Monthly Archives: April 2015

Complications Insurance for Medical Tourism: Coverage for Implementing Medical Tourism into Workers’ Comp

Once again, I am turning to the medical tourism facilitator, Trip4Care for a brilliant blog piece on medical travel that should be of keen interest to those in the workers’ comp world who pooh-pooh my idea for medical travel and workers’ comp. You can connect with Trip4Care by email.

There are many companies that provide medical travel insurance, and by bundling it together with monoline work comp coverage, an employer can reap savings on expensive surgeries abroad, and provide their employees with the best care possible, at the lowest cost, and can get them back to work faster by having them recover in pleasant surroundings, instead of at home on a couch in front of the TV.

Here is the article:

http://trip4care.com/understanding-the-importance-of-complications-insurance-in-medical-tourism/

To deny this option to injured workers, while group health and private pay patients can go abroad, smacks of discrimination, class bias, racism, short-sightedness, and ignorance about the quality of medical care in other nations that is rapidly changing and catching up to that in the US and the rest of the Western world.

Imagine what this would do for peaceful understanding and cooperation, if the most common of us could see how the other half lives. I am not advocating going to war-torn countries, but to those that cater to medical travel patients, and that are relatively free of strife. This will help cement peace and respect for all nations.

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I am willing to work with any broker, carrier, or employer interested in saving money on expensive surgeries, and to provide the best care for their injured workers or their client’s employees.

Call me for more information, next steps, or connection strategies at (561) 738-0458 or (561) 603-1685, cell. Email me at: richard_krasner@hotmail.com. Ask me any questions you may have on how to save money on expensive surgeries under workers’ comp. Connect with me on LinkedIn and follow my blog at: richardkrasner.wordpress.com. Share this article, or leave a comment below.

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North Dakota Air Ambulance Law Amended

Shout out to Maria Todd for bringing this to my attention.

As reported by Stephanie Goldberg in Business Insurance.com, (no relation to my mother’s side of the family), North Dakota has codified its payer rules for air ambulance services.

This is significant, because of the economic boom in North Dakota from the oil fields there, and since North Dakota is primarily an underpopulated state, it occurred to me some time ago that should a worker in the oil industry become injured on the job, they would have to taken miles away to a hospital for medical care, especially if that care cannot be provided locally.

Neighboring states such as Minnesota or South Dakota come to mind easily, but what if the medical need is one that no hospital in those states can handle? Perhaps there is one in, let’s say, Winnipeg, Manitoba, in Canada. That would be an example of cross-border workers’ comp, not unlike the examples I discussed in my previous posts, Cross-border Workers’ Compensation a Reality in CaliforniaNAFTA, Work Comp and Cross-Border Medical Care: A Legal View, Health Care Across US-Mexico Border: A Two-Way Street, and NAFTA, Work Comp and Cross-Border Medical Care: A Legal View: Update.

The future of medical care on this planet will not be confined to any one national border. Jet travel has made that impossible, and research currently conducted by the US government on scram-jet technology will make it even more so, as you will be able to fly from New York to London in one hour’s time, and travel to many other parts of the world in under four hours.

Antiquated state workers’ comp laws and statutes and conservative mindsets are only slowing the inevitable. For real change to occur in the general health care, and in workers’ comp in particular, medical travel outside the borders of the US must become reality. It cannot just be the province of a few wealthy and affluent patients who take medical vacations abroad.

This is one planet, and we all live on it, so the benefits of life here belong to all of us, not just to one class. Those who attack my idea are short-sighted, narrow-minded, bigoted, and paternalistic. And you know who you are. So get with the program, or get out of the way.

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I am willing to work with any broker, carrier, or employer interested in saving money on expensive surgeries, and to provide the best care for their injured workers or their client’s employees.

Call me for more information, next steps, or connection strategies at (561) 738-0458 or (561) 603-1685, cell. Email me at: richard_krasner@hotmail.com. Ask me any questions you may have on how to save money on expensive surgeries under workers’ comp. Connect with me on LinkedIn and follow my blog at: richardkrasner.wordpress.com. Share this article, or leave a comment below.

What Are the Transportation Guidelines for Medical Travel?

WorkCompWire reported last week that GENEX Services, a provider of integrated managed care services, has recently launched the most comprehensive guidelines for the use of transportation services, by ground or air, for workers’ compensation injuries.

