Often every 3 years, companies begin to feel the itch for a new HMO for their employees. Such is the average life-span of a company-HMO relationship, confirms Norman Amora, Vice President for Sales and Marketing of leading HMO Intellicare. But it need not be that way. Intellicare’s relationships with a lot of its clients prove it.
The need to look for a new one is usually triggered by laxity or the sudden successive failures of HMOs to deliver on their promises. Sometimes, it happens when top management actually experiences the failure of the HMO. This habit of shifting every 3 years or so can put a tremendous stress on companies, their employees, most especially who benefit from the health plans.
Part of what makes the use of HMO cards effective is the cardholder’s knowledge and keen understanding of the coverage of the plan. If a member does have a clear understanding of what his or her health policy covers, the member is able to maximize the use of the card to its best potential.
The set of pre-existing conditions in particular is a critical portion of a health plan. This is one aspect that leading HMO Intellicare pays meticulous attention to.
For Intellicare, a health plan’s set of pre-existing conditions defined early on is something they could never overemphasize. To them, no one should ever underestimate the repercussions of a misunderstood health plan.
By standards, pre-existing conditions are usually not covered on the first year of one’s membership. However, for corporate accounts, the one year waiting period may be waived depending on the agreement based on negotiations. Examples of pre-existing conditions include hypertension, goiter, cataract, tumor, cyst, arthritis, diabetes and cancer.
The consistency in service of HMOs must never vary. If patients get outstanding service in Metro Manila or where an HMO’s business is concentrated, then patients from other parts of the country must get the same deal. In the world of health care, no discrimination or neglect of any form should ever be allowed.
Leading HMO Intellicare is one HMO that strongly adheres to this belief.
HMOs are not entirely business ventures, as Intellicare has been tirelessly pointing out. It’s a business that should actually care, where one must be very keen enough 24/7, no matter the stress caused by irate patients and their families. Health care is a venture that has no room for compromises or excuses.
Unpleasant experiences with HMOs usually come from their lack of consistency in service. This consistency is manifested on two fronts—customer service and their medical facility affiliates.
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