CrossCare Global Health Plan Solutions™

Extend your healthcare network beyond borders.

Solutions for Employers, Health Plans, TPAs & Insurers

Connect eligible members with carefully evaluated international healthcare providers, specialist second opinions and global Centers of Excellence — while gaining greater visibility into the complete cost and coordination of each healthcare journey.

Global Healthcare Access. Intelligent Cost Management. One Coordinated Journey.

CrossCare Global is not an insurance company. We provide technology, evaluated global provider access, navigation, coordination and cost intelligence. Coverage determinations, medical-necessity decisions and authorization decisions remain with the relevant payer or plan.

How an enterprise case moves

An international healthcare navigation and coordination platform for employers, self-funded health plans, TPAs, insurers, benefits organisations and other approved healthcare purchasers seeking appropriate global Centers of Excellence, international second opinions and transparent total journey cost comparisons.

Employer / Health Plan / TPA / Insurer → CrossCare Global

01Clinical case preparation
02Global provider matching
03International second opinion
04Cost intelligence
05Authorization workflow
06Travel coordination
07Treatment
08Recovery
09Follow-up

The enterprise value proposition

Global Access

Extend access to carefully evaluated healthcare providers and specialists across international markets.

Cost Intelligence

Compare appropriate domestic and international healthcare pathways using the complete estimated journey cost — not hospital price alone.

Member Navigation

Coordinate medical records, consultations, treatment planning, travel, accommodation, hospital admission, recovery and follow-up.

Continuity of Care

Pre-treatment preparation and post-treatment follow-up are built into the international care pathway, not added afterwards.

Who we partner with

Approved healthcare purchasers offering eligible members or employees access to international healthcare options.

Self-funded employersEmployer health plansThird-party administratorsInsurance companiesInternational insurersEmployee-benefits organisationsBenefits consultantsGlobal corporationsGovernment health programsExpatriate health plansMedical assistance companiesApproved associations & healthcare purchasers

Case intake channels

Every case receives a unique CrossCare Case ID. Enterprise dashboards use role-based access and avoid exposing unnecessary personally identifiable information.

Member self-referralEmployer referralTPA referralInsurer referralBenefits administratorCrossCare coordinatorHospital referralAPI integrationSecure bulk eligibility integration

Member eligibility workflow

Your organisation configures the programme rules; the platform checks them before a case advances.

Eligible member populationEligible proceduresExcluded servicesPreferred countriesPreferred providersBenefit maximumTravel benefitCompanion benefitHotel allowanceFlight allowanceRecovery allowanceSecond-opinion requirementsPrior authorization requirementsDomestic second-opinion requirementsMinimum expected cost thresholdMinimum potential cost differenceClinical exclusions

Statuses

Potentially EligibleEligibility Verification RequiredEligibleNot EligibleAdditional Information RequiredAuthorization Required

AI never makes a final coverage determination. Those decisions stay with authorised human reviewers in your plan's workflow.

AI Medical Record Intelligence

  • Organise records
  • Classify document types
  • Identify dates
  • Create timeline
  • Identify missing documentation
  • Identify duplicate records
  • Generate structured case summary
  • Prepare case for professional review
  • Support translation where appropriate

Missing Information Detector

Additional information may be required before provider review:

Recent MRIPathology reportMedication listPrevious operative reportRecent laboratory results

Global Second Opinion Network™

  1. 01Case prepared
  2. 02Provider selected
  3. 03Records securely transferred
  4. 04Specialist review
  5. 05Written opinion received
  6. 06Teleconsultation if required
  7. 07Opinion returned to member / authorized payer workflow

Each opinion clearly identifies the specialist, hospital, country, credentials, review date, opinion status and follow-up recommendation. AI may organise and summarise an opinion — it never impersonates the physician.

Where AI stops and clinicians decide

AI performs

Data organisationMatching supportCost calculationsWorkflow automationMissing information detectionDocument classificationJourney coordination

AI never performs

Final diagnosisFinal medical-necessity determinationFinal treatment recommendationFinal insurance authorizationFinal provider clinical decision

Cases reaching these points are flagged Clinical Review Required for authorised clinicians or medical reviewers.

CrossCare Global Centers of Excellence Network™

View the network

Hospitals qualify for individual clinical categories — no hospital is designated excellent at everything, and no provider carries the designation before verification and compliance review.

Cardiac Surgery CenterOrthopedic CenterOncology CenterSpine CenterFertility CenterExecutive Health CenterNeurology CenterComplex Surgery CenterHematology CenterTransplant CenterAdvanced Cancer CenterCellular Therapy CenterRehabilitation CenterWomen's Health Center

CrossCare Value Matrix™

Provider selection weighs thirteen factors, so the lowest-priced hospital never becomes the recommended option by default. Providers are never ranked by referral commission.

Clinical suitabilityProvider qualitySpecialist expertiseAccreditationExpected costTotal journey costTravel burdenVisa complexityRecovery requirementsContinuity of careMember preferenceProvider availabilityRisk considerations

Decision hierarchy

  1. 1 Clinical appropriateness
  2. 2 Quality & safety
  3. 3 Member choice
  4. 4 Continuity of care
  5. 5 Total Journey Cost™
  6. 6 Financial value

Global Savings Intelligence™

Compare the domestic expected allowed cost against the complete Total Journey Cost™ — treatment, physician fees, diagnostics, travel, accommodation, companion, navigation, visa, recovery, coordination, follow-up and contingency. Results are shown as an estimated cost difference, never as realized savings.

