Social and Health Care Insurances SZV will be introducing some sweeping changes to its medical referral system mid-June in an effort to make the process more efficient and client friendly.
Under the new procedures medical practitioners will submit medical referral requests using SZV’s new web-based program. Patients will no longer have to visit SZV to take in their referral requests. SZV will also initiate the first contact with patients. Patients will be contacted within two working days of receipt of the request and will be given a detailed explanation of the process of their referral.
Three working days after the initial contact the patient will be informed whether their request has been approved or denied. An additional five working days afterward, the patient will receive an appointment date to visit SZV for their “intake-meeting.” A separate process will be applied to urgent cases, which require treatment within seven working days.
SZV will maintain close contact with the physician during the entire process and if additional information is required, the insurance service provider will contact the physician directly.
Unlike the current system, patients would only have to visit SZV’s office once to collect their travel documents. All arrangements including booking of tickets will be done by SZV’s Medical Referrals Department.
SZV has been working on the process to improve its referral system since the third quarter of 2013. “We have been working with internal and external parties on improving, documenting and finalizing the process,” said Manager of Health and Labor at SZV Dr. Chandra Rombley.
The new web-based program was developed by SZV’s in-house Information Technology team.
Rombley said the change was necessary. “It is no secret that medical referrals has been the talk for some time from articles in the newspaper and numerous complaints. SZV has been listening and has used this to improve the services for our clients. The ultimate goal of SZV is to provide better, faster and more efficient service to all insured,” she said.
“SZV knows that dealing with an illness can be very stressful on the patient. Having to travel abroad for medical treatment adds on to this already existing stress. With this new process SZV will do its utmost to eliminate the additional stress of having to travel abroad for medical treatment. The patient is and will remain the main focus. All arrangements will be made by SZV; the patient only has to visit the SZV office on one occasion. The patient will be fully informed and guided throughout the entire process.”
SZV sends an average of 200 patients abroad for medical treatment per month, which is a very costly process. “SZV together with its stakeholders are also looking at the possibilities of making more specialized medical care available locally which in turn will decrease the amount of medical referrals.”
SZV has had three information sessions and workshops for general practitioners on the changes. Almost all of the general practitioners in St. Maarten attended the sessions. They were informed about the new processes and a demonstration of the new web-based program was given. Those present had an opportunity to test the new web-based program and were able to give their feedback, which was used as a basis to tweak and improve the new process. Rombley said the sessions were “very interactive” and noted that “general practitioners are eager and enthusiastic to start working with the new process.”
SZV also met with the medical coordinator of St. Maarten Medical Center as the new program will also be used by SMMC medical specialists.