Here is the link to the article on WorkCompWire:

http://www.workcompwire.com/2015/04/genex-first-in-work-comp-industry-to-develop-comprehensive-transportation-guidelines/?utm_source=WCR+Weekly+4%2F20%2F15+-+New+WCRI+Report%21&utm_campaign=WCR&utm_medium=email

The guidelines were introduced to the company’s 1,500 internal case managers in January, and the roll out to customers is underway.

The GENEX Transportation Guideline is intended to provide research-based assistance about when and where, as well as what mode and vendor is best for injured workers, including ambulance, helicopter and air transport.

The Transportation Guideline also provides direction on expenses for transportation that have already been incurred as well as for prospective or future transportation expenses.

Much of the guidelines GENEX introduced concerned workers’ compensation injuries of an emergent nature, and discusses which mode of transportation, whether ambulance or helicopter, is the best mode of transportation for a particular type of injury.

For the purpose of medical travel, especially with regard to its implementation into workers’ comp for non-emergent care, as previously quoted in my white paper, the medical tourism industry needs to devise similar guidelines for transportation, especially since much of that transport will be by air, and not by ground transportation, except to and from an airport.

But the fact remains that in order to be able to successfully implement medical travel into workers’ comp, there needs to be guidelines for transporting patients going abroad for knee surgery, hip surgery, shoulder surgery, as well as how you transport patients requiring back surgery, especially on flights lasting more than four hours, or on shorter flights that might be delayed for whatever reason, and the patient is confined to the assigned seat for a long period of time.

These guidelines should already be in place for general health care medical travel, and can be applied to workers’ comp without difficulty. Medical tourism facilitators those whose business is solely focused on orthopedic procedures are best suited to advise on transporting knee repair/replacement patients, hip replacement patients, shoulder surgery patients, etc.

These guidelines would make it more likely that risk managers, claims managers, brokers, attorneys, case managers, and other professionals involved with handling workers’ comp claims will accept the option of medical travel for injured workers requiring surgery.

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I am willing to work with any broker, carrier, or employer interested in saving money on expensive surgeries, and to provide the best care for their injured workers or their client’s employees.

Call me for more information, next steps, or connection strategies at (561) 738-0458 or (561) 603-1685, cell. Email me at: richard_krasner@hotmail.com. Ask me any questions you may have on how to save money on expensive surgeries under workers’ comp. Connect with me on LinkedIn and follow my blog at: richardkrasner.wordpress.com. Share this article, or leave a comment below.

A Few Answers to ‘More Questions, Questions’

My article, “More Questions, Questions: A Call for Answers from the Medical Tourism Industry”, asked members of the medical tourism industry to provide me with answers to several questions posed to me by an individual I had a running discussion with that week.

I posted the questions in the article, and divided the questions into the following four areas of concern:

Legal Liability and Medical Malpractice

HIPAA

Physical Therapy and Rehabilitation

After-care and follow-up

One individual did respond to my call for answers, and here is his reply: (Note: this individual is a specialty lines broker)

Legal Liability and Medical Malpractice:

Legal Liability and Medical Malpractice are concerns of course; however, one can mitigate their exposure by doing several things. 1. Obtain professional liability cover that includes managed care liability for overseas medical treatment. 2. Obtain specialized medical complication and medical travel insurance – Global Protective Solutions can assist with both. In the event of a medical complication (no fault or fault) arising from the procedure in which someone travelled, this specialty insurance would provide first party cover for the medical traveler. By attempting to make the injured party whole again there is little reason for them to place blame on an employer, facilitator or medical provider.

HIPAA:

Whilst HIPPA concerns are warranted there are various programs that can assist in keeping medical records /data private. These range from the very complicated to simple formats. Global Protective Solutions also provides services from their partner Swiss MedBank, that allows the patient/medical traveler to be in charge of his/her own medical records thus not leaving it up to a third party such as an employer or facilitator. Swiss MedBank is a leading provider of secure, safe medical information storage and retrieval services, the program acts as a type of “medical passport”.

Physical Therapy and Rehabilitation:

Physical Therapy and rehab will need to occur no matter if the surgery was performed in the home city, another state or in a foreign country. This should be a non-issue. If a PT/rehab provider declines treatment because the surgery was provided out of the country I would be wary to use their services no matter what.

