For Insurers & Assistance Companies — Partner With Us
When your insured travelers get sick in Kathmandu, our clinic offers a predictable alternative to hospital OPD queues and inflated tourist-clinic pricing: transparent published rates, English ICD-10 documentation, direct billing, and a dedicated insurer WhatsApp line for case coordination.
What We Provide Assistance Companies
- Direct billing with written GOP — no out-of-pocket for your clients, no surprise invoices for you
- Transparent published rates — $40 consultation, itemized everything, no "foreigner pricing" markup
- ICD-10 documentation — every diagnosis coded properly for automated claims processing
- Same-day turnaround — lab results, reports, and receipts by email within hours, not days
- Dedicated WhatsApp case line — your case managers message directly for status updates, pre-authorizations, and GOP requests
- Cost containment — we recommend the cheapest appropriate level of care; we don't pad bills
- Post-evac receiving — we coordinate helicopter evacuation handoffs and receiving-hospital documentation
Case Management Workflow
- Your client contacts us or arrives as a walk-in with policy details.
- We email your case manager with proposed treatment + cost estimate for pre-authorization.
- You issue a written Guarantee of Payment (GOP) — we treat immediately.
- Post-visit: complete medical packet (ICD-10 report, itemized receipt, lab results) sent to your case manager by email within hours.
- Follow-up care and duplicate documents re-issued free — no administrative friction for your claims team.
Insurers We Already Work With
We maintain active relationships with assistance companies and insurers including World Nomads, SafetyWing, Allianz Partners, AXA Assistance, IMG, GeoBlue, and regional TPAs. Contact us to establish a new direct-billing relationship or add Thamel Clinic to your preferred provider network in Nepal.
Why Insurers Route Kathmandu Cases to Us
- Hospital OPD is expensive and slow — a Kathmandu hospital outpatient visit costs more, takes longer, and generates more claim paperwork than our $40 consult for the same conditions
- Tourist-clinic markup is common — the "international clinic" premium is a known cost issue; our published rates undercut it
- Case resolution speed — same-day documentation means your claims team closes files faster, not in weeks
- The WhatsApp case line — direct case-manager access eliminates phone tag and email lag; status updates in minutes
- Altitude-aware assessment — we understand trek context; "needs evacuation" vs "treatable in valley" is a clinical decision we make correctly
Adding Us to Your Provider Network
- Contact the billing desk — bookings@thamelclinic.org or the WhatsApp line; partnership setup is a single email exchange
- We send our rate card — published prices, no negotiation needed, no hidden fees
- Sample documentation — we send the ICD-10 report template so your claims team can verify compatibility
- Test case — route a client through us; the packet and the process demonstrate themselves
- Then direct-billing starts — your clients present, we treat, you get the invoice; the loop closes
Common Questions
The Insurer That Matters
Not all travel insurers understand adventure travel — the altitude limits, the activity exclusions, the evacuation coverage specifics. For Nepal trekking, the insurer must cover: your maximum elevation, the trekking activity, helicopter evacuation to Kathmandu, and the medical treatment that follows. The insurer that excludes altitude or trekking is the wrong insurer for this trip.
Reading the Exclusions
The policy exclusions are where coverage fails — trekking above X meters, adventure activities, pre-existing conditions, alcohol-related incidents. The list that determines what is not covered is the section to read before purchasing, not after the claim. The policy that excludes your activity is the policy that pays nothing.
The Pre-Authorization Question
Some insurers require pre-authorization for major treatment or evacuation — the notification before the helicopter is called or the treatment begins. The insurer's emergency assistance number should be saved; the pre-authorization call is the process that the coverage requires. For the event that needs evacuation, the insurer's coordination may be required — know the process.
The Exclusion Landscape
Common trekking exclusions: altitude limits (the specific meter caps that the policy sets), adventure activity categories (trekking may be excluded unless specifically added), pre-existing conditions (the untreated or the unmedicated conditions), and the substance-related incidents (alcohol/drugs involvement voids coverage). The exclusions list is where the coverage fails.
