Assistance & Claims Management

Travel Assistance Program

No matter how well travellers plan, travelling is always full of surprises. Smart travellers know that the best way to prepare for the unexpected is to rely on a top-notch assistance company.

Orion Travel Insurance Company is proud to partner with Active Care Management, Canada (ACM). Active Care Management has been providing medical and non-medical assistance services, full claims management services, comprehensive case and re-pricing services for over a decade.

 

World-Class Assistance & Claims Management

Orion’s assistance partner offers world-class emergency medical assistance and claims management that are constantly evolving to ensure they provide their clients with a complete set of leading solutions to manage the three universal fundamentals of healthcare: Access, Quality and Cost.

Backed by strong systems, processes and highly experienced management and skilled staff, their solutions deliver important value to partners and insured clients on a daily basis.

Orion Travel Insurance knows members need more than just hospitals for their emergency assistance needs. The main contributing factor to any successful assistance plan is to have access to a broad range of healthcare services and providers. Active Care Management focuses on all areas of the medical field when it comes to contracting and their network covers a comprehensive range of healthcare specialties and fields including, but not limited to, specialized diagnostics testing, labs, neo-natal care, cardiac care, serious trauma injuries or burns, oncology, orthopedic, and general to specialized surgery.

These assistance services include a team of dedicated provider relations network specialists actively contracting with healthcare providers around the globe. In order to ensure they are consistently working with the best providers at the best price, they regularly review and evaluate their contractual relationships with all their providers while building relationships with the best providers in each region.

 

24-hour Emergency Assistance & Medical Case Management

Highly trained and experienced medical management teams work together to manage all aspects of an insured client’s case; from initial contact to completion of medical treatment. The goal is to provide empathetic patient advocacy, while effectively monitoring and managing costs.

With a centralized hub located in Windsor, Canada, service is 24/7, 365-days-a-year access to:

  • Dedicated multilingual case management and assistance teams, as well as access to a language line with over 170 languages
  • Registered nurses, and Physicians who provide medical management and oversight
  • Support in accessing emergency, routine and planned tertiary care
  • Steerage of patients to cost effective providers while maximizing available benefits, coordination of admissions, monitoring of treatment, as well as constant patient support
  • Coordination of air ambulance and commercial evacuation
  • Assistance with direct billing with the provider should a member find themselves referred to a non-network provider
  • Cashless billing coordination
  • Direct toll free numbers or assisted toll free numbers to allow members easy access to reach the assistance centre 24/7

 

Large Claim Review & Audit

Large claim review and audit services provide clients with a full claims audit that includes line-by-line reviews of billed charges to identify and exclude any technical and coding accuracy errors. This results in claims charges being reduced before the application of the discount or reimbursement. In addition, this service can be applied to claims that are in or out-of-network.

Large claim reviews and audits result in a signed agreement with the billing provider, ensuring that the settlement is never disputed.

Review and audit services include:

  • Review of medical necessity
  • Unbundling of charges
  • Utilization review
  • Anesthesia services review
  • Supplies, materials and durable medical equipment (DME) review
  • Determining the room & board reimbursement rate
  • Comparison of charges against the hospital documentation