Optimum Referral

Optimum Referral is a great solution for large companies looking for health coverage that brings benefits to both your clients, and their employees.

We only recommend specialists who are trusted from a clinical perspective as they meet the high professional standards of the relevant governing bodies. We also only work with those whose charges we believe are fair and reasonable.

Once an employee has obtained an open referral from a GP, their care is tailored to their needs. This will depend on their symptoms or condition, and on the type of clinical referral that they've been given.

On this basis, our claims consultants will discuss a choice of specialists and hospitals with the employee – all of whom will meet our strict quality criteria.

Guaranteed bill payment

Optimum Referral promises 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 members and reassurance to employers that their benefits budgets will be spent wisely.

• Employees can manage their claims online via MyAviva or over the phone
• Extensive choice – our claims team will discuss options and provide information, so that employees can make an informed decision about who they want to see and where
• Simplicity – there's no need for employees to chase around looking for the right specialist or hospital. Our claims consultants can give a warm handover to key hospital groups from the initial call
• Quality treatment guided by needs – members receive the most appropriate treatment, undertaken in quality facilities
• Flexibility – we won’t interrupt the flow of a claim where the employee is already following a treatment plan. Equally, we’ll look to provide alternative treatment providers where required
• Bills are settled directly – no need to worry, eligible bills will be paid in full.

• Cost control and management – our pricing approach reflects the value of long-term relationships
• 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 mental health and musculoskeletal conditions, and of cancer claims, 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.

A key objective of the healthcare provided under Optimum Referral is reducing the costs of absenteeism and promoting wellbeing in the workforce.

BacktoBetter

• Musculoskeletal (MSK) conditions are one of the biggest causes of long-term absence.* The BacktoBetter service offers prompt access to clinical support for members who have MSK symptoms
• Members get the right treatment at the right time, with access to conveniently located physiotherapists where appropriate, without waiting for GP appointments
• BacktoBetter is included as standard within Optimum Referral.

Find out more about BacktoBetter

* Work-related musculoskeletal disorders statistics in Great Britain, 2022-2023. HSE, November 2023. Contains public sector information licensed under the Open Government Licence v3.0

Mental Health Pathway and Pathway Plus

We offer dedicated support for mental health, helping your clients to manage their employees mental health in the workplace. Available as an optional extra, mental health pathway gives your clients’ employees access to dedicated case managers, expert in managing mental health conditions. If chosen, this option will increase the policy premium.

Find out more about the mental health pathway

We want to help your clients' employees lead healthier lives and promote a feeling of appreciation towards their employer. That’s why we offer a number of added value benefits with our Optimum policies:

• Aviva Digital GP* - Provided by Square Health. The Aviva Digital GP app can give your clients’ employees and their covered dependents over 16 around the clock access to private GP video consultations and repeat NHS prescriptions (all NHS England exemptions accepted) at the touch of a button. Aviva Digital GP is available to residents of Great Britain, Northern Ireland, the Channel Islands and the Isle of Man at home or abroad. The terms and conditions and the privacy policy for Aviva Digital GP can be viewed in-app before they sign up. Mobile data charges may apply. If your client has BacktoBetter or Mental Health Pathway, remember they don't need a GP referral and can contact us directly. If the reason for the consultation is related to a complex health need, complex medical history or they have a health need that requires hands-on examination, we may need to get additional information from their clinical team.
• Aviva Wellbeing app* - Whether your clients’ employees want to sleep more, stress less, lose weight or get fit, Aviva Wellbeing could help them achieve lifelong change - one easy step at the time. Terms and conditions and the privacy policy for Aviva Wellbeing can be viewed in-app before signing up. Mobile data charges may apply.
• Aviva Line Manager Toolkit: Mental Health* - Empower line managers to spot the warning signs of poor mental health. The digital Aviva Line Manager Toolkit: Mental Health provides clinically-underpinned, bite-sized videos, designed to help line managers identify signs and symptoms of poor mental wellbeing among team members, both in the physical and remote work environment.
• Get Active* - With access to over 3,000 health and fitness clubs across the UK, as well as providers of at-home fitness and a range of other products and services designed to enhance healthy and happy lifestyles, your clients' employees will enjoy access to some great offers to help them stay fit, happy and healthy. Terms and conditions and the privacy policy can be viewed online before signing up. 
• Stress Counselling Helpline - If your members are having difficulty with the demands and expectations they face, it’s good for them to talk. They can do this through a secure helpline to trained counsellors, helping them to work through problems and resolve them. This service is available 24/7 to members and their insured dependents aged 16 or over.
  