After-care and follow-up:

Same as above. Certainly theses services would be needed, and pre-arranged before treatment is every given. In every situation the medical traveler would have received their initial follow-up and rehab before returning to the US. If there is a need for medical follow-up or further treatment due to a complication (fault or no-fault) it should be given be any licensed physician in the US. There could be some major laws being broken if treatment is denied, such as EMTALA as well as their Hippocratic Oath.

No difference between surgeries covered under group health care and workers’ comp

In my article, “Surgical Shenanigans: How Workers’ Compensation is being ripped off”, and in my article, “Clearing the Air: My Defense of Implementing Medical Tourism into Workers’ Compensation”, I asked the following questions:

Is there something different about patients who can afford to pay for medical treatment abroad or who have private health plans that do, from those who get injured on the job and have their treatment paid for by an employer or insurance carrier under workers’ comp?

What difference is there if a person injures their hip or knee by engaging in some sort of physical activity outside of their employment, or if the person gets hurt on the job? Are the surgical procedures for these types of surgeries different for a working person than those for a middle-class or upper-middle-class person?

Of course, the answer to both of these questions is no, there is no difference. And there should not be any difference when we consider the areas of concern I discussed above; namely, that if a patient has surgery that is covered by their group health plan or through their own insurance, they will require the same physical therapy and rehabilitation that would be required of a patient covered under workers’ compensation.

After-care and follow-up, as well as a return-to-work program, normally a part of the claims process for workers’ comp, would apply for the group health care or private pay patient. For example, in the second question, a knee operation would require a certain amount of after-care and follow-up, and a plan for the patient’s return to work, even if the patient injured their knee outside of their employment.

The problem is, and this was perfectly discussed in John Connell’s article that I cited in “Betting the Farm”, that we have separated the medical care received in general health care from the medical care received in workers’ comp, thereby placing them into two different silos of care.

There is a name for this way of thinking. It’s called “tunnel vision”, and in this case, there is no light at the end of the tunnel, only continued darkness. And until we all realize that medical care is really on one track, and one track only, there will continue to be darkness. The only difference between the types of care is how the care is paid for, and that too can be solved. It just requires the will to do so.

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I am willing to work with any broker, carrier, or employer interested in saving money on expensive surgeries, and to provide the best care for their injured workers or their client’s employees.

Call me for more information, next steps, or connection strategies at (561) 738-0458 or (561) 603-1685, cell. Email me at: richard_krasner@hotmail.com. Ask me any questions you may have on how to save money on expensive surgeries under workers’ comp. Connect with me on LinkedIn and follow my blog at: richardkrasner.wordpress.com. Share this article, or leave a comment below.

Costa Rica is Primed for Medical Travel

As I did last week for Colombia in my post, Colombia as Medical Travel Destination for Workers’ Comp Surgery, here is an article about Costa Rica:

http://trip4care.com/costa-rica-at-the-forefront-of-medical-tourism/?utm_source=rss&utm_medium=rss&utm_campaign=costa-rica-at-the-forefront-of-medical-tourism

This is by the same medical tourism facilitator who wrote the Colombia article, and I am sharing it because people need to know that medicine in Latin America is not primitive, backward, or dangerous.

Look for more of these country-based reviews in the future, either by myself, or by others.

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I am willing to work with any broker, carrier, or employer interested in saving money on expensive surgeries, and to provide the best care for their injured workers or their client’s employees.

Call me for more information, next steps, or connection strategies at (561) 738-0458 or (561) 603-1685, cell. Email me at: richard_krasner@hotmail.com. Ask me any questions you may have on how to save money on expensive surgeries under workers’ comp. Connect with me on LinkedIn and follow my blog at: richardkrasner.wordpress.com. Share this article, or leave a comment below.

Betting the Farm

David Dias, Founder and Chairman of Insurance Thought Leadership.com posted the following article to his site this afternoon:

http://insurancethoughtleadership.com/move-workers-comp-silo/?sthash.IZT1sXHd.mjjo#sthash.IZT1sXHd.v7TnXKZz.dpbs

The author, John Connell, is the President of the Western Region of EPIC Insurance Brokers and Consultants, and is responsible for Employee Benefits. Mr. Connell’s article brings to light something I have thought of when trying to explain implementing medical tourism into workers’ comp.

