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Medisinar Klinik & Surgeri Fasa 2 Pekan Lok Kawi Hospital Admission Guide

Hospital Insurance Claim Precautions Guide

📝 Pre-Admission Checklist

  • Ensure an initial diagnosis has been conducted by a general practitioner.
  • If specialist treatment is needed, obtain a formal referral from your doctor.
  • Before making an appointment, confirm that the clinic or hospital is in the insurance company’s panel network.

📄 Before Applying for the Guarantee Letter (GL)

  • Obtain a treatment plan or surgical recommendation from your doctor.
  • Prepare related medical records, test results, and the referral letter.
  • Submit complete insurance documentation to the clinic or hospital.

Important Reminder: Be sure to receive approval for the Guarantee Letter before undergoing surgery or treatment. If not approved, you will need to pay first and submit a claim for reimbursement afterward.

❌ Common Reasons GL Applications Are Rejected

  • The treatment is not covered under your policy.
  • Inconsistent or undisclosed medical history.
  • Incomplete or incorrect documentation.
  • The policy is expired or payments are outstanding.

💡 Tips to Improve Approval Success

  • Use clinics or hospitals listed in the insurance company’s panel.
  • Keep your medical history clear, consistent, and fully disclosed.
  • Familiarize yourself with the policy’s terms and coverage.

💰 Claim and Reimbursement Process

  • Keep all receipts and medical documentation after treatment.
  • Eligible expenses must be submitted for reimbursement within three months.
  • Follow-up treatment expenses (e.g., return visits) can be submitted within six months.

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