Background

Medical Case Management

background
Medical Case Management
Medical case management is the operational backbone of cross-border healthcare. It connects eligibility, clinical coordination, provider selection, bedside support, and reporting into one accountable workflow so insurers, corporates, and government institutions can deliver consistent outcomes across countries and time zones.

Scope of the Service


We coordinate the full episode of care: triage and intake, clinical guidance, provider and specialist routing, appointment scheduling, admission support, inpatient and outpatient follow-up, translation where required, medical documentation collection, and discharge planning. We align the treatment plan with policy rules, authorizations, and service limits defined by the contracting entity.

How the Process Works


1) Intake and case opening with clear data capture (member details, symptoms, policy context). 2) Clinical review and routing to the right provider within the network. 3) Coordination of appointments, diagnostics, and treatment steps with real-time status updates. 4) Ongoing medical follow-up and escalation for critical decisions. 5) Consolidated reporting (medical summary, utilization, and next-step recommendations) for stakeholders.

Why Mest Assistance


We combine medical expertise with operational control: 24/7 case coordination, structured documentation, and transparent communication. Our multi-country network and local execution help reduce delays, prevent fragmented care, and keep decision makers informed with practical, audit-friendly case notes.

Who This Service Is For


Insurance companies (TPA/assistance), self-insured corporates, government programs with international members, and high-volume international clients needing standardized case handling and measurable outcomes.