How a robust medical department brings additional value to clients?
Will my insurance cover my medical bill? Where can I find a trusted doctor for my specific case? Am I going to be properly treated in the country I live in? As awareness of the use and need for medical insurance among the general public keeps on rising, these are some of the relevant questions that clients face in seeking medical care. And while the level of coverage can be somewhat similar between insurance packages of different health insurance providers, they may not have the same level of medical expertise that comes along with the plan.
We sat down with Dr Léonard Poirée, an emergency physician leading the Henner medical department in charge of performing controls, serious cases follow-up, prior approval analysis, and medical check-ups at Henner. The interview sought to understand the essence of having a dedicated eam of medical experts and how a robust medical department brings additional value to clients.
Q: How does the availability of medical experts provide value-added service to clients when they seek medical advice or diagnosis?
Dr. Poirée: Not all insurers have a medical department of doctors working full time. Some have nurses who may have a medical background but can only work within a very precise algorithm. There will always be cases outside the algorithm and that’s when our expertise provides added value.
For example, in underwriting, diabetes or cancer patients might be refused for enrollment if you follow that algorithm. In the presence of a medical expert however, a diagnosis can be made to check the actual risk based on the history of the prospect. If the prospect is young and there seem to be no complications to be had in the short-term, then we may agree with the insurer to accept this client.
Q: How does Henner medical team make the difference?
Dr. Poirée: Henner houses its own full-time doctors and nurses in locations such as the United States, France, Tunisia, Lisbon, and in Asia. Our medical department was historically created for international servicing. In addition, all our doctors remain in practice and they are updated with new medical developments.
Having medical experts gives us an edge in making decisions, especially in cases that are out of the usual. We don’t just say “no” when we hit a wall. We build solutions for the client to access the best treatment or the best possible care.
Q: How does Henner work in terms of the client’s best interest?
Dr. Poirée: We seek the balance of two pillars in handling every case, which could be considered as a state of mind of our medical experts.
One pillar is medical accompaniment, which allows us to make sure our members get the best medical service or to identify sensitive cases and propose tight follow-up and support activities. For instance, we can accompany and follow up members suffering from a very severe chronic or complicated condition. The fact that they have one only correspondence on a medical point of view, who is able to have empathy regarding what’s happening in a very crucial time of the medical life of the member is mandatory for us.
The other one pillar is expense control, which we provide based on our expertise and knowledge of what is the right cost for a certain treatment in a given geographical area. In certain cases where there may be out-of-pocket expenses on the part of the member, we can suggest alternative providers within our network who can give the same level of care versus a provider outside our network. The more follow-up we provide for a case, the more we can avoid the medical expenses to drift.
Q: Can we state that the added value of the Henner medical network lies in this balance between medical accompaniment and expense control?
Dr. Poirée: Indeed, this level of service in terms of support, balanced with the discipline of watching expenses, this is our edge in medical expertise that makes a difference when we present to the client and to the members.