benefit program are concerned that they might lose talent or be inundated with media requests for data they are not yet prepared to share.

Jumbo accounts have been testing medical tourism benefit programs and expanding them for more than a decade. In recent years, dozens of companies -- including GE, Walmart, Lowes, Delta Airlines, Serigraph, a few furniture manufacturers, B&H Photo, Pepsi and Intel -- have explored medical tourism in their self-funded healthcare programs. Now the trend is trickling down to smaller accounts in the 50-150 employee and dependent range. Most don't slingshot their plan participants outside the USA.

Again the trend and growth projects relevant to corporate medical tourism benefit program implementation are not aligned with or relevant to the Visa and Oxford reported statistics or projections and cannot be taken as such because we don't know what data they are measuring and how. And we don't know the skill and experience of the analysts and any prejudices that may be inherent in the data. Until there is some reporting requirement and validation method, we can only go by what we know from our client statistics and that's still at the anecdotal level. Todd says that she can afford to be patient with corporate medical tourism benefits management and consulting because it is not the only source of income for her firm.

What design elements should be included in our program?

The best medical-tourism programs share several features. These include, cultural and linguistic alignment with the employers' workforce, compliance with U.S. laws, adequate medical malpractice insurance coverage, arbitration agreements, accreditation from recognized and well respected accrediting bodies, and a means to implement continuity of care and exchanges between physicians in the home and treatment locations. For each of our clients, these design elements are the most basic and fundamental features on the checklist. Each company's expansion beyond these basics are unique to what is relevant to their population and how they might use the benefit.  

As a solution partner for our clients, we help them design and implement their unique vetting and due diligence criteria starting with transparency about the quality data, bundled inclusions in pricing agreements, and weighted scoring models to determine which procedures might be more appropriate than others for a beta test or pilot program.  We involve a medical epidemiologist with extensive background in managed care and insurance industry statistics if the client doesn't already have one under contract.

Our partner, Higowell, based in Ireland and Germany developed the first and only software platform that connects hospitals anywhere to medical information systems back in home countries using sophisticated data protocols that are also HIPAA, PIPEDA and EU Compliant. The system was designed to overcome the challenges we encountered years ago in connecting medical reports, outcomes and other need-to-know data more efficiently and securely.  People still talk about this ability as if it is years down the road, but Higowell has been at the forefront and doesn't seem to be losing any ground to new competitors. We're sure that day will eventually come.  The Higowell platform can be used today by case managers anywhere the need arises if an Internet connection is available at the clinic or hospital on each end.

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We leverage sophisticated analytics to improve quality of care for your employees and members and their families.

Quality & Safety
Destination Analysis
Price & Value
Clinical Outcomes

Mercury Health Travel's  dedication to client service and safety and our focus on creating value for our provider and payor partners has allowed us to grow each year since 2003, our first full year since we launched as a stand-alone division of Mercury Healthcare International. Before that, our medical tourism work occurred on a much more casual basis, as a service to employers, unions, association health plans and insurers, but wasn't a stand-alone division of our company. Our work in the domain began in 1977.

We are well positioned to continue our growth, based on our diversified growth strategy - partnering with health plans, employers, unions, associations, healthcare professionals and facilities  - through organic growth and corporate medical travel relationships.

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