|
The GlobalHealth Asia team prides itself on providing our members with industry leading service. Our excellent service standards include processing your claims in a clear, convenient and timely fashion.
Please take a moment to review the information below. It will assist you in understanding how to take advantage of GlobalHealth Asia’s ability to pay medical providers directly as well as how to claim for reimbursement when you have paid for medical services.
Claims Chart - Claiming Overview
Out-patient – Direct Billing
For your convenience, GlobalHealth Asia has established an out-patient Direct Billing Network (DBN) which includes hundreds of general practitioners and specialists across Asia. Members who have an “OP” designation on their membership card may enjoy this service. Here is the current list of Direct Billing Providers.
 |
Your Membership Card is important
When seeking a consultation / treatment please present your card together with one piece of photo identification to the receptionist prior to consultation. |
|
Exclusions
Your policy may exclude certain types of treatment. Please be aware that excluded items are NOT eligible for coverage. If you are not sure whether or not a treatment is excluded under the terms of your policy, please contact your Pallas GlobalHealth Customer Service Representative or your insurance advisor for assistance. Alternatively you may review the details of your policy by logging onto the Member/Policyholder Corner under Member Care at the top of the page. |
|
Maternity & Dental Benefits with Sub-Limits
Direct billing for out-patient maternity and dental benefits may also be arranged within our network, but please be advised that this can be established with only ONE PROVIDER per policy year (per pregnancy). Out-patient services incurred at other medical provider(s) will NOT be direct billed. We therefore encourage you to first test a provider’s service i.e., the Dental First Exam requirement, before appointing a medical/dental facility as your sole direct payment provider.
Once you have decided upon your one medical/dental provider within the GlobalHealth Asia Direct Payment Network, please complete the “ Option for Direct Billing Service Form” and return it to us. We will then provide you with a Letter of Authorization and a benefits balance for you to present to your chosen medical/dental provider for their record keeping. |
Out-patient – Pay and Claim
In cases where the Direct Payment Network has not been utilized, you will be required to settle the consultation, laboratory, or pharmacy charges with the provider first and then submit a claim for reimbursement. Submitted claims should include Original Receipts and a completed Claim Form. For your convenience, claim forms can be downloaded by visiting the Forms section at the top of this page.
At the top of the Claim Form you will find instructions on how to complete the form correctly. Please take note that for complicated out-patient treatments or where treatments are expected to continue over a period of time, your physician is required to complete the relevant section of the Claim Form as indicated. Some examples of outpatient claims which would require your physician to complete a portion of the Claim Form include:
|
special diagnostic tests such as CT scans, MRI, stress testing, endoscopy, allergy testing, etc. |
|
where surgery or hospitalization is involved or anticipated |
|
multiple outpatient visits or when physiotherapy/chiropractor/acupuncture treatments will be required |
|
cases involving accidentals or injury (see below for further instructions) |
To ensure there is no delay in processing your claim, please ensure that bills and receipts have enough information filled in by the doctor’s office, laboratory, or pharmacy for the claim to be considered. Here is a summary of the basic details required:
|
name of the patient |
|
date of treatment |
|
doctor’s name and professional qualifications |
|
country where treatment took place |
|
the amount paid by the patient |
|
an explanation of the service(s) rendered and the itemized charge(s) |
|
the diagnosis or other reason for the visit |
Hospitalization / Surgical Claims – Direct Billing
For both planned and emergency hospitalizations, in most cases it is possible for GlobalHealth Asia to arrange a Hospital Guarantee whereby the hospital is paid directly.
In cases of planned or expected hospitalization or surgery and where a Hospital Guarantee is desired, please contact your Pallas GlobalHealth Customer Service Representative.
In cases of medical emergency, in order to arrange a hospital guarantee or prepayment of a hospital deposit, please call our 24-hour emergency assistance provider AA International at (603) 7628 3880 or (603) 7841 5770. A collect call is acceptable.
Please have your name and policy number ready. Inform AA International that you are a policy holder with Pallas GlobalHealth under GlobalHealth Asia. Give your location and contact details and, in case of accident/illness, complete information about your condition and any medical contacts.
Hospitalization / Surgical Claims – Pay and Claim
If you are seeking reimbursement on a pay and claim basis, please note that a claim must include full details and original receipts and must be accompanied by a fully completed Claim Form.
In Cases of Accident or Injury
In cases of Accident or Injury, you should provide GlobalHealth Asia with a written statement giving full details of how the accident occurred (including date, time and place). We may also require other documentation, such as a police report.
Filing Period
Please ensure that claims are submitted within 90 days of the date of treatment unless it is shown that it was not reasonably possible to file all claim documents within this time. Claims related documents not submitted within 12 months from the date of service will not be considered.
Note: offsetting claims against premium(s) is not possible.
Reimbursement Methods - Please note that reimbursement methods vary from country to country. For further details please contact GlobalHealth Asia.
Credit Card: reimbursement can be made to your Visa or MasterCard.
Bank Transfer: reimbursement can be made direct to your chosen bank account. We will of course absorb payor (sending) bank charges, but are unable to reimburse you for any charges levied by the payee’s (receiving) bank.
Cheque: a cheque can be issued to the policyholder/member in US$, HK$ or SG$.
|
