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Featured Managed Care Vendor

Global Care

This overview highlights the services available through our new business relationship with GlobalCare, Inc. GE Insurance Solutions and Summit Re recently negotiated a preferred pricing arrangement, on your behalf, to build a customized cost containment process that fits your needs. GlobalCare can assist your organization (and its members) in saving money by reducing costs on out-of-service-area or out-of-network claims, by providing access to medical assistance and tertiary-care referrals worldwide, by helping expand your service area for “outlying” members, and by reducing many administrative processing concerns.

GlobalCare is a medical assistance and cost containment organization that:

  • Provides access to over 100 networks (nationally and regionally) as a service area “wrap” of both facilities and physicians and utilizes 8 national negotiation firms to reduce medical costs. GlobalCare Inanet™ is a re-pricing program of out-of-network and out-of-service area claims at in-network rates.
  • Utilizes its own international network in 197 countries as a “travel” PPO solution, which includes language interpretation, evacuation, and repatriation services. GlobalCare MedPass International Services is a “reassurance” program that members can access for advice and support while traveling internationally.
  • Operates a 24-hours-a-day, 7-days-a-week medical help desk to assess, triage and refer patients who are traveling outside of your service area to the appropriate level of care and to facilities where in-network discounts can be accessed. The GlobalCare Medical Help Desk is a medical assistance call center for your members who are traveling anywhere around the world.
  • Works in conjunction with your organization’s medical management department to assist with patient referrals to tertiary-care facilities, both during and after normal business hours.
  • Offers primary network solutions to expand an organization’s service area. GlobalCare Inanet™ Primary provides access to a portfolio of over 100 networks to assist with primary network selection for members residing outside of your service area.
  • Evaluates claims to eliminate unwarranted and inaccurate charges through its Medical Bill Review process by performing a financial and clinical review of both ‘in-network’ and ‘out-of-network’ medical claims. This process can also be used in conjunction with the standard PPO re-pricing methodology.
  • Can assist in helping develop a direct, front-end EDI interface that fits your organizations preferences, alleviates administrative workloads and addresses the needs associated with the standard HIPAA/EDI transaction requirements.
  • Provides a Web-based claims tracking and inventory system with monthly performance-based reporting.

For more information, please contact Debbie Stubbs Director, Managed Care Services of Summit Re at 973-835-3134 or dstubbs@summit-re.com, or Byron Spooner of GlobalCare at 440-331-2963 or btspooner@globalcare.net

 

Past Vendors:

Integrated Healthcare Information Services

Health Decisions

 

 

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