Euro-Center Newsletter Vol.01 Issue 03

Page 1

guidelines for classification, new require-

ments for network development, improved

provider search mechanisms for the bene-

fit of customers and expansion of the geo-

graphical coverage area of some Euro-

Centers.

The reporting structures are likewise

getting an overhaul, and our intention is to

provide an updated performance report

considering the different requirements of

our clients.

We are further excited to be welcoming

our many new Spanish colleagues in Janu-

ary 2015 when MESA commences opera-

tion as Euro-Center Madrid. A lot of work

has gone into ensuring a smooth transition,

our networks are being paired promoting

the best agreements and MESA staff are

being trained in Globo, which will ease case

tracking and communication.

We wish you all the best for 2015.

Year 2014 has been an operationally

eventful year with a myriad of positive

developments towards our ongoing pur-

suit of superior customer service. One of

our aims is to streamline procedures

across the Euro-Centers to obtain greater

international alignment and smooth oper-

ations.

Throughout the year our department has

been coordinating working groups with

key operational staff from all Euro-

Centers, who then convened in Prague to

discuss their output. The eventual execu-

tion of these strategies should result in

many progressive developments for the

Group in the coming year.

Network development is a primary topic

and we are focusing on increased stand-

ardization of our extensive provider data-

base. This includes introducing further

Euro-Center Holding

Krizikova 36a

186 00 Praha 8

Czech Republic

Phone: (+420) 221 860 330

Email: commercial@euro-center.com

Website: www.euro-center.com

The Global Insider December, 2014

Irene Munkholm

Chief Operating Officer

Irene Munkholm page 1

Chief Operating Officer Euro-Center Holding

Gudrun Nylen page 3

General Manager Euro-Center Cyprus

Lucy Song page 5

Operations Manager Euro-Center China

Lucia Krajcovicova page 4

Operations Euro-Center Czech Republic

Manager

Fraud Avoidance In China

The more languages you know, the more

human you are

Winter joys, winter insurance worries

Network and Coverage

Political and Economic Crisis Management

A glance into 2015

Bodil Fricke page 2

General Manager Sydney Euro-Center

Regional Network Development

Cost Containment and Steerage

Featured Euro-Centers

Euro-Center Newsletter Vol.01 Issue 03

Page 2

In March 2014, the Australian Federal Gov-

ernment introduced privacy law reform;

Australian Privacy Principles regulating the

handling of personal information by Aus-

tralian and Norfolk Island Government

agencies and some private sector organisa-

tions.

As an Australian registered company, Syd-

ney Euro-Center has had to update our

Privacy Policy and introduce changes in

case management. It has now become a

more extensive, and sometimes a costly

task to promptly obtain medical infor-

mation and medical reports in certain cas-

es. In response to this, Euro-Center has

implemented new processes with our pro-

vider network, including a more stringent

requirement for Release of Information

documentation, in order to collect medical

information and expedite efficient case

management. We recommend that policy

holders request their own medical reports

personally.

Not only is this good practice for their con-

tinued care and medical management,

whether travellers or expatriates; but this

will, in many cases, achieve a more prompt

outcome and no referral to hospital legal

Sydney Euro-Center covers a geographical

region of 26 countries and territories,

stretching over Australia, Japan, New Zea-

land and the South Pacific.

During our recent Japan site visits in

March the focus was on our provider net-

work in the Yokohama region, as well as

other changes and developments within

our existing Tokyo network. As a result of

this visit, we have further established our

network in Yokohama; expanding direct

settlement and cashless services in a num-

ber of hospitals and clinics.

Increased case volume in Okinawa has also

Regional Network Development

Across public hospitals in Australia, there is increased pressure to manage non acute cases

in Emergency Departments with limited resources. It is not always ideal to steer non-acute

cases to public hospitals, as these patients will be left to wait sometimes for many hours, as

their medical condition is prioritized down heavily.

Patients with minor ailments such as flu, middle ear infection and dermatitis should be seen

at a medical centre rather than a hospital emergency department. This has been highly

published in the local media recently, especially regarding Reciprocal Health Care entitled

patients.

