How our care management team helped a member overseas with a serious health issue

Dealing with a serious health issue is stressful. It’s important to use your energy to get healthier. But so often, there are other factors that cause worry, like how to find the right care and how you’re going to pay for it once you find it.??

The help you need is part of our plan?

“That’s one of the distinct advantages of being an Aetna International member,” said Seeta Hammer , Head of Clinical Services at Aetna International. “Our care management team differentiates us, helping our members navigate unfamiliar territory – literally and figuratively – taking a huge weight off their shoulders. And it’s all included with every Aetna International plan.” Hammer recounts a recent member scenario that perfectly illustrates her point.?

“While on an overseas assignment, one of our members started experiencing severe back pain. A visit to the local hospital determined the pain was caused by a herniated disc that would require surgery. But because the member was in a remote part of the world, the hospital was unequipped to handle the surgery.”?

Can you imagine? You’re in agonizing pain, in an unfamiliar country with an unfamiliar health care system and you’ve just been told you’ll have to travel to another country to have the surgery you need. Overwhelmed, our member reached out to us for help.?

AI care management to the rescue?

Our international care management team sprang into action. We determined the closest center of excellence for the type of surgery our member needed. We arranged the members travel, as well as clinical consultations and diagnostic work upon arrival. Once the diagnosis was confirmed, we helped the member arrange and prepare for surgery.??

“Navigating an unfamiliar health care system can be overwhelming,” our care management clinician said. “We knew we could take a huge weight off the member’s shoulders.”?

Our international care management, network management and account management teams joined forces to:??

• Arrange emergency medical travel to ensure the member was as comfortable as possible in route to the surgery.?
• Set up direct pay with the providers, so the member didn’t have to worry about the financial details or delayed care.?
• Ensure immediate and appropriate care by identifying the nearest center of excellence.?
• Keep the member and employer updated throughout.??

The member’s employer shared their appreciation, saying “Aetna International understood the challenges, worked quickly and diligently to solve them and helped reduce our employee’s stress. This allowed the member to focus on what was most important…getting healthy.” ??