Imagine visiting a farm, and after being shown around the parts where the animals are kept, the farmer shows you his silos. There are two of them; one very big, and one very small.

Curious, you ask the farmer what is in the first silo, and he replies that that is where he stores his grain. Then you ask, what is in the second silo, and he replies, that that is where he stores his other grain.

Totally confused, you ask another dumb question of the farmer. “Why do you have two silos if you are just storing grain? What is different about the grain in the second silo that requires a separate silo?”, you ask.

He shakes his head, laughing at the city slicker, and replies that the grain in the first silo is from that field over there, and he points to a large wheat field. Then he tells you that the grain in the second silo is in a field in another direction, and informs you that there are certain rules, regulations and laws that apply to not only growing the wheat that is stored in that silo, but also how it is stored in the silo as well.

At this point, you are dazed and confused, because it’s just wheat, no matter how you slice it in the end, but you are so incredulous that you shake your head in disbelief.

That is the point Mr. Connell is making, that it makes no sense to have two silos for the same thing, namely the medical care that is covered by group health plans and by workers’ compensation. And as he points out so well, there are companies that are combining the two, much like our farmer should with his wheat, and never mind the rules, regulations, laws and statutes about how to grow or store the grain from that second field. It is these rules and regulations, etc., that hinder improvements in how workers receive benefits from on the job injuries.

And somewhere in the new silos these companies are creating, there should be room to include medical travel as an option for injured workers to receive better care, and for their employers to realize lower cost for surgeries common to workers’ comp. I’d call that betting the farm on real change that will save money and provide workers with the best care possible.

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I am willing to work with any broker, carrier, or employer who is sick and tired of being bled by the Wall Street vulture capitalists and the entire medico-legal system known as workers’ comp, to save money, and to provide the best care for their injured workers or their client’s employees, while at the same time, helping to break the monopoly of the American health care cartel.

Call me for more information, next steps, or connection strategies at (561) 738-0458 or (561) 603-1685, cell. Email me at: richard_krasner@hotmail.com. Ask me any questions you may have on how to save money on expensive surgeries under workers’ comp. Connect with me on LinkedIn and follow my blog at: richardkrasner.wordpress.com. Share this article, or leave a comment below.

Más preguntas, preguntas: Una llamada para obtener respuestas de la industria del turismo médico

En los últimos dos años que he estado escribiendo este blog, he tenido contacto con muchas personas en la industria del turismo médico. Algunos que he conocido en línea, y otros que conocí en las tres conferencias de turismo médico que he asistido desde octubre de 2012.

La mayoría de ustedes está en partes del mundo que están demasiado lejos para que muchos norteamericanos viajar a, especialmente aquellos que podrían beneficiarse de ir al extranjero para la cirugía como un paciente de compensacion de trabajadores. Así que me he centrado mi atención en la América Latina y el mercado caribeño, ya que generalmente existe una creciente población latina en Estados Unidos y dentro de la fuerza de trabajo en particular.

Así que mi propósito en este artículo es obtener respuestas a preguntas que planteé anteriormente, y que se han planteado recientemente por individuos seguros que he estado en contacto quienes no están seguros mi idea es viable. Por lo tanto, esta convocatoria de respuestas de la industria del turismo médico.

Estas son algunas de las preguntas por estos individuos:

¿Cómo se logran seguimiento post operatorio a veces durante semanas o meses? ¿El tiempo y el esfuerzo de los repetidos viajes desalentará a la gente? ¿Esos costos adicionales compensará cualquier ahorro en el costo básico de la cirugía? ¿Si se desarrolla una grave complicación post-operatoria (infección del sitio quirúrgico, neumonía, problemas cardiacos, etc.), allí será doctores en los Estados Unidos que están dispuestos a aceptar al paciente de complicación de otro médico? Si se produce por negligencia (y será), ¿por qué un médico estadounidense querría convertirse en un participante en caso como riesgo eventualmente fue nombrado como un acusado? Yo no lo haría, y abogados ir después de que el médico más vulnerable y fácilmente sued (médicos extranjeros están a salvo de mala praxis americano). ¿Donde PT se realiza después de la operación? ¿Qué garantías los empleadores tienen que un médico extranjero entiende el concepto de retorno al trabajo adecuado o incluso se preocupa por los efectos de que la pérdida del trabajador tiene en su negocio? ¿Qué recurso tiene el trabajador lesionado si el médico extranjero arruina todo lo relacionado con el reclamo de compensación de trabajo?