Such patients and insurers are receiving poor publicity as they are viewed as taking ad-

vantage of a public health care system and clogging up public hospitals just to receive free

treatment for non acute care.

Due to varied State legislated charges for overseas patients; admission costs can be signifi-

cantly higher in a public hospital in some States across Australia. In several cases, Sydney

Euro-Center has been able to achieve significant cost containment as high as AUD 1,000 per

day, through steerage to private hospital admissions.

Our team in Sydney Euro-Center is always happy to assist with local knowhow, in particular

case management scenarios and locations. This is the true value of local knowledge.

Cost Containment and Steerage

Bodil Fricke

General Manager

Sydney Euro-Center

Sydney Euro-Center Staff

departments, which can incur extra charg-

es. Sydney Euro-Center is always available

to assist locally with facilitating these re-

quests as required.

Office of the Australian Information Com-

missioner:

http://www.oaic.gov.au/privacy/privacy-

act/privacy-law-reform

Sydney Euro-Center’s Privacy Policy :

www.euro-center.com/eurocenters/

sydney

significantly expanded Euro-Center direct

settlement options in this area.

In Tokyo, a number of preferred outpatient

clinics have had significant changes to medi-

cal staff - doctors retiring, clinics closing, and

we also identified an important clinic to

avoid. Our English trained doctor continues

in Tokyo as our local medical consultant for

relevant case monitoring and medical evalu-

ation. Such case management is initiated by

Sydney Euro-Center, based on Sydney Euro-

Center claim assessment and customer re-

quests.

In the latter part of 2014 we are seeing vol-

ume growth in a number of South Pacific

island nations, in particular Fiji, Vanuatu,

Papua New Guinea and French Polynesia.

This has resulted in a further expanded Euro

-Center network outside of the usual key

tourist locations. Due to higher volume, we

have recently implemented "flash the card”-

direct billing services with a number of pro-

viders in Fiji and Vanuatu.

Euro-Center Newsletter Vol.01 Issue 03

Page 3

It has been a turbulent time for Euro-Center

Cyprus over the past few years. We have

had to deal with the Arab Spring revolution

in Egypt and two major financial crises in

Greece and Cyprus. This has been a great

challenge for our Euro-Center staff. Howev-

er, we adjusted appropriately to all of these

major changes. I strongly believe that we

have come out stronger, and are increasing-

ly able to react immediately to all kinds of

situations and demands with a more flexible

and professional insight.

When we opened Euro-Center Cyprus in

1992, our main focus was on Scandinavian

clients in major tourism destinations, focus-

sing on cost containment, good customer

care and network development. This contin-

ues today, together with a broad range of

services for a wide selection of customers

with new requirements.

In a service region with a variety of lan-

guages, religions and politics, Euro-Center

Cyprus is committed to providing high quali-

ty assistance for our customers.

Euro-Center Cyprus

Network and Coverage

Egypt, Israel, Cyprus and Greece fall under the regional responsibility of Euro-Center Cyprus and have all experienced major turmoil in the

last few years. We found that while political instability directly affects tourism, a financial crisis such as in Greece and Cyprus did not have

much effect on tourism levels.

Following the Arab Spring revolution in Egypt, tourism dropped to almost zero, but is slowly picking up again. We find that tourists are in

particular returning to the Marsa Alam area in the south. Simple medical care is available there and if more complex treatment is required,

we transport to Hurghada, Cairo or to the home country. Israel is seeing a current drop in tourism following the recent civil unrest, but facili-

ties are functioning as usual.

The terms “BAIL IN/BAIL OUT” and “the haircut” have become daily vocabulary the last two years in Cyprus. Although this island is a tiny spot

on the world map, it saw itself becoming a topic in all major news bulletins around the world in March 2013, when it became the first country

in the world to receive financial orders from the TROIKA (European Commission, European Central Bank and International Monetary Fund).

