Throughout the world, many public health authorities supplement their local healthcare services for citizens through procurement of health services outside their borders.
Maria Todd works as a special attaché assigned to the diplomatic or administrative staff of Health Authorities, Embassies, and Insurers to help their International Patient Care Division (IPC) procure and arrange international patient care when medical treatment is not available from local hospitals or specialists.
Healthcare Cost Containment
Dr. Maria Todd, a former surgical nurse and medical travel coordinator with more than 35 years of experience is one of few international healthcare consultants who work as a special attaché to government authorities, health ministries and insurers to help them arrange the international patient care services they require.
For each client, she develops a bespoke, seamless, culturally- and linguistically-aligned care continuum that connects local care to select, high performing international patient care suppliers in the USA, UK, Germany, and other preferred or requested destinations. She then connects the aftercare to make a seamless continuum through an "episode of care". The episode of care lasts as long as there is active treatment, physical therapy, rechecks, or follow up services until the patient is discharged at maximum medical improvement (MMI).
How she works
Dr Todd takes no commissions or referral fees from the providers. Instead, on behalf of her clients, she negotiates the best possible rates and services they require at a reasonable price. Her fiduciary responsibility and professional services are paid by the client for her work as their advocate.
Dr Todd begins the project by learning what is required, preferences, priorities, preferred service level, cultural and language alignments, and other specifications. She then prepares a short list of candidate suppliers for the client's review.
- Site inspections; quality and services review
She travels to each candidate supplier designated by the client as their representative. Her assignment is to conduct site inspections and report on finding and interpret suitability aligned to client specifications.
- Supplier contract negotiation
Upon final approval by the client, she returns to the supplier to conduct negotiations and sign contracts for services, pricing, payment terms, refund terms of unused funds paid in advance as deposits, and other quality and safety and service terms and conditions required by her clients. Her competency for this is drawn from more than 30 years of managed care contracting experience and expertise at both the payer and provider side of the table and as a trained mediator of managed care disputes. She leverages professional relationships that span more than 4000 hospital and healthcare suppliers in 116 countries. To save clients money, she negotiates multi-year contract terms for specific procedures. Her acumen with negotiation of fully-inclusive bundled case rates is unparalleled.
Once the hospital contracts are finalized, she rounds out the care continuum for international patient care by inspecting hotels and alternative accommodations, ground support, transportation, and other necessary services for the patient and his/her entourage. These candidate suppliers are presented on a short list as vetted suppliers which she certifies meets her clients' requirements. Upon authorization by the client, she negotiates pricing and other terms and conditions as the representative and advocate of her client. She does not accept commission payments from suppliers.
- International Patient Services Program Design
Once the supply chain is developed, she assists the client to document the program specifics, develop applications for treatment abroad, authorization forms, appeal appeal policies and procedures, extension policies and procedures, and policies and procedures to coordinate escort or companion travelers who are eligible to accompany the patient on their international patient care. She works with actuaries and predictive analytic software programs owned or used by the client to predict utilization and develop budgets.
- Coordination of Patient Movement
Dr Todd then establishes the system to coordinate patient movement, travel, arrival reception, destination backstopping, problems solving, departure coordination, discharge management conferences for proper handoffs, and continuity of care and follow up after the patient's return home. The coordination of patient movement is facilitated by the use of Higowell Cloud software.
Local destination coordinators are positioned in each contracted international patient care destination according to frequency and duration of international patient services requirements and utilization frequency. They are subject to criminal background and reference checks, and vetted for language fluency and cultural sensitivities prior to engagement. Drivers are subject to driving history and insurance and vehicle model and maintenance. If required, private armed or unarmed security services are also arranged.
- Bill auditing and verification of charges against contracted case rates
Dr Todd will audit supplier bills against negotiated case rate inclusions, and certify bills as ready for settlement or request additional information to substantiate any unexpected charges. She draws upon her clinical training and experience to decipher any extra charges outside the case rate for medical necessity, departures from authorizations, or exceptions which may or may not be payable in accordance with the terms of the agreement. Once approved for payment she transmits the invoice as "approved to pay" and the amount of the payment recommended, if any, to be paid directly to the provider. She leverages her knowledge of U.S. billing, coding and supporting documentation practices to afford her clients maximum cost containment benefit.
- Measurement and Evaluation of Outcomes
Clinical, functional and international patient satisfaction outcomes are measured and evaluated. If a complaint is received, Dr Todd investigates and acts upon it as required and authorized by the client. Meaningful periodic reports are produced to record and demonstrate cost savings, quality, safety, and value at the frequency of measurement and evaluation specified by the client.
- Contract Renegotiations and Renewals
Six months prior to the expiration of the in-force contract term, Dr Todd initiates dialogue with suppliers to renew contracts, end the relationship and find replacement suppliers, or renegotiate terms and conditions according to current requirements. Amendments and service expansions to add new procedures is available at any time during the in-force contract term. Addition to approved network suppliers is available at any time.
Maria Offers a Complimentary 15-minute Introductory Call
Call or email Maria to schedule a brief discussion so you can explain your concern or situation and see if she can help.