In our ongoing effort to streamline our booking process and ensure seamless service delivery, we have established four key procedures for handling requests from our Insurance Partners.
Affiliate Partner within Designated Service Area
In order to keep all booking as convenient as possible for the Clients MedWorks Corporate Booking Team books appointments at clinics that are conveniently located for clients.
CASE 1:
When the MedWorks Corporate Booking Team receives a request from one of our Insurance Partners via email or through the MedWorks portal/APP (The Core Booking TEAM) will look into the “National Affiliate Partner Spread Sheet” (provide/insert link) to locate an Affiliate Partner that provides the service that is required.
Once a clinic is located that provides the service that is required the clinic is contacted for available appointment dates based on the clients requests. Once dates are secured from the clinic, the dates are presented back to the insurance company for approval/confirmation.
Once confirmation is received back from the insurance company, MedWorks proceeds to book to the appoint with the clinic.
If no paperwork is involved or the clinic does not use any form or email form of communication via email then the clinic will provide the results back to the patient directly. The MedWorks Team will notify the insurance company that the insurance results will be shared with that patient directly.
In some cases some insurance companies require paperwork. In these cases, they provide MedWorks with the paperwork or GOP as required, which is then uploaded to clinic specific -BOX folder in advance of the appointment for the clinic.
Clinic then retrieves the paperwork from BOX and the appointment will be completed. The Physician will sign off on all the paperwork and upload all completed documents in to the BOX folders for Core Booking to access for billing and processing.
Follow the same/existing (new) process for Box and payments.
Affiliate Partner Outside of Designated Service Area-Escalation to Management Required
Step One
If there is an instance where the availability of a clinic location is not available within the defined proximity that is requested by the Affiliate Partner at the time that a booking is being requested, then the MedWorks Corporate Booking Team is to make an immediate escalation to management.
Step Two
Once the MedWorks Corporate Booking Team escalates a case to the Management Team member (Clinic Manager, Sales Manager, Director of Operations, etc.,) The Senior Manager will locate the nearest service provider willing to accept pre-payment for the services booked. This is through researching various online sources and reaching out to networks.
Once the appointment is scheduled, the Booking Team will collaborate with the Corporate Booking Coordinator to manage the payment to the chosen affiliate partner or service provider.
CASE 2:
Should there not be an Affiliate Partner within close proximity (usually within an hour of the address provided) that can provide assistance, the Booking Team is to contact Sales Manager to find the closest service provider available that would accept pre-payment for services booked.
Once the Booking Department is able to book the appointment for the patient, they will then need to involve Corp booking coordinator with regard to payment to the affiliate partner/service provider.
At time of booking, the Booking Department will prepare an order/invoice in email form for the service and include 50% increase for our services. HST is to be applied to the final amount and forwarded to Joy. Email to include:
Insurance Partner’s contact details
Email confirmation of charges
Credit Card Details (if provided)
Name and Canadian Address of Patient
A brief summary of what is required for the patient along with symptoms if provided by Insurance Partner.
The Booking Department will get the confirmation email from the Insurance company on the amount MedWorks is going to charge to them for the specific service.
CASE 3:
A billing process will be developed with each of the larger Affiliate Partners whereby we will be invoiced for the services provided and we in turn will add our fees and invoice the insurance partner for payment.
CASE 4:
For individual Affiliate Partners, we will request if pre-payment can be made for services they will be providing to the patient by either credit card or electronic funds transfer.
In the event that billing can be established, MedWorks will opt for that option whenever possible. The Booking Department will get the confirmation email from the Insurance company on the amount Medworks is going to charge to them for the specific service.
Booking department will share the details of payment in below format to Chief of Staff for CEO’s approval. Once we receive an approval from CEO, Booking department will take Chief of Staff on call along with the clinic to share the credit card details and payment.
When an Insurance Partner requests to pay for services via their own corporate credit card, we will require all information (card number, name on card, expiration date and security code on reverse of card.
MedWorks will pay the provider either by paying the provider’s invoice, paying by its corporate credit card or via Electronic Funds Transfer. We will then take payment directly from the Insurance Partner’s credit card, charging for services and appropriate mark-up.
Corp booking coordinator will be required to reconcile:
Email details from Booking Team
Reconfirmation of Payment Process (Direct Billing/MedWorks Credit Card/EFT or payment by Insurance Partner Credit Card
Any Invoice received from Affiliate Partner
Confirmation of Payment or receipt of Payment from Insurance Partner
S.No | Order Id | Patient's | Service Requested | Order | Appointment | Appointment Location, Clinic | Clinic Cost | Medworks | Total Cost- To bill to Insurance Co |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|