Direct Billing and Claims Procedures

The GlobalHealth Asia team prides itself on providing our members with excellent service. This includes processing your claims in a clear and timely fashion.

Please take a moment to review the information below. It will assist you in understanding how to take advantage of GlobalHealth’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 chosen nil deductible option and completed a Release for Direct Billing Service form and who have an “OP” designation on their membership card may enjoy this service. A list of DBN providers is included with your Policy Package. Alternatively, click here.


  • Release for Direct Billing Service
    Completion of the Release for Direct Billing Service form, whereby you agree to reimburse GlobalHealth for ineligible treatments, is required before access to the DBN can be granted. Kindly send the completed form to GlobalHealth Asia Head Office or your insurance advisor so that they may forward it on to us.
  • Your Membership Card is important
    When seeking a consultation / treatment please present your card together with one(1) 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 a treatment is excluded under the terms of your policy or not, please contact GlobalHealth or your insurance advisor for assistance. Alternatively, you may review the details of your policy by logging onto the Member / Policyholder Corner.
  • Dental Benefits
    Direct billing for 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. We therefore encourage you to first test a provider’s service i.e., the Dental First Exam requirement, before appointing a dental facility as your sole direct payment provider.

    Once you have decided upon your one dental provider within the GlobalHealth Asia Direct Payment Network, please complete the Release 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 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 of this website.


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 accidental 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 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 GlobalHealth during normal business hours at least three (3) working days prior to admission. While we will do our utmost to assist you, late or incomplete requests may affect our ability to provide this service.


In cases of medical emergency, in order to arrange a hospital guarantee or prepayment of a hospital deposit, please call our emergency assistance provider AA International at the number shown on your membership card or click here.
 


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 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
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 HK$.