Med-Sure Services Ltd.

Our experience tells us that the designing and implementation of employee benefits packages is an ongoing and evolving process.  It will need to meet the continually changing needs of your organisation, adjust to market conditions as well as meeting the latest legislative requirements.  Any employee benefits plan is complex and needs to be perceived as being fair both by the employee and the employer.  Indeed, deciding the level of benefits and remuneration offered is a challenge on its own.  Our role is to provide you with all the data your need to make informed decisions.

Managing your employee benefits plan includes claims administration, helping with regulatory compliance, educating your workforce and the need to provide constant information to employers, divisional managers, unit managers, departmental manager and employees.

At Med-Sure, we offer far more than mere transactional function, the role that many of our competitors offer. We focus on the overall administration of your plan.  Our role is to ensure that it meets the needs of your employees while guaranteeing that costs don’t spiral out of control.  To effectively achieve this, you need a highly-skilled and dedicated support team, and this is what Med-Sure offers.  We fulfil this by:

• Having a software system that was developed in-house so delivers the right information for clients. It is flexible and can be adapted to meet your specific needs which you deem to be relevant to your plan.
• We employ a team of fully trained analysts and medical professionals who handle all claims and queries from both employer and employees. Our dedicated team can resolve most issues on the first call.
• Med-Sure has adopted a policy of selecting small teams which are specifically dedicated to your plan as opposed to more traditional “assembly-line”. Of course, performance and quality is constantly monitored with audits and productivity reports.
• In the cases where complex adjudication is required, this is conducted by a separate department staffed by medical professionals.

We appreciate that emergencies don’t necessarily occur within office hours, so we have an emergency hotline number which is handled by bilingual medical professionals ready to handle your situation.

Medical costs can quickly mount up if they aren’t correctly monitored. We provide our clients with comprehensive reports that will enable informed decisions to be made, such as costs by department, cost centre or location. Should you require any bespoke reports, our software will almost certainly be capable of producing it.

Our team of data analysts continually measure the performance of the plan of your behalf. We will actively assess the efficiency of providers and produce any other performance indicators/reports that you may require.

Managing prescription benefits includes claims processing, allowing you to provide convenient and efficient services to your staff.  For example, the introduction of a pharmacy benefit can have significant savings in the treatment for routine coughs, colds and other common ailments, thus avoiding the need for costly hospital visits.

Through our years of experience within the industry, we have an established network of around 500 hospitals and clinics which are strategically located throughout Thailand, Cambodia, Vietnam, Laos and Myanmar.  By simply selecting the right hospital, you could make significant savings, while your employees are still able to access the best health care providers.

Stop-loss insurance covers you for medical expenses that are above a certain threshold and is designed to cover extraordinary or catastrophic events.  As a general rule, routine medical expenses are still relatively inexpensive in Southeast Asia; however, severe or long-term illness cost can quickly escalate meaning that a significant sum is required.  Stop-loss insurance is designed to cover these eventualities.

For your added security and protection of your employees, Med-Sure will open a bank “in trust” on your behalf.  The account will be replenished as when required to ensure that there are sufficient funds to pay any outstanding or pending claims. Transparency is essential, so if there is any movement within the account, designated members of staff will be informed. No fees are deducted for the TPA services until the costs agreed have been signed off for payment.

Naturally, Med-Sure will prepare all the necessary supporting documentation, including membership handbook and ID Medical Cards for your employees. We will work closely with your team to ensure that all information is up-to-date.

Routine claims are usually very straightforward; however; this is rarely the case with serious or long-term illnesses.  Med-Sure have a dedicated team to handle such claims on your behalf and comprises of medical personnel with a higher level of clinical expertise.  The team also covers outpatient therapies such as dialysis, chemotherapy, pain management and speech and physical therapy.

The tangible benefits of this form of case management include:

• Empowering the physician with more information – thereby enhancing their ability to make choices concerning medical interventions. This may be based on cost-effectiveness and cost availability information provided by the care manager.
• Improvement in management’s ability to assess the cause of adverse outcomes and inefficient processes, and the degree to which treatments, devices, procedures and interventions are comparatively ineffective
• Identification and possible elimination of health care delivery service excesses through claims data analysis
• Reduction of readmissions, prolonged length of stays, repeat surgery and other costs of corrections, general over treatment and over medication
• Access to a 24/7 Nurse Line, potentially keeping patients accessing the right care at the right time (optional)
• Enhancement of clinical quality through continuous management of process variation, feedback, group process, ownership and delivery system coordination
• Where appropriate, assistance in the development of policy wording and regulatory approvals

Intangible benefits of case management include:

• Improvement in reporting of credible performance measures
• Improving patients’ healthcare understanding
• Improvement in client and patient service as well as overall satisfaction. The objective is that this will lead to new and retained clients and contracts
• Flexibility in the design of patient services to encompass customer demands

Some companies generously offer to extend some or all of their employee health benefits to immediate family and dependents. However, you may be surprised to learn that independent membership audits often reveal that up to 10 percent of these enrolments do not meet a plan’s eligibility criteria.

Sadly, there will always be those that abuse and manipulate the system for their own gain at the detriment of the company. Med-Sure continuously monitor claims to check for blatant inappropriate use, and this is done by checking for:

• Inappropriate use of ICD-10 codes for procedures undertaken
• The frequency of OPD visits
• Any potential cosmetic procedures
• Elective procedures the employee is not entitled to
• Investigational/Experimental procedures and treatment that hasn’t be authorised
• Surgical assistant procedures and treatment

How do you manage your employee benefits plan?

There are two relatively straightforward methods that you can adopt to manage your employee benefits plan effectively. These are:

Select a Third Party Administrator (TPA)

Selecting an experienced and professional TPA such as Med-Sure Services is one of the most effective ways of ensuring the success of your package. We have access to an extensive range of services which are not available elsewhere. This includes our knowledge of the health care networks in Southeast Asia, our expertise as well as our experience in designing bespoke plans to suit your needs.

Have an effective benefits plan

We will work closely with you to develop a plan that rewards your employees and meets their healthcare needs while also proving to be cost-effective for your business.