4 THINGS YOU MUST KNOW BEFORE MAKING A HEALTH INSURANCE CLAIM
HAVE ALL DOCUMENTS READY1
- Claim form. It should have your doctor’s signature and the hospital’s stamp. If you need to file for multiple claims, please remember to get all the claim forms signed and stamped.
- Original hospital receipts, diagnostic reports, discharge summary, and sick-leave certificate. Some insurance companies may accept certified true copies. If you need to file for multiple claims, do ask the insurance company to send back the original documents and certified true copies.
CHECK ON THE DEFINITION OF “MEDICAL NECESSITY” IN YOUR POLICY1
- Was your condition urgent?
- Was outpatient treatment not feasible? "Outpatient" means you merely visit the doctor for consultation and treatment. "In-patient" means you spend a night or more in the hospital.
- Did you only get diagnostic scanning? Your insurance company may consider your hospital stay less necessary if you were not given medication.
SEE “REASONABLE AND CUSTOMARY CHARGE”1
- Insurance Authority (n.d.). Understanding Medical Insurance-Tips on Making Claims. Retrieved from
https://www.ia.org.hk/en/medical_insurance/tips_on_making_claims.html. Accessed 31 March, 2022.
- BUPA (n.d.). Pre-authorisation - Bupa Health Insurance. Retrieved from
https://www.bupa.com.hk/en/customer-care/pre-authorisation/. Accessed 30 March, 2022.
- HealthCare.gov (n.d.). Preauthorization - HealthCare.gov Glossary. Retrieved from
https://www.healthcare.gov/glossary/preauthorization/. Accessed 30 March, 2022.
This health information is provided for reference only and is not intended to replace discussions with a healthcare provider.
All decisions regarding patient care must be made with healthcare provider.