Reading the Schedule
The policy schedule specifies: the coverage limits (medical, evacuation), the deductibles, the geographic coverage (does Nepal count as covered area?), the duration limits, and the altitude caps. The comparison shopping should compare the schedule terms, not just the premium — the policy that costs less may exclude the essential coverage.
The Policy Document
The insurance policy document — the actual terms and conditions — is the contract that governs the coverage. The marketing summary does not override the policy language. For the coverage question, the policy document's specific terms (the exclusions, the limits, the definitions) are the answer.
The Pre-Existing Waiver
Pre-existing condition waivers — the insurance that covers the pre-existing conditions if the waiver is purchased (usually within the days of the initial trip purchase). For the traveler with the pre-existing conditions, the waiver option that is available at the purchase provides the coverage that the standard policy excludes.
The Emergency Assistance
The insurer's emergency assistance line — the 24/7 number that coordinates the evacuation, the hospital admission, and the guarantee of payment. For the emergency, the assistance number that is called first.
The Claim Documentation
The insurer requires the claim documentation — the itemized receipt, the diagnosis, the treatment records, and the payment proof. For the traveler who intends to claim, the documentation that is collected at the point of care.
The Policy Language
Insurance policy language — the terms that determine the coverage (the "adventure sports" definition, the "pre-existing" exclusion, the altitude limit that varies by the plan). For the policy selection, the language that is understood.
The Assistance Line
The insurer's 24/7 assistance line — the emergency coordination that arranges the evacuation and the guarantee. For the emergency, the number that is called.
The Policy Language
Insurance policy language — the "trekking" vs the "mountaineering" (the different coverage that is required), the altitude limit that is specified, and the pre-existing that is disclosed.
The Assistance Line
Insurance assistance line — the 24/7 emergency assistance that is called for the evacuation or the serious injury. For the emergency, the assistance that coordinates.
The Policy
Insurance policy — the coverage that is verified (the altitude, the activity, the evacuation that is confirmed). For the trek, the policy that is adequate.
The Assistance
Insurance assistance — the 24/7 (the emergency that is called), the coordination that is done, and the direct billing that may be arranged.
The Direct Billing
Direct billing insurer — the arrangement where the clinic bills the insurer (the cashless that is the convenience). For the supported insurer, the direct billing that is confirmed.
The Out-of-Pocket Route
Out-of-pocket reimbursement — the pay first then the claim (the receipt + the report that is submitted). For the non-direct insurer, the reimbursement that is the route.
The GOP Flow
Insurer GOP flow — the assistance call → the authorization → the direct billing (the coordinated that removes the upfront). For the covered, the activated that is arranged.
The Out-of-Network
Out-of-network cost — the pay-then-claim (the reimbursable that is slower). For the non-partner insurer, the documented that is provided.
The Network
Insurer network — the direct-billing (the partnered that is the GOP). For the covered, the in-network that is the seamless.
The Out-of-Pocket
Out-of-network — the pay-then-claim (the self-pay that is the fallback). For the uncovered-setting, the receipted that is the reimbursement-path.
How does direct billing work for insurer clients?
The client presents policy details; we email your case manager with the proposed treatment and cost estimate; you issue a written GOP; we treat immediately with no out-of-pocket for the client. Post-visit, the complete ICD-10 packet goes to your case manager within hours.
What is a GOP and how do I issue one?
Guarantee of Payment — written authorization that you will pay our invoice directly. Email it to our billing desk or confirm via the WhatsApp case line; we proceed immediately on receipt. GOP eliminates client out-of-pocket and your reimbursement-claim friction.
How fast is documentation turned around?
Same day — the complete medical packet (ICD-10 report, itemized receipt, lab results, treatment notes) is emailed to the case manager within hours of the visit, not days. Duplicate documents re-issued free on request.
Do you control costs or pad bills?
Cost containment is the model — we recommend the cheapest appropriate level of care, publish transparent rates ($40 consultation, itemized everything), and never use "foreigner pricing." The goal is a predictable invoice your claims team can process without surprises.
Can you handle evacuation coordination?
Yes — we coordinate helicopter evacuation handoffs and receiving-hospital documentation, communicate with helicopter operators and your assistance line simultaneously, and stabilize the patient during the GOP/pre-authorization window. Post-evac receiving and follow-up care documentation included.
