The Importance of Due Diligence and Vetting Global Healthcare and Insurance Provider Network Partners

In this iPMI Global Insights article, we read the recent iPMI Global LATAM iPMI Strategies Round Table, and ask, how important is the selection and subsequent vetting of network partners? Is Due diligence important?

Firstly, vetting ensures access to a network of quality healthcare providers, hospitals, and clinics. AP Companies highlights the importance of their "extensive global medical network, featuring top-tier healthcare providers, hospitals, and clinics across LATAM". This suggests that a process of vetting is necessary to guarantee that the network consists of reliable and high-standard medical facilities and professionals.

Secondly, vetting is crucial for cost containment. AP Companies explicitly mentions delivering "cost-containment solutions tailored to the unique challenges and opportunities within the LATAM region" and their "expertise in reducing medical and operational expenses through sophisticated automated systems and negotiations with providers".

Similarly, AXA Partners US focuses on "helping LATAM insurers control medical claims costs both within the US and globally without compromising access to high quality of care".

New Frontier Group also mentions building "custom networks to ensure fair pricing and discounts". These statements imply that vetting partners involves evaluating their pricing structures and negotiating favourable terms, which directly contributes to cost efficiency.

MDabroad further emphasizes that provider network management must be proactive to ensure fair pricing and avoid fraudulent billing, suggesting that vetting is a preventative measure against overcharging and fraudulent activities.

Thirdly, vetting contributes to operational excellence. AP Companies states that their local presence and robust provider networks ensure "tailored solutions that meet the region's diverse needs while addressing growth opportunities effectively" and that their "deep understanding of the region allows us to streamline operations and ensure regulatory compliance".

Best Doctors Insurance also notes that efficient operations help companies "navigate regulatory environments". This suggests that vetting involves selecting partners who can align with operational standards and regulatory requirements, leading to smoother processes and reduced risks.

Finally, vetting helps in building strong and reliable partnerships. New Frontier Group mentions maintaining "strong relationships with providers", and AP Companies refers to "strategic provider partnerships". Establishing such relationships likely involves a vetting process to ensure that partners are dependable and share similar standards of service and ethical practices.

iPMI Global Analyst Christopher Knight concludes, “In summary, vetting network partners in the Latin American insurance market is essential to guarantee quality of care, control costs, ensure efficient operations and regulatory compliance, and foster strong, reliable partnerships.

Vetting and maintaining a high-quality global healthcare network supports operational excellence. Partners who adhere to high standards of service and ethical practices contribute to smoother claims processing, reduced administrative burdens, and fewer compliance issues.”

ON THE FRONT COVER: One of the most famous landmarks in Latin America is the ancient site of Machu Picchu in Peru. This World Heritage Site is an impressive Incan citadel nestled at the high altitude of 2,430 meters and set amongst the postcard-perfect Andes Mountains.

"The Latin American insurance and assistance market presents a dynamic and promising landscape with significant growth potential. However, success requires a deep understanding of the regional nuances, effective management of complex regulatory frameworks, strong operational capabilities, and an unwavering focus on providing accessible and affordable solutions to diverse populations. Companies that embrace innovation, leverage technology, and build strong partnerships will be best positioned to capitalize on the opportunities and drive positive change in the region." Christopher Knight, CEO, iPMI Global.

Download iPMI Global LATAM iPMI Strategies Round Table 2025

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We hope you enjoy reading this RT report, as much as we enjoyed pulling it together.