Healthcare 99 appoints Gallagher Bassett to administer the fund
After careful consideration, the Trustees of Healthcare 99 scheme have made the decision to move the claims management for the scheme to Gallagher Bassett. The effective date of the change is 28 October 2019.
Gallagher Bassett is the largest multi-disciplinary Third Party Claims Administrator in New Zealand, managing claims on behalf of insurers, brokers, government bodies and self- insured organisations. We are also pleased to let you know that we will have a dedicated Claims Manager, Christine Madden.
New options - Direct Payment to Provider
We are delighted to be in a position to offer this new service. What this means for members, is that as part of the pre-approval process for surgical claims, the pre-approval letter will set out how much Healthcare99 will fund, and request the provider to send invoices direct to Gallagher Bassett up to the pre-approved amount for payment. To provide increased comfort, before incurring the cost, we would also recommend seeking pre-approval for diagnostic procedures such as MRI scans, with Gallagher Bassett being able to pay direct to the treatment provider should the claims be accepted.
We believe the ability to have costs pre-approved and paid direct to treatment providers lets you, the member, get on and have the treatment, without having the worry about funding the entire treatment cost and seeking reimbursement.
What happens if I lodge a claim now?
Aon will continue to assess and manage claims until the 23rd of October. From the 23rd, Aon will scan and send any new claims to Gallagher Bassett, who will assess member's claims.
What happens if I already have a pre-approved claim?
If you have paid the invoices, claim these back in the normal way. Any claims assessed and approved after the 23rd of October will have the choice of either paying the provider direct, or having the invoices paid directly by Gallagher Bassett.
Is there a minimum amount that Gallagher Bassett will pay direct?
The offering to pay providers direct is really there to help financially with larger bills, such as MRI scans, ultrasounds,
and surgical costs. Most providers for the likes of prescriptions etc will still require payment upfront, which will need to be claimed back.
I am still unsure how this affects me. Who should I ring?
We are working hard with Gallagher Bassett and Aon to ensure a smooth transition, and whilst we remain confident that this will be the case, sometimes things don’t always work out. Here’s a plan to work by:
- I have questions about the changeover – Contact Amanda Smith 0800 653 473 Amanda@firefighters.org.nz
- I have a question contact the team at Gallagher Bassett via option 2 on our 0800 653 473
We are also very excited for future developments that Gallagher Bassett will roll out to members, making access to benefits simplified and easy.
Respectfully
The Trustees of Healthcare 99
