As a payer, you can maintain and grow your brand identity while leaning on the 24/7 operational plateau, the worldwide providers network and the cost containment programs of WMMS. We white label, using your brand front and center with every healthcare entity to whom we direct your insureds for care. We will process calls, bot chats, what’s app chats, and emails under your brand, as well as using your brand in all our communications with the providers network. In this way, you benefit from brand recognition through the entire medical case handling process.

• Our first priority is to prevent simple cases from escalating by leveraging our network of urgent care clinics and board-certified house call doctors.
• Adherence to care protocols. When further treatment is required, we recommend in-network providers and ensure that care adheres to InterQual guidelines to avoid overutilization.
• Second Medical Opinions. Before any invasive procedure, we coordinate second medical opinions.
• Real-time reporting. During the course of treatment, we expedite the release of medical reporting so that you can make treatment decisions proactively, not reactively. (Normal hospital records release could involve wait times of as long as 60 – 90 days).
• We benchmark Medicare rates on clean claims. When claims are received, they are cleaned before they are repriced. Regardless of claim date, we negotiate repricing with Medicare rates as our benchmark.

WMMS emphasizes in observing all the drivers that deliver quality care to your insureds. Our patient satisfaction research tells us that these factors drive patients satisfaction with their payer during an episode of care in every country around the world:

• Care quality. We identify and direct patients to Centers of Excellence based on outcomes for the condition being treated.
• We arrange for patients to get prescribed medications, often providing delivery right to their doors.
• Provider choice. Each patient may choose from a minimum of three highly qualified physicians and/or in-network care facilities. Suggested facilities are based on outcomes (e.g. the highest survivor rates and the lowest infection and mortality rates) and cost, ensuring the best possible patient treatment at a fair price.
• Care Coordination. We coordinate patient appointments. We minimize out-of-pocket payments.

Communication. During the episode of care, we communicate with the family member appointed as the point person, to keep family members apprised of the patient’s status. We provide translation in English, Spanish, Portuguese, Haitian, French and Russian.