The fallout from this crisis has affected many areas. In the medical field it meant that many providers in the private sector had lost their capi-

tal and we saw a huge increase in the usage of state hospitals. A decision imposed by the TROIKA to charge 10 Euro for an emergency visit

and extra for other examinations in general hospitals, which used to be free of charge, has however, given a boost to the economy. TROIKA is

currently pressuring the Cypriot government to impose a national health scheme to be implemented by the end of 2016.

Greece, suffering with its financial problems, is also battling with overcrowded general hospitals, lack of medication and profiteering in the

private sector. Fortunately, we know where to steer policy holders and no one under our care has suffered from a lack of treatment.

we managed after tremendous effort to

achieve a successful set up in this region.

We now service a high number of expatri-

ates and tourists from all over the world.

Today we provide the entire range of Euro-

Center services in Dubai, including arranging

doctor appointments, local house calls, di-

rect billing, issuing of payment guarantees,

cost containment services within the private

sector, assuring cash payment in govern-

ment hospitals and local emergency assis-

tance.

Political and Economic Crisis Management

Dubai is a popular travel destination and

business hub for the Middle East and often

the greater EMEA region. Following a fi-

nancial slump, Dubai’s economy and ex-

patriate community numbers are now

recovering. Out of the country’s 9.2 million

population, 7.8 million are expatriates. A

network in this country is therefore essen-

tial.

Starting out with a literally non-existent

network in 2005 with much red tape and

many restrictions for foreign companies,

Gudrun Nylen

General Manager

Euro-Center Cyprus Staff

Euro-Center Newsletter Vol.01 Issue 03

Page 4

Euro-Center Czech Republic

What an amazing first year we have had in

Euro-Center Czech Republic!

Following several months of intensive prep-

aration, the doors of the newest addition to

the Euro-Center Group were opened to

customers on January 1, 2014.

Our office is located within the Euro-Center

Holding headquarters building in Prague.

Starting with just six fulltime employees we

have set ourselves several challenging tar-

gets in our premier year.

The Euro-Center Group “Covers the

World” and this capability has been fur-

ther enhanced due to our Czech branch

which has accommodated under its roof

40% of Europe’s countries, from which

Germany and the United Kingdom are

ranked among the top 10 most visited

countries in the world.

Together with the other countries we

have in our service region, all of which

offer delicious gastronomical delights,

beautiful nature and many amazing city

sights to see, we believe there is definitely

high potential in this region for us!

Jumping straight into a busy winter season, we had to hit the ground running. Our main tasks

were arranging ground transportation, mainly in Austria, and also establishing new contacts

with medical and transport providers in the Austrian, German and Swiss Alps. With currently

eight preferred medical transport providers located across these three countries, we fulfilled

our target of establishing direct cooperation, and have been very satisfied to find the ground

travel expenses paid through our office were up to 20% lower than previous arrangements.

For the upcoming 2014/2015 winter season we are preparing to make more make efficient use

of the Austrian public healthcare infrastructure and reducing misuse of private travel insurance

products. There is potential in a mismanaged insurance scenario for the insurer to easily end up

paying 10.000 EUR for a non-complicated knee injury, which really only requires a first aid assessment, x-ray and immobilization. Why such

a horrific scenario for such a common skiing injury? This type of common scenario can easily become a reality when the injured skier is tak-

en down the slope by a helicopter rescue service (costing 3.000 - 4.500 EUR) ends up in a private orthopaedic clinic where after an initial x-

ray, an MRI is also done (500 - 1.000 EUR) though not medically necessary, and then is given further surgical intervention (5.000 EUR).

Knee distortion, anterior cruciate ligament rupture, lower leg fracture and brain concussion are the most common injuries sustained during

the winter season, when skiing or snowboarding. It is therefore of the highest importance to focus on creating close relationships and good

lines of communication with the mountain rescue service, securing, whenever and wherever feasible, a rapid evacuation down the slope by

a sledge/scooter (saving up to 3.500EUR), then a transfer of the injured client to a preferred medical facility, thereby avoiding overtreat-

ment and the resultant excessive medical expenses (saving of additional 5.000 EUR).

