Medical Claims and Case Management

Medical Claims and Case Management

Global Health Insurance Services is equipped to manage all medical treatment bills, both in – patient and out – patient. All medical cases are managed from prior to admission, during the hospital stay, as well as after discharge. More complex cases require special management, ensuring that the treatment is in accordance with what has been approved by the funder (insurer or corporate). This management extends to examining the actual charges, ensuring that there are no overcharges and that the rates charged are in line with agreed prices between GHIS and its service providers. (GHIS has preferential agreements with most service providers in Afghanistan.) All bills are put through a rigorous auditing process to ensure that charges are in line with the treatment provided. Overcharges and discrepancies with providers are addressed and resolved as speedily as possible. Where necessary, our medically qualified medical case management staff visits with the patients and service providers, ensuring that patient satisfaction is a priority at all times. It is through this intervention that treatment costs are contained. These savings are passed on to the client.