Healthcare

AXA Assistance's Health Business Unit provides a wide range of services to insurance companies, self-funded employers, mobile work forces, and a variety of other client types help with managing the cost of health care while providing top quality providers through a comprehensive network.

Lower Costs, Improve Quality

Greater access & bigger impacts

AXA Assistance provides a wide range of clams services globally to help with managing the cost of health care while providing access to top quality providers through a comprehensive network. 

Relying on intelligence, technology and an extensive provider network allows AXA Assistance to outperform industry standards thus improving our client's bottom line.

 

Cost-effective health management services

AXA Assistance Health Services provide customers with cost-effective health management services and innovative healthcare solutions. The services include:

✓ Comprehensive Claims Management: Avoids and reduces costs while increasing transparency

✓ U.S. and International Medical Network: Provides premier access to exclusive U.S. carriers and localized PPO networks plus international access to thousands of physicians and facilities

✓ Experienced Case Management: Maintains quality while avoiding over utilization

✓ Connected Health: Supports global teleconsultation capabilities

 

To learn more about how AXA Assistance Health Services can help you ensure better health experiences for your customer, employee or member programs, contact us at info@axa-assistance.us

Claims Management

AXA Assistance Health Services provides cost-effective health management, patient-centered programs to promote exceptional care and innovative healthcare solutions for travelers, expatriates, students and individuals traveling for treatment.
 

Cashless Access

Lower Costs, Improve Quality

AXA Assistance offers its members quick, seamless and cashless access to medical services through pre-authorization or direct access to our network verification of benefits (VOB) tool to ensure that providers receive coverage information in a timely fashion for both inpatient and outpatient treatments. Claims are efficiently processed, reviewed and re-priced at the preferred discount rate based on audit findings and network participation. 

Claims Audit & Review

AXA Assistance's claims management and cost containment solution is based on a combination of the efficient use of our proprietary and carrier network claims administration systems along with the expertise of our licensed medical coders and examiners.

AXA Assistance's advantages include:

✓ TPA licenses in all required U.S. states

✓ Ability to adjudicate claims in any language and currency

✓ All claims coded to U.S. standards for data consistency

✓ Detection of duplicate, unbundled, up-coded and fragmented

    provider bills

✓ Inpatient bill screening and audit

✓ Robust fraud screening protocols

✓ Strict claims payout turnaround time

✓ Industry leading leakage reduction standard of less than 1%

 

Claims Administration

Customized Reporting

AXA Assistance takes pride in providing its clients a high level of account transparency and analysis. We believe that savings achieved should be measured against a nationally recognized benchmark. AXA Assistance combines Savings and Medicare Reimbursements; UCR benchmarks give our clients an in-depth analysis of how their claims are trending.

Account Management

We believe in implementing a strong account management and communication process early in our client relationships. A dedicated Account Manager will analyze account and individual portfolios on a regular basis, providing extensive reporting and feedback. Through a consultative approach, the Account Manager offers support and transparency in adapting, advising and designing our service to meet our client’s strategic goals.

Case Management

AXA Assistance Health Services' Case Management department is committed to ensuring that patients receive high quality care at the lowest possible cost. Through our cost avoidance approach, our team can effectively steer to cost-effective levels of care, provide cost estimates and reserves to help our clients manage their book of business. 

 

Cost Avoidance through Medical Case Management

Managing Care Efficiently and Effectively Before, During & After

Available 24/7, AXA Assistance medical and URAC accredited case management teams are highly qualified in assessing medical appropriateness, recommending and implementing high quality, cost effective treatment plans as the case progresses.

To maintain quality, yet avoid overutilization, AXA Assistance Health Services employ the following protocols:

  • Staffing of a team of medical professionals to review cases and ensure services are medically necessary and relevant
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  • Utilization of an industry standard evidence based management guidelines that focus on medical necessity, level of care and length of stay
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  • Pre and post medical cost estimates for all inpatient cases, medical evacuations and repatriations

By vigorously managing all aspects of Quality, Access and Cost, our case management team is able to positively impact overall expenses through reduced inpatient lengths of stay, reduced re-admission rates and avoidance of unnecessary admissions. Our team also provides clients related cost avoidance savings reports and clinical summaries on an ongoing basis.

                                            

Direct Negotiation Capabilities

AXA Assistance's dedicated Claims Settlement department consists of experienced medical negotiators well versed in applying various negotiation methodologies to a case as a whole. The settlement team will leverage our Medicare and paid claims databases to negotiate with providers based on true cost of service, as opposed to the standard approach that ineffectively pursues discounts without any cost reference.

Connected Health

Our Global Teleconsultation Program is complemented by leveraging AXA Assistance's existing international capabilities, medical network and U.S. medical professionals to develop an end-to-end service delivery model. The program enables members to have a U.S. healthcare experience via smartphone, tablet or web by accessing U.S. licensed providers which get medical advice, treatment options, assistance with prescription refills and provider referrals, when needed. 

Teleconsultation

A New Model of Care

All core competencies of our medical team are available around the clock, serving all time zones.  Providing members with access to U.S licensed providers can overcome many barriers when seeking healthcare abroad, potentially decrease health expenditures and enhance member experience.

✓ A U.S. medical team easily accessible 24/7/365 allowing a face-to-face virtual consultation

✓State of the art platform with security layers to ensure data privacy

✓Medical advice provided in a confidential, comfortable and controlled setting

✓Remote prescription transfer in the U.S. and internationally, where legally applicable

✓Convenient options provided to member on initial activation; consistent interaction between medical team and member throughout life of case

✓Providing a new form of cost containment by diverting unnecessary emergency room usage or treatment in a local facility