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Medical Insurance Process Guide

Having medical insurance coverage is one of the best ways for you to prepare for a rainy day. As healthcare costs surge over the years, financial implications can be as equal, if not more than health. At Sri Kota Specialist Medical Centre, we are proud to be partnered with insurance providers, both local and international, as well as Third-Party Administrators (TPA) to ensure that healthcare is always accessible to the people.

 

Now, we do hope that you would never have to worry about using this guide. But as all things, unexpected events may befall you. In that case, let us share with you a brief overview on the insurance process from admission to discharge.

 

Let’s say you fell ill, or got into an accident which requires hospitalization. The first thing to know is to identify the panel hospitals under your insurance coverage. For example, Sri Kota Specialist Medical Centre is a panel hospital for AIA, Allianz, Great Eastern, Prudential etc. 

 

After arriving at the hospital, depending on the severity of your condition, you may be put into emergency treatment. For normal inpatient or day-care procedures, registration is typically done at the main reception/counter. Regardless, you will be required to complete an Admission Counseling Form.  You and your guarantor are to provide a photocopy of IC/Passport for record purposes.

 

It is also during registration that you should provide the hospital with the details of your insurance coverage. This is for the hospital to arrange for a guarantee letter for your admission. A guarantee letter is vital as it serves as a document that your insurance provider will cover the cost of treatment. 

 

Occasionally, some hospitals will require a deposit even with a guarantee letter. If you planned a procedure beforehand, you can also prepare your GL ahead of time to ensure that your admission goes smoothly.

 

Once your procedure or treatment is completed, the doctor will certify you for discharge. The doctor and ward staff will prepare discharge documents to be sent to the hospital billing department. At this point, the process will be slightly different depending on your paying method. 

 

Self-paying patients will have their final bill ready approximately 2 hours from when the discharge order is given. For patients under insurance, the hospital will obtain a Final Guarantee Letter from the insurance company or TPA. The process usually takes around 3-4 hours. If you wish to leave the hospital before having the final GL, hospitals will also require a deposit payment. 

 

Once discharged, you may need to return to the hospital for follow-ups and/or subsequent treatments that do not warrant admission. Many insurance companies will also provide coverage for follow ups and recovery treatment. 

 

For example, you need to return to the hospital for physiotherapy. You can complete your session at the hospital and settle the bill accordingly. After that, be sure to file your claim as soon as possible. Most insurance companies have a reimbursement period of 30-60 days from the day of your procedure. 

 

Sri Kota Specialist Medical Centre is on the panel for international and local medical insurances and Third Party Administrators. We are proud to be one of the first and only private hospital in Klang / Shah Alam that have the achievement of being:

 

  • AIA Platinum Hospital Network
  • Great Eastern Tier One Hospital
  • PruBSN Preferred Hospital
  • Allianz Blue Ribbon Hospital
  • Manulife Preferred Hospital

 


For more information about our hospital, kindly contact us at +603 3375 7799, or make an appointment here!

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