Guarantees of payment
The promise, as a record rather than an email attachment.
Issued during the emergency, while the patient is still in a foreign hospital, to stop them paying out of pocket. Everything downstream refers back to it — adjudication exists to compare the final bill against what was promised here.
- Reference
- GOP-2026-000123
- States
- Draft · Issued · Sent · Acknowledged
- Ends as
- Amended · Expired · Honoured · Cancelled
- Issuing
- Its own grant, separate from drafting
The problem
In most assistance operations the guarantee is a Word document, a PDF in a shared drive and a reference number somebody wrote on a whiteboard. Nobody can say what has been billed against it, whether the hospital acknowledged it, or what the figure was before it was raised.
What it does
Guarantees of payment, in practice.
Human-readable references
GOP-2026-000123, allocated per company. Somebody reads one down a phone line at 3am and quotes it back on an invoice a month later.
A real letter, rendered by the platform
The undertaking is stated as a full sentence naming both parties, the patient and the ceiling — because it is read at an admissions desk in seconds, often in a second language, and a bare figure beside the word 'Amount' is the ambiguity that gets resolved the hospital's way. It carries four conditions every time and identifies the patient by name and date of birth with no clinical information, because it travels to a third party's inbox.
Drawdown against the promise
Billed versus authorised, keyed on the guarantee's own case and provider — not the case total, because a letter addressed to the hospital promises nothing about the air ambulance's invoice. Grouped by currency, and it refuses to compare across them.
Cover checked before commitment
Eligibility is asked before anything is rendered, as of the date of service. Ineligibility is an answer rather than an error: the coordinator sees the insurer's reasons and unknowns, and may override with a written reason that lands on the timeline, in the audit trail and in the logs.
Sent from your own mailbox
With a mailbox connected, the letter goes to the provider with both an HTML and a plain-text body — hospital gateways in several countries strip HTML — and an idempotency key, so one letter sends once however many times Send is clicked.
What this does not do yet: Sending requires a connected mailbox. With none configured the platform refuses and tells you to connect one or send the letter by hand — it does not pretend to have sent anything.
Rules that are not obvious
Why it behaves this way.
Each of these is a decision with a cost behind it. They are the difference between software that records what happened and software you can defend in an audit.
There is no path back to draft.
An issued guarantee is a document a hospital is holding a copy of. A row that can be reopened for editing is a row that will disagree with that copy.
Raising the budget supersedes; it never overwrites.
An amendment writes a new letter pointing back at the original and moves the original to amended. A budget raised mid-treatment is a decision somebody will be asked to justify months later, and the original figure, date and author all have to survive to answer it.
Sent moves only when the mail layer accepts the message.
A guarantee sitting in draft and one that was issued but whose email bounced look identical otherwise — and the difference is whether a patient is still being asked for a credit card.
Nothing has been billed reads as 'nothing to compare', not 'no overrun'.
Those are different answers and only one of them means the promise is holding. A zero would report every untouched guarantee as intact.
The currency of a guarantee cannot be amended.
A guarantee in another currency is a different undertaking. The drawdown stops being comparable and the hospital holds two letters whose amounts cannot be ranked.
Works with
The modules next to this one.
Case management
Every assistance case from the first call to closure — patient, trip, clinical picture, transport legs and one timeline that holds all of it.
ExploreClaims
The financial file for a case: collection, scrubbing, audit, adjudication — with an appeal path that keeps the history attached.
ExploreSettlements & EOB
The disbursement and the closing statement — four-eyes approval, exactly one payee, and totals frozen at issue.
Explore
See it against one of your own files.
The fastest way to judge CareTrack is to walk a real case through it — intake, guarantee, charges, adjudication, settlement, statement. Bring one and we will do exactly that.
Or email contact@sthiramtechnologies.com