Utilizing CISI in an Emergency

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Presentation transcript:

Utilizing CISI in an Emergency Comprehensive Worldwide Health Insurance & 24/7 Medical/Travel/Technical Assistance Utilizing CISI in an Emergency Presented to: University System of Georgia Board of Regents Presented by: Steve Hopkins, Senior Account Executive Cultural Insurance Services International (CISI)

Cultural Insurance Services International (CISI) and our Partners: Located in Stamford, CT Primary Focus – Insuring Cultural Exchange Participants Claims processed by CISI’s Benefit Analysts in Stamford, CT CISI Hours: Mon-Fri 9:00 to 5:00 pm Medical Assistance Partner – AXA Assistance, Chicago, IL – available 24/7 Security Assistance Partner – i-JET, Annapolis, MD – available 24/7

Georgia System Plan Benefits/Limits:

Working Together to Ensure Success CISI is the designated TPA for the proposed plan. The underwriter for CISI policies are generally Chubb/ACE Insurance If the emergency is medical or technical in nature, Team Assist will work to resolve the issue If the emergency is security related, Team Assist will make a “warm transfer” to our security partner (iJET) The CISI Claims Team will work with Team Assist to make sure all eligible claims are paid. The CISI Crisis Team will monitor open case files and act as liaison for University and the assistance company. FROM POINT OF ISSUE, Insureds have one number to call. Our Team Assistance partner, (AXA), takes the call and proceeds as needed (from security evacuations to medical issues to simple questions) There are always two routes of contact for the University. The Account Manager is ALSO available to the University to address concerns, to provide guidance and advice, to aid communication, and to make sure that all of the other pieces are functioning as designed.

Checklist: Basic Claim If emergency – seek local emergency services first When possible – Notify AXA (pre-approval is not required. Notice is important but not necessary.) Payment: Direct Pay or Reimbursement Monitoring / Adequate Facility / Adequate Course of Treatment Other Issues: *Semantics of “Insurance”

Pay and Submit for Reimbursement Often times, international medical providers prefer to collect money from the participant up front for acute medical care. Should the participant pay out-of-pocket, they may submit a claim for reimbursement: Collect Itemized Invoice, Bills and or Receipts from Treating Facility Complete CISI Claim Form Submit Claim form and Receipts to the Claims Department by Mail, Fax or Email Direct Bill or GOP CISI has the ability to pay International Providers directly in any currency. In the event that they are unable to direct bill, and the Participant can not pay for the treatment being received or if they are hospitalized, CISI or our Assistance Partner will provide a Guarantee of Payment so your student or staff do not have to pay out of pocket.

Checklist: Medical Evacuation Contact AXA Assistance to open a medical file Transport to nearest adequate medical facility or Transport back to the Home Country if unable to continue the program Must be deemed Medically Necessary by the treating physician in conjunction with one of AXA Assistance’s physicians Evacuation plan specs are provided by the treating physician Must be arranged and approved by AXA Assistance in order for expenses to be covered Other Issues: *Mental/Nervous Nuances, Supervision Before Evac

Return of Mortal Remains/Cremation: Contact AXA Assistance to report the death Transports an insured’s remains back to their Home Country Expenses for embalming, cremation, and a minimally necessary container appropriate for transportation are covered Shipping expenses and necessary government authorizations are covered Must be arranged and approved by AXA Assistance (24/7 assistance provider) in order for expenses to be covered

CISI Mobile Apps (“CISI GROUP”, “MYCISI”) for IOS and Android

EMERGENCY and POINT OF CONTACT FOR INSUREDS: AXA Assistance (Team Assist) (855) 327-1411 (calling toll-free from within the US) (312) 935-1703 (calling from outside of the US, collect calls accepted) Medassist-usa@axa-assistance.us CLAIMS: CISI Claims 1 High Ridge Park Stamford, CT 06905 (800) 303-8120 (203) 399-5130 claimhelp@culturalinsurance.com ADMIN CONTACTS: Non-emergency: 800-303-8120, claimhelp@culturalinsurance.com Emergency or After-hours: 203-550-9028, crisis@culturalinsurance.com Escalation of Claim or Enrollment Issues: Christine Wasil, Director of Operations 203-399-5508, cwasil@culturalinsurance.com Enrollments and Material Fulfillment: Enrollments@culturalinsurance.com (Enrollment Team) Jeanette Torres, Client Services Manager 203-399-5134, jtorres@culturalinsurance.com Kathleen Connors, Associate Account Rep 203-399-5509, kconnors@culturalinsurance.com YOUR ACCOUNT REP AT CISI (For any questions or issues across all of these categories above): Steve Hopkins 866 866 4691 (toll free) / 401 952 8598 (cell) shopkins@culturalinsurance.com