The more languages you know,

the more human you are

Winter joys, winter insurance worries

Lucia Krajcovicova

Operations Manager

Covering a region of twenty-four countries

with more than fifteen official languages is a

constant challenge in our daily operations.

However with much enthusiasm and perse-

verance, we have pulled down the linguistic

barriers, and penetrated into many new

markets, establishing contacts and relation-

ships with providers, and have made our-

selves independent of local agents.

This all has been possible thanks to the

multilingual staff that our office is proud to

have. Our six full time employees of five

nationalities are able to communicate in

twelve different languages. The latter is of

immense importance and enables us to

react immediately in any emergency situa-

tion on a 24/7 basis. Our team are all born

in different European countries and have all

lived abroad for several years, making them

very capable of dealing with a variety of

cultures, and an understanding of local

specifics which allows them to manoeuvre

among many different cultural constraints.

This skill in customer service, together with

a deep knowledge of our region, enables

Euro-Center Czech Republic to be the link

between the consumer and the local net-

work. This human touch and understanding

we provide in all of our communications

with the customer is a crucial element in

our success.

Euro-Center Czech Republic Staff

Euro-Center Newsletter Vol.01 Issue 03

Page 5

Euro-Center China

‘Local Assistance - Worldwide’. With offices

all over the globe we really are able to pro-

vide worldwide local assistance for our cus-

tomers.

Each office’s cover area has their own

unique cultures and regional practices which

often bring with it their own unique prob-

lems. This is where our professional staff

come into their own.

Euro-Center China works in a challenging

environment, especially considering the

variety of dialects, and distinct written lan-

guage differences. Local knowledge and

awareness is key.

The following article is an example of the

true value that our offices provide to our

customers.

As everybody knows all insurance companies are paying more and more attention to cost

containment. This applies also for China, as China is one of the most expensive areas for the

medical care of foreigners.

The health care system in China is particularly special due to language barriers and the

difference in patient approach from European countries. Although there are quite a few

international medical clinics/hospitals available in the bigger cities we also work with the

International Departments of public hospitals in order for us to secure reasonable medical

expenses and ensure that the patient meets medical staff with the best medical skills. We

know the prices, language ability, types of medical certificates, etc. and we maintain good

relationships with the public hospitals.

There was one client with a private health care insurance handled by us who submitted

claims reaching the amount of CNY14.250,00 (approximately EUR 1900,-). Due to the high

cost of the outpatient visit, the claims handler forwarded the medical certificate and Chi-

nese invoices to me for review.

By reading the medical certificate and checking the invoices, I found out that the Outpatient

Medical Registration Number was different on the invoices and the medical certificate. As

the diagnosis was an accident, we had to request more detailed medical information from

the client.

We received the medical records and tests results after a few days but they still contained

the same wrong information. The amount written in Chinese characters on the invoices

didn’t match with the Arabic Numerals; furthermore the diagnosis was also different from

the first document that was submitted by the insured, and all the test reports seemed to be

faked as the hospital logo in the letter head was different from the stamp on the test re-

sults.

Fraud Avoidance in China

Lucy Song

Operations Manager

According to our experiences with this hospital the cost should not have been that high, as the hospital was a public hospital, and due to the

suspicion of a fraudulent case, we contacted the hospital who confirmed that this client had never been to the hospital in the years 2011 and

2012.

During our investigation the client kept calling us and demanded to have his claim reimbursed, knowing that the documentation he had pro-

vided was still under evaluation. He subsequently provided more documents which only showed more flaws and he refused our offer to con-

tact the hospital directly.

Due to the findings above we came to a conclusion that this was a fraud case.

After all investigations we informed the insurer; the result being that nothing was reimbursed to the client and the contract with this client

was cancelled.

The client used to send all claims directly to the insurer for reimbursement, and even though most of the invoices were in Chinese, the insur-

er had processed the claims themselves and paid directly to the client without thoroughly checking.

This specific individual product is more complicated and requires more effort than standard policies. However, since we started to handling

this product we have successfully made extensive savings for the insurer and avoided paying out unnecessary claims expenses by using our

local-how knowledge.