Frequently Asked Questions

Providers and Suppliers FAQ

 
How can we become an Approved Provider?

The Mercury Health Travel Approved Provider Network spans the USA and 120 countries.  Many of these Approved Providers have been designated as such by Mercury Healthcare International through a number of avenues. In every case, our experts have visited the facility or clinic and conducted an inspection of the operations and physical plant, the surrounding area, local accommodations and airport operations.  How we learn of new facilities is by client interaction on an entirely different matter (revenue cycle, managed care, service line expansion, health travel program development, accreditation preparation, culture and language sensitivity training, marketing, branding, customer service / HCAHPS training, etc.). In other instances, we may be invited by a local tourism board to survey the destination for medical tourism readiness and have taken that opportunity to conduct health facility site inspections. This includes our surveyors who inspect and evaluate candidate destinations for our quarterly publication, Medical Tourism Destinations of Distinction.

The third method is by direct inquiry and Letter of Interest.

When a health facility or practitioner contacts us by direct inquiry and Letter of Interest, we add the candidate to the list for our next visit to their area to schedule an interview and inspection. This saves us considerable expense to coordinate the site inspection and interview to coincide with other work we are doing (speaking, consulting, fam tours, etc.) in the area or in close proximity.

If we do not have planned activity in the area within the next 6 months, we will agree to conduct a fully-hosted site visit (air, hotel, ground transfers, city tour) by invitation of the health facility in collaboration with the local tourism board, who can coordinate interviews and site tours with other local value chain partners (hotels, airport, DMCs, etc.) whose services must be coordinated in order to create a medical travel destination attractive to group health buyers.

Site inspection and interview, regardless of hosting arrangements, does not guarantee Approved Provider status in our network. If a candidate supplier is not approved, a letter explaining the reasons and recommendations is sent to the provider with an invitation to re-apply at a later date after the deficiencies have been addressed and remedied to our satisfaction.

"We are into medical tourism. Will you send us patients?"

We receive notes saying these exact words approximately 10 times per week. About 80% come from India. The rest come from Turkey, Mexican border towns, Costa Rica, and more recently, parts of Eastern Europe.  Many of these questions are received by our CEO, Maria Todd through her LinkedIn email account and social media connections on other platforms (Facebook, Twitter, etc.)

Mercury Health Travel works with destination management companies in the following countries:

Our rigid standards for Approved DMC services are applied equally worldwide. Criteria includes a minimum of 10 years of verifiable operations, insurance on all vehicles and drivers, completion of specialized training for medical travel visitor assistance, and professional liability insurance. ISO 9001:2015 certification is preferred.

Referral Requests

As for the last question: "Will you send us patients?". We do not work with the general public. Our medical tourism services are designed to work with corporate medical travel administration. Our business model provides that the Approved Provider network of providers is made available to the employer or labor union plan administrator.  In turn, they create their own short list of candidate destinations and providers.  If they would like to explore an unapproved provider or health facility, our process is the same: due diligence inspection and benchmarking to standards we have developed to determine readiness for health tourism.

Once a client has chosen their short list and made their decision regarding final selection, it is up to the group health plan participant to decide if they would like to use the medical travel benefit option. If they decide to travel for healthcare, Mercury Health Travel logistics coordinators and travel planners, working together with case managers follow the preferences of that plan participant, working within the parameters of the program of the employer or labor union.  Therefore, we regret that we are unable to influence their choice or otherwise promise to refer patients to your business.

How likely are labor unions to procure international medical travel?

Many labor unions throughout the USA and other countries have a deep commitment to backing local businesses to create jobs and stimulate the economy to deliver growth.

The Policy:

  • enhances opportunities for local businesses to compete for union health and welfare benefit program paid medical travel business by:
    • requiring the union to negotiate with domestic entities to take into account the wider community and social benefits of purchasing decisions; and
    • promoting within union membership, the advantages of buying locally;
  • reduces administrative burden on businesses providing services by simplifying procurement documentation;
  • provides businesses (and Government entities) with key information, tips, tools and training to effectively increase their future competitiveness to win government business; and
  • increases transparency in relation to union health and welfare benefits program procurement activities.

Most follow these common procurement principles:

Procurement by union health and welfare benefit programs are often undertaken in a way that is consistent with the principles of:

  • value for money: this means achieving the desired quality outcome at the best possible price, after weighing up the costs and benefits of each proposal. It does not mean only accepting the lowest price;
  • open and effective competition as well as compliance with ethical standards and
  • observing the any adopted Code of Conduct for procurement: this means using transparent, open purchasing processes, adequately testing the market, avoiding biased specifications and treating all suppliers consistently and equitably, so that potential suppliers and the public can have confidence in the outcomes; and
  • enhancing opportunities for local businesses: this requires buyers to actively seek involvement by local businesses, and to ensure that requirements do not unnecessarily preclude those businesses from bidding or otherwise disadvantage local suppliers.

