1st Edition

Medical Tourism Facilitator's Handbook

By Maria K. Todd Copyright 2012
    180 Pages 9 B/W Illustrations
    by Productivity Press

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    In addition to coordinating health travel logistics and gathering medical records, medical tourism facilitators play the role of travel agent, appointment setter, concierge, hotel reservationist, tour operator, and hand-holder to clients seeking health services domestically and abroad. Addressing the issues that are likely to emerge as clients travel, the Medical Tourism Facilitator's Handbook is a must-have resource of hard-to-find tools, checklists, terminology, and other helpful information for hospital-based, lay facilitators, travel agents, and even retired physicians and nurses.

    Supplying the advice of a recognized expert in global healthcare, the book provides a detailed and empathic understanding of patient needs and expectations. It covers the full range of best and worst case scenarios that can occur when clients travel to obtain health services. Using a conversational tone, it includes coverage of international travel logistics, where to find answers to immigration concerns, confidentiality/privacy issues, and unanticipated care in transit in the event of complications or missed connections.

    The book delivers a fast-moving presentation of useful information and teaches readers how to decode the language, what to look for in terms of safety and quality, how to decode hospital facilitator agent agreements, and how to anticipate clients’ needs and expectations. It also includes access to a regularly updated website with helpful worksheets and reference material so you will be prepared to handle any scenario that might present itself when your clients travel.

    Defining the Role of the Facilitator
    Professional Medical Travel Facilitator
    Case Management
    Travel Planner
    Travel Agent Individual Designations
         The Travel Agent Proficiency (TAP) Test
         Certified Travel Associate (CTA) Designation
         Travel Agency Credentials
         IATA/IATAN Endorsement
         IATAN Credentials/ID Cards
         Agency Appointments
         Airlines Reporting Corporation (ARC)
    Agencies Without ARC Accreditation or Appointments
    Regulatory Oversight
    Computer Software and Programs to Support Your Travel Agency Business
    Web Portal (Electronic Mail)
    Additional Resources
         Trade and Industry Organizations
         American Society of Travel Agents
         ASTA Future Travel Professional (FTP) Club
         National Association of Commissioned Travel Agents, Inc.
         International Airlines Travel Agent Network (IATAN)— www.iatan.org
         Airline Reporting Corporation—www.arccorp.com
    Travel Agency Bonds
    Travel Trade Publications
    Travel Agency Software

    Business Startup
    Business Plan
    Present Status of the Business
    Describe Your Competitive Advantage
    Industry Overview
    Marketing Plan
    Customer Service Plan
    Technology Plan
    Consultants for Your Business
    Compliance Plan
    Basic Privacy Laws
    Developing a Medical Records and Electronic Data Privacy and Security Plan
    The Red Flags Rule: Fair and Accurate Credit Transactions Act (FACTA)
    Health Insurance Portability and Accountability Act (HIPAA) Privacy and Security Compliance
    Health Care Business Associate Agreement
              Specific Definitions
              Obligations and Activities of Business Associate
              Permitted Uses and Disclosures by Business Associate
              Obligations of Covered Entity
              Permissible Requests by Covered Entity
              Term and Termination
    Health Information Technology for Economic and Clinical Health (HITECH)

    Developing a Business Startup Budget
    Financial Projections
    Cash Management Plan
    Costly Contingencies, Refunds, and Liabilities
    Nonrefundable and Partially-Refundable Deposits
    Ostensible Agency Liability
    Failure to Perform Due Diligence
    Privity of Contract
    Joint and Several Liability
    Liquidated Damages
    Slow Pay

    Understanding Managed Care and Health Care Reimbursement
    Health Plans in the United States
    Health Maintenance Organizations (HMOs)
    Administrative Services Organizations (ASOs)
    Preferred Provider Organizations (PPOs)
    Third-Party Administrators (TPAs)
    Exclusive Provider Organizations (EPOs)
    Consumer-Driven Health Plans (CDHPs)
    Medicare and Medicaid

    Building Your Product and Inventory
    What Do You Sell?

    The Procedures
    Paper or Software?
    Anesthesia Overview
    General Anesthesia
    Regional (Block) Anesthesia
    Spinal Anesthesia
    Epidural and Caudal Anesthesia
    Peripheral Nerve Block
    Intravenous Regional Anesthesia (Bier Block)
    Monitored Anesthesia Care (MAC) (Anesthesia Standby)
    Local Anesthesia
    Acupuncture and Hypnosis
    Hypnotic Anesthesia
    Postanesthesia Recovery
    An Overview of Medical Procedures
         Diagnostic Procedures
         Cancer Treatment
         Cardiac surgery
         Cricothyrotomy or Corodotomy
         Endoscopic Thoracic Sympathectomy
         Eye Surgery
              Corneal Transplantation
              Refractive Surgery
              Cataract Surgery
              Macular Degeneration
              Retinal Detachment
    Gynecological Surgery
         Tubal ligation
         Tubal reversal (tubal anastomosis)
         Foreskin restoration
         Penectomy or Peotomy
    Bilateral Cingulotomy
    Cordotomy or Chordotomy
    Orthopedic Surgery
         Hip Replacement
         Hip Resurfacing (Birmingham HipTM)
    Knee Replacement (TKR)
         Partial Knee Resurfacing/Unicondylar Knee Arthroplasty (UKA)/Journey Deuce
         Anterior Cruciate Ligament (ACL) Reconstruction
    Shoulder Reconstruction
         Ulnar Collateral Ligament Reconstruction or Tommy John Procedure
    Shoulder Replacement
         Pediatric Surgery
         Plastic Surgery
         Rhytidoplasty or rhytidectomy
    BOTOX® Cosmetic, Dermal Fillers, and Other Wrinkle Treatments
    Breast Augmentation (Implants)
         Breast Lift (mastopexy)
         Breast Reduction
         Breast Reconstruction
         Reconstructive Mammoplasty
         Mammectomy or Mastectomy
         Flap Procedures
         Buttock Augmentation/Buttock Lift
         Eyelid Surgery (blepharoplasty)
         Ear Surgery (otoplasty)
         Frontalis lift or Forehead Lift
         Tummy Tuck (abdominoplasty)
         Thigh Lift
         Facelift (rhytidectomy)
              Thread Facelift
         Rhinoplasty (Nose Surgery)
    Podiatric Surgery
    Regenerative Medicine
         Spine Surgery
    Urological Surgery
         Abdominal Surgery
         Kidney Transplantation
         Lung Transplantation
         Pneumonectomy or Pneumectomy
         Heart transplantation
         Hernia Repair
         Nissen fundoplication
         Cesarean section or C- Section
         Colon resection
    Weight Loss Surgery (Bariatric Surgery)
         Bariatric Surgery "Lite"

