Identification of Best Facility Expedites Successful Hernia Operation
Even routine surgery can be complicated to arrange, especially when groundwork is needed to determine the best facility in a given region and to compare the treatment options and travel costs involved.
A 55-year-old expatriate living in Vietnam called MEDEX to say that he had been diagnosed with a hernia on the left side of his groin. He was told that he would need surgery, but that it was not urgent that he have it right away. The patient told MEDEX that he would prefer not to have the operation in Vietnam. He asked for MEDEX's help with scheduling the surgery and making travel arrangements.
MEDEX obtained the patient's medical report from his treating physician and reviewed the situation with his primary insurance company. Consulting with the patient and his primary insurance company, MEDEX Physician Advisors determined the nearest appropriate facility for the surgery. Based on quality of care and treatment costs, all agreed that the procedure should be done at a MEDEX preferred facility in Bangkok.
The surgeon at the treating facility in Bangkok anticipated that the patient would be well enough to fly back to Vietnam two to three days after the surgery, but would require a follow-up visit after a week. It was decided that the patient could go to a clinic in Ho Chi Minh City for follow-up care, rather than returning to Bangkok.
Although the Bangkok hospital was unable to provide an itemized bill for the primary insurance company before the procedure, MEDEX Assistance Coordinators were able to obtain a maximum limit from the surgeon that the primary insurance company could approve. MEDEX was then able to issue a guarantee of payment on the patient's behalf and, as required by the treating facility, prior to treatment.
The patient underwent surgery for an umbilical hernia, was discharged, and returned to Vietnam. He called MEDEX to say that the surgery went well, and to express his gratitude for the efficiency with which MEDEX and the primary insurance company expedited his case.