Many times labor unions and other corporate buyers apply a local benefits test for all procurements over a certain amount of money (e.g., USD $50,000)

Often, for all procurement with a value of more than $50 000, where local capability exists, buyers tend to approach at least two local, or regional suppliers. Then they widen the reach but still prefer domestic suppliers. Only in rare instances do they seek cross border / international sources.

The test generally requires suppliers to provide information on their impact on local Small to Medium Enterprise (SME) environment should they be awarded the contract, as part of their response to corporate and labor union procurements. This enables suppliers to outline how their supply of goods/services will provide a positive impact on the local economy and will ensure that local SMEs are provided with every opportunity to participate in the procurement.

This information is often taken into account by purchasers in the evaluation process through the inclusion of a specific evaluation criterion. They may apply a weighting to the criterion of a certain percent. Submission of the information is voluntary, however, suppliers that fail to submit the relevant information are often the first to be cut from any shortlisted status.

For procurements valued at $50 000 or less (or where a formal evaluation process is not required), a formal statement by suppliers is not mandated. In medical travel, that is often a single surgical case or 15-20 Executive Checkups. However, labor unions often consider the objectives of these policies as a whole in the course of their procurement planning and when developing benefit program specifications and provider evaluation criteria. As such, where an entity considers it appropriate, similar information may be required for those procurements.

Apply critical thinking!
For these reasons we strongly urge you to consider any promises by conference organizers and others purporting to bring you hosted buyers if you'll agree to purchase expensive sponsorships or rent exhibit stands. Many claim to be in a position of influence over labor unions and group health purchasers (e.g., employers, insures, etc.).  Many will promise to influence or send patients from corporate and other group health benefit programs. They do so with impunity because they know most suppliers will simply not come back, but will also be unlikely to pursue a legal action for misrepresentation.

You may even read in syndicated columns (triggering an echo in publicity and paid promotional press releases) about high profile, anecdotal successes in corporate medical travel administration for business that operate with labor union members who traveled to other countries for healthcare. Pay close attention to the words used and run the alleged numbers out. You may find one story echoed 40 times, rather than 40 individual case examples.

The likelihood is high that union and other corporate buyers will be constrained from cross-border procurement programs with an overarching "buy local" or "buy domestic" policy in place.  You'll encounter them at events, and they will be polite, but the solutions they are there to investigate are largely domestic.

On the other hand, if a deal does get transacted, be on the lookout for a potential for later disruption. Often these arise because the plan participants themselves object to foreign procurement and prefer adherence to the "buy local" policy. In the USA, whistleblowing to the authorities is simple. It requires one telephone call or email to the authorities to trigger an investigation of possible corruption (e.g., favoritism, unfair dealings, unfair competition, bribery, and kickbacks) and a media fiasco.

The headache and soft costs to be entangled in these complications, even as an innocent seller, may come at great financial and time losses and brand risk. The investigation and rollback may also jeopardize the sustainability of your deal going forward.  The likelihood is even higher that a deal could be quashed and sanctions and stiff penalties imposed if tax incentives are associated with the operation of a health and welfare benefit plan, which in the case of labor unions and self-funded corporate health benefit plans is normal and expected.

Do self insured plans deny more claims than fully insured plans?

There is no data source that provides systematic, nationally representative data on denial rates for self-insured and fully-insured plans.  RAND was able to obtain data from one firm,athenahealth, which in turn obtained data from 11 plans that offer fully-insured products and also administer self-funded products as a TPA.  The fragmentary data from this limited set of plans suggests that claim denial rates are similar in the two types of products.  This evidence is consistent with the qualitative findings from discussions with stakeholders, indicating that they did not experience any differences in denial rates between self-insured and fully-insured plans.

How do self insured plans manage financial liability for excess claims?

In a typical stop-loss arrangement, the reinsurer agrees to pay a proportion of medical expenses (for example, 80%) if claims for an individual are above a threshold, or attachment point (for example, $75,000).  Some self-insured employers also purchase aggregate reinsurance, in which the reinsurer agrees to pay claims if aggregate medical expenses for the group are greater than some percentage (for example, 125%) of the expected expenditures for the group.

Do you publish a list of your clients?

No.  The reasons are as follows:

1. The employer decides who should know that it operates a medical tourism benefit option. Not us. We are pledged to confidentiality.

2. The employer may choose not to reveal to its TPA, ASO or other local providers that it has given the option for plan participants and beneficiaries to leave the local area to seek care.  Knowledge of this fact could derail local negotiations and discount arrangements and give rise to skeptcicism about the value of their local book of business.  That is why they often ask us to set up their program and supply both the case management and TPA provider settlement as a bundled package of services.

