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Anonymous

23 Apr 2019

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Insurance

What are the procedures or SOP for insurance when need to be hospitalised or loved one need to hospitalised/surgery?

What's the step by step procedure and SOP? I heard need letter of guarantee etc.

What if you are the one who fainted/unconscious and no other kin to call your agent, then how?

Discussion (2)

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It depends on the manner u are admitted to the hospital. Say a typical planned admission for a surgery (u had seen the doctor and arranged a date for the procedure beforehand). On that day of admission (before advised admission time), go to the hospital's admission counter, take a queue number. You will need to have your NRIC with you, and the admission forms (will be given to u by the clinic nurse). You have to decide on the ward type u would want to stay in (single beded etc, depending on availablity), if it is day surgery then u will not required to choose.

The staff will be able to check in the system if u have integrated shield plan. You will also have to sign a medisave authorization form. This allows the hospital to access your medisave info, and use it to pay any bills (if needed). The staff will check if your shieldplan is valid and able to issue a letter of guarantee. If yes, the staff will print out the LOG for u to sign.

Then, the admission staff will go through with u on the estimated bill size base on your chosen ward and typical length of stay for your procedure, and other financial matters. This is a mandatory process called 'financial counselling'. You'll have to sign the form to acknowledge u understood the financial counselling.

Depending on each individual hospital policy. If your LOG is able to cover your estimated bill size, a deposit is usually not required. If u do not have a valid LOG, u will need to pay deposit, using cash or creditcard for example. Some local hospital offers cashless service, Eg, for Gleaneagles, bills size of under $30k can be waived of payment on admission and discharge, IF u are a singaporean/PR, have the private tier shieldplan, with rider that covers full deductible and coinsurance of at least 1year being inforce,

Otherwise on discharge, u might be required to pay the remaining bill first. You'll have to wait till your insurance approves the payout, the hospital will refund u the amount.

Assuming u admitted using your integrated shieldplan, After u are discharged, your hospitalisation bill will be electronically filed (efile) within a few business days. Your insurer will be able to receive the claim on the same system. Approval time by the insurer can vary. Depending on the type of procedure u went through, size of bill, and even your policy inforce length, and other factors. If the claim officer of the insurer can raise query on the claim if he or she wants to investigate the claim. Either he or she suspects something, or it is part of random checks. Query can involve sending letters to the doctors incharge and u(the insured) asking various questions, or checking on your past medical history if any. This process can take weeks or even months in some cases. But do not worry, as most cases are straigth forward and usually approved within weeks and some days.

For emergency cases, u will still be hospitalised first. Just wait for your next of kin to do the admission process for u. Bring your ID, acknowledge financial counselling, etc and make payment etc.

You do not need to call your agent. Insurance agents are not trained in these areas. Few might have personal experiece. Even if u call your agent, he or she can only tell u what is the plan u bought (and what bed u are entitled up to).

If u wish to learn more details or need help with admission etc. Feel free to ask me on my facebook.

Clarence Chua

23 Apr 2019

Financial Planning Specialist at Prudential Assurance Singapore

It seems that you are talking about the integrated shield plan.

In the event of hospitalisation, the hospital will be able to check through their system that you have an integrated shield plan and will be able to e-file for you. This process is seamless.

Letter of guarantee comes when the hospital requires an upfront cash deposit. You can ask for the letter of Guarantee from your insurer.
The letter of guarantee purpose is simply for you to get a waiver on the required deposit (normally only Private Hospital ask for a deposit)

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