Optimum Referral. Easily accessible, appropriate healthcare for businesses with more than 250 employees.

Optimum Referral is designed to deliver a high standard of medical care in the right place, at the right time, working on an open referral basis.

What this means is that during a visit to their GP, employees simply ask for their onward clinical referral to be unrestricted, so it doesn’t name the consultant or facility where they will receive treatment. This enables our claims consultants to work with the member to identify the specialist and hospital best suited to their specific needs, all of whom meet our quality criteria.

As patient safety is our key concern, all the facility choices are underpinned by industry quality standards with the majority of hospitals having been hand picked based on Care Quality Commission and Health Improvement Scotland ratings.

We’ll also only recommend specialists who meet the professional standards of the relevant governing bodies, including, but not limited to, the General Medical Council. Rest assured, we’ll only work with specialists who are trusted from a clinical perspective, and whose charges we believe are fair and reasonable.

We also promise that where the open referral process is followed, there will never be a shortfall when payment is due. Eligible bills are settled in full, directly, ensuring peace of mind to the employee receiving treatment as well as reassurance that benefit budgets are being spent wisely.

We’ve created a useful brochure and handy aid to help you understand how Optimum Referral can be of benefit to the entire workforce.

A great choice for employees

  • Employees can manage their claims, their way – they can choose to start their claim online via MyAviva or over the telephone
  • Extensive choice – our claims team will discuss options and provide information so they can make an informed decision about who they want to see and where
  • Simplicity – there's no need for employees to chase around making contact with a specialist whom they've never met; our claims consultant can transfer an employee to the right person from the outset
  • Quality treatment guided by needs – members receive appropriate treatment, undertaken in quality facilities.
  • Flexibility – we won’t interrupt the flow of a claim where the member is already following a treatment plan. Equally, we’ll look to provide alternative treatment providers where required.
  • Bills settled directly – no need to worry, eligible bills will be paid in full.

A great choice for business, too

  • Cost control & Management – our pricing approach reflects the value of long-term relationships. And, we challenge doctors, evaluate fees and embrace medical advances to maintain quality and value.
  • Tackling the key reasons for escalating costs – Dedicated case management of conditions such as mental health, musculoskeletal and cancer, to aid employee recovery and return to work
  • Regular reviews and reports – to demonstrate how the scheme is running, in terms of both cost and performance.

For more information on all the benefits available on Optimum, please call our Sales Support team on 0800 001 4272 or speak with your usual Aviva account manager

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