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Negotiating savings under sensitive circumstances

Background

A 75 year old patient was admitted to hospital in Cancun, Mexico with heart failure and probable acute myocardial infarction (AMI). The charges for his medical treatment were initially quoted at US$140,000.

It was clear that costs had been inflated by the hospital, which were unrealistic for a two-day treatment. Very sadly, the patient did not survive despite his treatment.

The challenge

Minimising charges and ensuring fair pricing.

The hospital claimed that according to the Mexican law, they were only obliged to put the price list in the front entrance of their hospital, and anybody entering their building would automatically be accepting these costs. We argued that the patient was referred to them by the hotel and would not be in a condition to choose another hospital and/or move elsewhere, he was not made specifically aware of such high costs, and he and his family were put under pressure to keep requesting for the insurance to cover all costs.

The medical assistance team did the utmost to manage the case, despite being under pressure from the hospital requesting cover. Direct negotiation with the hospital took around 15 days of intensive review and included online meetings with the billing manager of the hospital in the USA.

Outcome

Cost savings of US$38,000 achieved.

The remains of the deceased were brought back to UK.

Healix was careful to avoid disturbing the family with financial matters after such a sad event and instead carried out work in the background, to maximise cost savings for the client, which totalled around US$38,000 in savings after negotiations were completed.

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