3. Some employers are concerned that if they offer a medical travel option, it might attract applicants seeking to use the program (adverse selection). Others are concerned that if the program is not well understood, the program might discourage talent from considering that company as a potential employer.  Therefore, in both cases, they prefer to manage communications about benefit programs through their own channels and messages.

At such time that discussions between Mercury Health Travel and a prospective client reach a point where the prospective client requests references from existing and past clients, we will obtain specific permission to release their name and contact information. Generally this occurs after the situation assessment has been done and the determination to develop a medical tourism program has been made to move forward.

With whom do we execute a contract?

Approved Providers execute a Memorandum of Understanding with Mercury Health Travel regarding roles and responsibilities as an Approved Provider. The MoU outlines expected standards and practices, credentialing and privileging matters, etc. This is executed at the time that the group health purchaser executes their Service Agreement with the Approved Provider or Supplier.

The Service Agreement which outlines procedures and bundled case rates and negotiated fees for extra services is signed directly with the Corporate Health Benefit Plan Sponsor. This enables them to have flexibility to use Mercury Health Travel for the program setup and case management, or to have the freedom to disengage after the program setup and do their own case management, hire it out to another firm, and engage a different TPA.

Will you market our clinic to your corporate clients?

Yes.

As advocate of the facility

On occasion, health facilities and other providers hire Mercury Health Travel to assist with business development and reach out to employers with a compelling offer. We accept these assignments on a fee for service engagement and we do not guarantee any specific results.

Typically how it works is, a hospital in Rome that would like to attract steerage of patients from international employers within Rome (PepsiCo, Coke, IBM, Citibank, Exxon, Vodaphone, HSBC, MAST Industries, Leo Burnett, BP, etc.) They contract with us to contact the company, research and identify the appropriate parties, initiate discussions and determine interest. If the outcome is favorable, a second phase assignment is assigned to Mercury Health Travel to bring the parties together. Mercury sits at the negotiation table as the advocate of the healthcare provider and facilitates negotiations and program design. Mercury Health Travel accepts these consulting assignments on a fee-for-service basis.

As advocate of the corporate sponsor

In other instances, Mercury Health Travel works as the advocate of the Health Plan Sponsor during negotiations. The client short lists a group of 5-6 candidate destinations or suppliers and we accompany them on site visits, interviews and negotiation meetings.

As a neutral to both parties

In the event that both the hospital and the corporation are clients of the firm, we ask each side to sign a facilitator agreement with us so that we may act as a disinterested third party neutral to facilitate the business arrangement between both parties. In this sense, we generally act as Subject Matter Experts to the mutual benefit of each client.

Do you recognize certifications of the MTA®?

We recognize them for what they are. There are numerous certifications of this type in the market. Their certifications are not a part of our evaluation criteria and don't influence our Approved Provider decisions in any way.

  • For non-hospital providers, we recognize ISO 9001:2015 certification.
  • For hospital and clinic providers, we recognize the accrediting bodies whose standards sets are accredited by the ISQua.
Which Accreditations and Certification programs do you recognize?

We congratulate you and recognize the commitment, time and financial investment and efforts put into preparation for any internationally-recognized accreditation or certification survey or inspection. We do not require any particular brand of accreditation or certification.

Current accreditation or certification does not place your organization at any specific advantage with Mercury Health Travel. An organization's accreditation or certification is at risk for revocation at any time during the period of accreditation or certification. What accreditation asserts is that some accrediting or certifying body has determined that you satisfy their requirements for service delivery at the average level of the delivery of the community in which the service is delivered. Many accrediting and certifying bodies have themselves not been accredited or certified by any overseer or trier of facts, outcomes or inter-rater reliability.

Many certifying and accrediting bodies are actually commercial "wallpaper" outlets that sell attractive framed certificates and plaques of little value or recognition by the market. We monitor and are aware of hundreds of competing accreditation and certification programs. Unfortunately, some fall into the wallpaper category at great expense.

Currently, no well-established health tourism accreditation or certification standards set specific to health and wellness tourism has been accredited by ISQua, nor its surveyors skills and experience vetted or its standards published for critical review and acceptance by us. Therefore, Mercury Health Travel conducts its own site and operational inspections of healthcare facilities, accommodations, ground transfer services, airports, restaurants, and other health and wellness tourism value chain partners.

Our inspection standards have been developed over a quarter century of active operations in health travel and medical tourism. Our Approved Provider and Diamond Rating programs are our proprietary corporate standards of performance, quality, safety and service delivery for health and wellness tourism operations. These designations are 100% merit based and no charge or payment is exchanged to participate in either program.

 

Which certification is recognized for medical tourism facilitators?

We recognize firms who have been certified to meet the standards of ISO 9001:2015.

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