• Mental Health Support* - Looking after mental health is as important as looking after physical health. That's why we've put together a range of information, advice, guidance and tools to help your clients' employee's identify and manage mental ill health, stress and anxiety. It means they can have meaningful help at their fingerstips, exactly when they need it. We've produced ten bite-sized videos for your clients' employees to watch whenever they need to. Designed by our expert clinician, they cover a range of mental health topics. 
  
• MyAviva - We know life is busy, so that’s why we’ve developed MyAviva to make things easier for your clients’ employees. Our online portal will help manage their Aviva policies and schemes in one secure and easy-to-use place. It puts a whole host of benefits at their fingertips, letting them check their policy or scheme information, including cover and benefit details to starting a new claim, update us on an existing one and view authorised treatments. It’s available to download from the App Store or Google Play. Mobile data charges may apply. 

* These services are non-contractual benefits that could be changed or withdrawn by Aviva at any time. To be eligible for Wellbeing services, your clients' employees must be permanent residents of Great Britain, Northern Ireland, the Channel Islands, or the Isle of Man.

We understand that receiving a cancer diagnosis could be life changing and your client’s employees may experience a whole host of emotions. Our specialist cancer services provide help and support for them and their loved ones throughout their cancer journey and beyond. 

• Dedicated Cancer Claims Team – Our Cancer Claims Team are so much more than claims consultants. They’re people like you and your client’s employees with families and loved ones. They’ve been specially chosen for their understanding, patience, and empathy. With training from our qualified medical experts – now including a cancer surgeon, they’ve an in-depth understanding of what it means to be living with cancer - offering so much more than just paying medical bills. 
• Our Cancer Care Guide* – Developed in partnership with Macmillan Cancer Support, our guide makes it simple for your client’s employees and their loved ones to find information to help make life that bit easier. It’s packed full of useful tips to help them every step of the way. And, if they’d like practical support or to talk to one of Macmillan’s specialist cancer nurses, there is a helpline number for them to call.
• Talking Through Cancer – Is on hand to help your clients' employees and their loved ones throughout the cancer journey and beyond.   With a thorough knowledge of the different experiences people go through when living with cancer, the dedicated team of specialist cancer therapists will help both them and their loved ones work through the emotional ups-and-downs offering compassionate support and practical techniques along the way. They will help your clients' employees feel more in control of the situation, listening and gaining a thorough understanding of their needs, going at their pace - offering the right support, when they need it.
• Careology* – At a time when life can feel overwhelming, the Careology app offers a simple way for your clients' employees to record and manage information relating to their cancer care. Whether they want to make a note of their questions, thoughts, and feelings, receive reminders to take medication, or keep track of their side effects and symptoms, it holds everything securely in one place - helping them feel a little more in control.
• Cancer Care with Get Active* – our Get Active wellbeing offers include savings on products and services that could help make a small difference if your clients' employees or someone close to them is living with cancer. So, whether they’re looking to improve their current health and wellbeing, show someone their support, or they just want to feel more like themselves, there’s a choice of specially arranged products and services to help.
• Cancer Care with Aviva Digital GP* – Aviva Digital GP is there 24/7 for your clients' employees. From talking to a private GP about symptoms that could be linked to a possible cancer diagnosis, to getting swift, convenient, empathetic support for general medical concerns following a diagnosis or during and after treatment – it’s there when they need it. 

You can find further information about these services in our Cancer guide for Large Corporate Clients (PDF 179KB). 

* These services are a non-contractual benefit Aviva could change or withdraw at any time. To be eligible for Wellbeing services, your clients' employees must be permanent residents of Great Britain, Northern Ireland, the Channel Islands, or the Isle of Man.