While we have negotiated discounts with most of our direct pay providers, the Regional Service Center1 (RSC) model is critical to our ability to deliver significant cost savings in three major ways.
Discounts and Local Fee Schedule2
Many doctors and hospitals outside the US use different fee schedules for foreign and local patients, and foreigners are frequently charged higher rates. By working with local networks that have strong market leadership positions, we are able to enjoy discounts from local fee schedules that our competitors may be unable to offer.
Local Case management and advice
Expatriates have the benefit of local clinical expertise from over 450 medical professional located within our RSCs or medical emergency service. They provide 24/7 guidance, especially valuable in critical, complex medical situations. Through local medical monitoring and utilization management, we can reduce unnecessary bed days, promote lower cost / lower intensity treatment when medically appropriate, and provide feedback to contracted providers helping them correct medical over- or under-treatment.
Oversight of the billing process
As providers know that local experts are overseeing the process, providers are more apt to bill properly. This provides better detection and remediation of provider "mis-billing" - what is called the "deterrent effect"
1 Some Regional Service Centers are operated by MetLife affiliates and some by third parties contracted by MetLife.
2 Cost savings are largely the result of the purchasing power of the RSCs and their ability to monitor local providers.