    Initial Contact
    Contacting the Medical Experts
    Reporting Back to the Client
    Day Before Travel
    Travel Day
    On Arrival at the Destination
    Hotel Considerations
    Second-Tier City Considerations
    RevPAR—Watch Out For "Ancillary" Fees
    Keeping the Terms of the Negotiated Rates Are Key
    Pointers on How to Negotiate
    On the Day of Surgery or the Day Prior to Surgery
    On the Day of Discharge
    Postoperative Tourism and Leisure Activities
    On the Day of Departure
    On Return Back to the Client’s Home Country
    Contracting for Your Services
         Working Up a Price Estimate
         Dealing with Extra Charges that May Arise
    Travel Planning
         Planning the Travel for a Surgical Client
         Planning the Travel for a Wellness Visit Client
         Planning the Travel for a Diagnostic Services Client
         If the Client Is Unable to Travel in Commercial Airliners
    Peri-Operative Planning
         Preoperative Details and Preparations
    Postoperative: In Country, Prior to Departure
    Postoperative, Follow-Up, and Aftercare
         Recuperation Period

    Spa Tourism; Derek Bryson Hedden
    Target Market
    Getting to Know Your Client
    Types of Spas
         Medical Spas
         Resort Spas
         Destination Spas
         Hot Springs
         Weight Loss Spas
    Spa Associations

    Quality and Safety Transparency; Lisa Beichl, Transparent Borders LLC
    Types of Medical Tourism Groups and Venues
         Medical Tourism Venues
         General Medical Tourism Flow (Domestic and International)
    Risk Assessments
         Market Risk
         Transition Risk
    Importance of Transparency in Managing Risks
    Importance of Market Transparency in International Medical Tourism
    Quality and Safety Transparency
    Patient Safety
    Quality Tools to Promote Transparency
    Risks and Rewards of Medical Tourism
    Measuring Outcomes
         Surgical Site Infection Rates
         Readmission Rates
         Mortality Rates and Discharge Status
         Patient Satisfaction
    Movement to Standard Best Practices

    Putting It All Together: Your Provider Network
    Professional Liability Issues
         Disclaimer of Liability
         Option 2: Each Responsible for Own Acts
         Theories of Liability
         Ostensible Liability
         Vicarious Liability
         Shared Liability
         Assignment of the Contract
    Provider Credentialing and Privileging
         Agreement to Accept Hospital’s Credentialing
         Dispute Resolution
         Liquidated Damages
         Reimbursement and Financial Terms
              Exclusions and Inclusions
              Cancellations and Provider Refund Policies, If Any
              Forms or Methods of Payment
              Revenue Cycle
              Time Period for Provider to Receive Payment
    Physician and Dentist Agreements
         Credentialing and Privileging
         Malpractice and Professional Liability
         Hotel Agreements
         Chauffeur Services
    Contracts, Agreements, and Forms
    Market Research
    Medical Association Contact Information
    Quality Metrics and Outcomes
    Dealing with Late-Reported or Delayed Adverse Outcomes
    Additional Resources



    Maria K. Todd, MHA, PhD, is the CEO of Mercury Healthcare. Dr Todd's background includes postgraduate degrees in Health Administration, and more than 30 years of healthcare industry experience. Her professional experience includes work as a HMO provider relations coordinator, an Independent Practice Association (IPA), Physician Hospital Organization (PHO), and Management Services Organization (MSO) developer and executive director, contract analyst and negotiator, medical group administrator, surgical assistant and EMT, hospital business office manager, health law paralegal and certified mediator. She is the author of the industry's bestselling book, IPA, PHO MSO Development Strategies: Building Successful Provider Alliances (1997, McGraw Hill and the HFMA, Chicago).

    Dr. Todd has led the project management of more than 150 integrated health delivery systems, many still in successful operation today, and is a highly-regarded international healthcare industry consultant and contract negotiator who authored hundreds of journal articles, several white papers and nine professional trade books. Since 1989, she has presented more than 2700 US and International educational presentations and keynote addresses on topics ranging from managed care contract analysis, integrated delivery system development, medical tourism, contracted reimbursement, and global healthcare program development.

    In her role with Mercury Healthcare, she leads the world's first and only globally integrated health delivery system® making its vast integrated provider network available by contract to a variety of payers of health benefits, including insurers, third party administrators or employers. Mercury also grants access to individual consumers seeking local care and domestic and international health travel for elective healthcare and related services, and manages logistical coordination and medical case management services for clients.