Open cost comparison
Demo DataIllustrative programme aggregate

Estimated aggregate domestic cost

$1,842,000

Estimated aggregate Total Journey Cost™

$903,400

Estimated net cost difference

$938,600

Average case coordination time

34 days

Orchestrated by Journey Intelligence™

One journey object drives every authorised dashboard. Enterprise cases reuse the existing CrossCare modules — no parallel systems.

01Case received
02Eligibility
03Medical records
04Missing information
05Clinical review
06Provider match
07International second opinion
08Provider quotation
09Total Journey Cost™
10Global Savings Intelligence™
11Payer authorization
12Member choice
13Teleconsultation
14Travel preparation
15Treatment
16Recovery
17Return home
18Follow-up
19Claims / cost reconciliation
20Outcome reporting

Member Choice Center

International treatment is presented as an option, never as pressure. Members see the domestic option where available, hospital and physician information, travel requirements, potential risks, cost information, recovery requirements, follow-up arrangements, their responsibilities and alternatives.

I'm InterestedRequest More InformationSpeak With Care NavigatorRequest Second OpinionDecline International Option

Declining an international option carries no negative consequence for the member.

Member incentive engine

Configurable where legally permissible. Nothing is activated by default — every incentive requires enterprise compliance approval before it appears to a member.

$0 member cost sharingReduced deductibleReduced coinsuranceTravel paidHotel paidCompanion airfareDaily allowanceRecovery supportCash incentive where legally permittedPaid caregiver travel

CrossCare Global Care Concierge™

Passport readinessVisaHospital invitationFlightsAirport pickupHotelCompanionInterpreterHospital appointmentsAdmissionTreatment scheduleMedication coordinationDischargeRecovery accommodationGround transportationReturn flightMedical recordsPost-treatment consultationDomestic physician handoffTelecareEmergency escalation information

Care doesn't end when the flight lands.

Before travel

  • Identify domestic physician
  • Confirm medical history
  • Prepare records
  • Confirm fitness for travel where required
  • Establish follow-up plan

Before discharge overseas

  • Discharge summary
  • Operative report
  • Imaging
  • Pathology where relevant
  • Medication list
  • Follow-up instructions
  • Complication warning signs
  • Emergency contact information

After returning home

  • Teleconsultation
  • Domestic physician handoff
  • Rehabilitation
  • Medication management
  • Wound care where relevant
  • Lab monitoring
  • Outcome collection

Care Escalation Protocol

  1. 01Identify whether the member is overseas or home
  2. 02Display the appropriate hospital emergency contact
  3. 03Notify the CrossCare coordinator
  4. 04Notify the authorized payer contact where permitted
  5. 05Notify the treating provider
  6. 06Provide relevant records
  7. 07Coordinate local medical evaluation
  8. 08Track incident and resolution

AI is never used alone to manage a medical emergency. In an emergency, contact local emergency services immediately.

CrossCare High-Cost Case Navigation™

For eligible planned cases where international alternatives may warrant evaluation. Emergency cases are never routed internationally.

Orthopedic surgerySpine surgeryCardiac proceduresOncologyComplex diagnosticsFertilitySelected planned surgeriesAdvanced specialist treatment

CrossCare Advanced Treatment Access™

Where the objective is clinical access, expertise, treatment availability, second opinion, evidence and regulatory status — not cost. These cases never lead with savings.

International second opinionsAdvanced oncologyCAR-T / cellular therapyRare disease expertiseComplex surgerySpecialist expertiseClinical trial exploration

Governance, roles and compliance review

Roles & permissions

Enterprise Super AdminBenefits DirectorPlan AdministratorMedical DirectorClinical ReviewerClaims AnalystFinanceCase ManagerCrossCare CoordinatorRead-Only ExecutiveHospital UserMember

Compliance review areas

HIPAAERISAState insurance regulationBusiness associate agreementsCross-border health dataProvider contractingMedical licensureTelemedicineInformed consentClaims administrationUtilization managementAnti-kickback considerationsMember incentivesTravel liabilityMalpracticeClinical trial regulationsInternational payment requirements

Each area carries a review status: Not Reviewed • Under Review • Requirements Identified • Approved • Restricted.

Authorization statuses

Not RequiredPendingAdditional Information RequiredClinical ReviewApprovedApproved With ConditionsDeclinedExpired

Every authorization action is written to the audit log.

Designed to support enterprise healthcare privacy and security requirements. CrossCare does not claim certification that has not been independently verified.

Integration architecture

Secure APIs and webhooks are architected for the systems below. Integrations are only described as live once they are actually connected for your organisation.

Eligibility systemsClaims platformsTPAsHR benefits platformsInsurer systemsElectronic health recordsHospital systemsTravel providersPayment platformsTelehealth platformsIdentity providers

Global Healthcare Value Report

Board-ready reporting for your programme. Estimated differences are never presented as realized savings.

Cases reviewedCases completedDomestic expected spendActual international program spendTravel + coordination spendFinal total spendRealized cost differenceMember satisfactionClinical outcome measures availableFollow-up completionTop destinationsTop procedures

Discuss a global health plan strategy

Tell us about your population and objectives. A CrossCare enterprise lead will follow up with an appropriate programme design conversation.

CrossCare Global is not an insurance company and does not make coverage, medical-necessity or authorization determinations. Those decisions remain with the relevant payer or plan and its authorised clinical reviewers.

Illustrative estimates are not guarantees. Final costs require confirmation from providers and applicable service partners. Designed to support enterprise healthcare privacy and security requirements.