Full patient journey support

The patient journey management service offered by SmartHumed helps stakeholders without specialised knowledge to navigate the complex labyrinth of the sector (e.g. alternatives, processes, financing, etc.). The main goal of patient pathway management is to play the role of independent quality assurance on the side of individual users and service financing companies-insurance companies-funds, across institutions, during the use and administration-accounting of health-social services.

In practice, the patient journey manager team, which knows the entire process well, not only supports the client at each step, but also takes him by the hand throughout the entire service process, so he really only has to deal with his recovery.

General elements of the patient journey management services provided by SmartHumed:

navigation: perusal of health documentation, assessment of health status, pre-qualification and online or telephone counseling and patient management (e.g. consultation with e-family doctor or practice, prior selection and involvement of specialist specialist and service provider)

assistance: pre-sales administration support, comprehensive healthcare service organization and other support, quality assurance of hospital and other service processes (diagnosis, consultation, surgical preparation, surgical intervention, post-operative rehabilitation, other)

aftercare: support for medical, financial and other administration documentation, as well as financial settlement with insurance companies and other institutional financiers (e.g. prior authorisation, subsequent reimbursement, etc.), follow-up and related online or telephone advice (including health consultation support)

Surgery date within 15 days

During the use of health services, with continuous, personalized SmartHumed patient journey manager support, the process of conducting surgeries:

information about the service within 48 hours after the application for surgery and the complete availability of the medical information required for pre-qualification

if necessary, within 15 days, a proposal for a personal specialist consultation or other examination

within 15 days of the full examination, a recommendation for surgery (provider, specialist, date)

According to the protocol, there is no longer waiting time than necessary, so recovery can be much faster!

Up to 6x faster recovery

The guaranteed surgery date within 15 days means that the difficulty of the process can be overcome in a few weeks, and in the state system, compared to the often hundreds of days of waiting for surgery, a much faster recovery can be achieved, and a return to normal life sooner.

Type of surgery	Hip replacement	Knee replacement	Major extended spine surgery
Average waiting time	up to 210+ days	up to 430+ days	up to 320+ days

Type of surgery	Corneal surgeries	Gallbladder removal	Hernia surgeries
Average waiting time	up to 300+ days	up to 160+ days	up to 160+ days

Source: NEAK database (data as of 31.12.2022)

HUF 3 million surgical coverage

The risk inpatient insurance provided by Alfa Biztosító Zrt. is a so-called all risk type product, i.e. the coverage includes all surgical interventions that are available on the market as private healthcare services. Basically, three rounds of surgery are not covered:

surgeries financed by national insurance and thus primarily available in state hospitals,
based on the insurer's decision to assume risk, surgeries that are excluded from coverage (e.g. cardiology),
as well as interventions that become necessary in connection with pre-existing diseases excluded based on the individual medical history of the insured.


Surgery performed as part of inpatient care	HUF 3,000,000 / insured event / year

	if the cost of surgery	the total cost of the surgery
	Between HUF 100,000 and HUF 200,000	20%, of max. 40 000 Ft
	Between HUF 200,001 and HUF 500,000	15%-a, of max. 75 000 Ft
The cost of additional tests and medical consultations	Between HUF 500,001 and HUF 1,000,000	10%, of max. 100 000 Ft
	Between HUF 1,000,001 and HUF 2,000,000	7%, of max. 140 000 Ft
	Between HUF 2,000,001 and HUF 3,000,000	5%-a, of max. 150 000 Ft

The private market price of some surgical interventions, which can be a significant cost burden for individuals and families if they arise unexpectedly:

Type of surgery	Hip replacement	Knee replacement	Major extended spine surgery
Private hospital price:	from approx. HUF 1.5-2.3 million	from approx. HUF 1.5-2.3 million	from approx HUF 1.5-2 million

Type of surgery	Corneal surgeries	Gallbladder removal	Hernia surgeries
Private hospital price:	from approx. HUF 0.5-0.6 million	from approx. HUF 0.5 million	approx. HUF 0.4-1 million

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