En orden para que usted pueda ser capaz de responder a éstas y otras preguntas, yo estoy restaurando tus recuerdos de los últimos artículos que escribí que cubría algunas de estas preguntas.

Vuelta en enero de 2014, escribí un artículo titulado, “preguntas, preguntas — cómo turismo médico puede convertirse en una alternativa Real en cuidado de la salud y qué significa para la compensación de trabajadores“.

El artículo discute varias preguntas que la industria del turismo médico suficientemente no ha respondido, como responsabilidad legal y mala praxis médica. Estas preguntas para que la implementación del turismo médico en compensación de trabajadores, como su aplicación en general salud puede lograrse la satisfacción de todos los actores involucrados en las reclamaciones de compensación de trabajadores.

Estos actores van desde el trabajador lesionado él/ella, a su empleador, la compañía de seguros (si está asegurado a través de seguros comerciales), el Gerente de riesgo para la empresa, los gerentes de recursos humanos, su corredor (otra vez, si comercialmente asegurado) y cualquier otra entidad involucrada con la colocación o la administración del programa de compensación para trabajadores. También implica cualquier terceros administradores y médicos.

También debatió la cuestión de las clasificaciones de deterioro en el artículo y se indica los tipos de deterioro de los médicos de calificaciones deben estar certificados para asignar a los pacientes. La comprensión de estas calificaciones es necesaria para los médicos que tratan a los trabajadores lesionados, pero no para aquellos que están cubiertos por planes de salud colectivos o privados pago seguro.

En febrero de 2013, escribí un artículo titulado “qué papel puede turismo médico juegan en terapia física y rehabilitación para la compensación de trabajadores?”.

En ese artículo, os hablé de la diferencias significativas en el tipo y la duración de la terapia física proporcionada a los demandantes de compensación de trabajadores. mencioné un estudio que encontró que tres conclusiones principales:

  • Centros corporativos fisioterapia facturados para visitas más y más unidades por episodio que otras configuraciones de práctica.
  • Hubo una “gran diferencia en la utilización de tratamiento entre las regiones geográficas, independientemente de la configuración de práctica, diagnóstico, intervención quirúrgica y tratada de parte del cuerpo”
  • Estos centros corporativos facturados por “una menor proporción de agentes físicos, lo que indica un mayor uso de las intervenciones apoyadas por directrices basadas en la evidencia (terapia manual y ejercicio) comparadas con otras opciones de práctica”.

Entonces concluí el artículo diciendo que la terapia física y rehabilitación servicios podrían ser empaquetados junto con la cirugía y proporcionarían al paciente con un mejor resultado.

Por último, para que la gente en la industria del turismo médico pueda entender comp qué trabajadores es todo esto, escribí un artículo titulado, “Cartilla de compensación A los trabajadores para la industria del turismo médico” que te di las definiciones de conceptos y términos de compensación a los trabajadores comunes.

Lo que pido a todos ustedes que hacer ahora es esto: me dan respuestas a las preguntas que planteé anteriormente, y que ahora están siendo criados por aquellos en el corretaje y campos de la medicina que han criticado mi idea para implementar el turismo médico en compensación de trabajadores.

Se podría decir que yo estoy pidiendo que ponga para arriba, o callarse sobre cuánto mejor turismo médico es y puede ser, porque estas personas necesitan ser vendidos en esto, y ustedes son los únicos que pueden hacer la venta.

A continuación las principales áreas de preocupación a la dirección:

Responsabilidad legal y mala praxis médica

HIPAA (mencionado en mi libro blanco)

Terapia física y rehabilitación

Asistencia y seguimiento

Si quieres negocio compensación de los trabajadores, es usted, no yo, quien tiene que responder a estas preguntas primero. Entonces yo puedo transmitir las respuestas a los de industria comp y seguro de los trabajadores que están haciendo las preguntas.

Traducido por Microsoft Translator

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