Claims are the most important part of an International Health Insurance companies. They need to be competently handled with speed and efficiency. The consumer’s satisfaction is mostly based on the way the insurance companies handle the claims.
There are some ways in which insurance companies cover medical expenses:
1. Emergency Treatment. Doctor, client or family member has to contact the 24 hour Alarm Center. The Pre Certification Medical Form has to be completed by the client and the doctor and sent to Alarm Center. The insurer will send the Guarantee Letter for any eligible claim. Hospital will send the bill to the Insurer for Payment.
2. Planned Treatment. The client has to contact the insurer prior to the Inpatient. The Medical Form and the Release of Medical Information / Consent Form have to be completed by the client and relevant practitioners and sent to the insurer. Where possible, the insurer will offer guarantee letter to the hospital. Client obtains treatment as inpatient. Where possible the hospital will send the bill to the insurer or client has the option to pay and claim.
3. Outpatient Treatment – Non Provider Clinic. The Client receives treatment and pays the claim. The original receipt and completed claim form have to be submitted to the insurer. The insurer will response within 15 working days after receiving completed claim document.
4. Outpatient Treatment – Provider Clinics. The member presents the card and secondary identification to the Provider Clinics and gets the treatment.
Complaints regarding Claims
The incomplete or incorrect information can delay the claim process and this commonly dissatisfies the insured. To make sure the prompt reimbursement, it is the client’s responsibility to make sure all the documents are in order before sending it to their insurer.
The most reason for an insurer does not reimburse the claim is the insured’s pre-existing conditions..