We are going to share two recent cases that shine a light on the remarkable aspects of comprehensive insurance coverage. These instances not only saw our insurance covering the entire cost (yes, a whopping 100%) of serious medical situations but also showcased our active involvement in guiding our clients through the complexities of the healthcare system.
To safeguard the privacy of our clients, we will refrain from disclosing specific details, including the names of the hospitals involved. Let’s delve into these narratives, shedding light on the vital role of insurance in times of medical crisis.
Case 1: A Swift Surgical Solution.
It all began with a call, an urgent summons to action, regarding a client already confined within the walls of a hospital. The clock was ticking – insurers require notification within 48 hours for comprehensive coverage.
This window facilitates critical arrangements such as Direct Billing (DB) and the issue of a Guarantee of Payment (GOP). The patient urgently needed surgery, which was necessary to be performed at the earliest possible day.
In response to this critical situation, we immediately activated our team in charge of in-patient treatment. The objective was clear: orchestrate Direct Billing (DB) before the discharge from the hospital.
The result? A success story.
The client smoothly transitioned to recovery at home post-discharge, and to top it off, the insurance covered the entire bill.The numbers tell their tale.
The required hospitalization spanned one week, with the cost amounting to JPY 4,156,000, approximately equivalent to US$27,600.
Case 2: Navigating Unpredictability
In the second case, we encountered a unique scenario. A typically healthy individual, rarely in need of medical attention, faced the stark reality of an unforeseen diagnosis – cancer.
The unpredictability of life struck hard, underscoring the importance of preparedness for the unexpected. Though the specifics of the case will remain undisclosed out of respect for privacy, the overarching message is clear – life can take unexpected turns, and it’s essential to be ready for such surprises.In both cases, clients wisely designated someone to communicate with me on their behalf, allowing them to focus on treatment. It allowed them to focus entirely on the healing process, leaving the administrative aspects in capable hands.
For the cancer diagnosis case, the client had time to schedule the date and time for admission to the hospital. A prompt notification reached me as soon as all details had been confirmed. Subsequently, a comprehensive health report was sent to us, initiating immediate communication with the insurance team. The primary task at hand was to verify eligibility for the proposed treatment. Thankfully, due to the absence of any pre-existing conditions related to current health, the approval by the insurer was fast.
Step 2 (Pre-admission): Direct Billing (GOP)
The next phase of the journey involved our Special Japanese Team in Tokyo. As native speakers, this dedicated team interfaced with the treating doctor, securing estimated costs and successfully issuing a Guarantee of Payment (GOP) before the scheduled admission. It’s worth emphasizing the quality of communication in both cases, marking them as prime examples of effective teamwork.
The required hospital stay for this case was one month, and the initial cost amounted to a staggering JPY 20,000,000, equivalent to US$133,500.
This substantial figure encompassed not only the surgical procedure, but also the provision of a private room, meals, and other amenities. It is important to note that radiotherapy may require an additional cost, which would be seamlessly covered by insurance.
