What is Direct Billing?
When you receive treatment at a designated provider (Hospitals, clinics, laboratories, diagnostic centers, and pharmacies listed under the designated network of hospitals under the policy) and for which you pay applicable deductible/coinsurance the remaining claim amount will be raised by the hospital to the insurance company and accordingly insurance company pays the claim directly to the hospital.
How Direct Billing Works?
- Download the mobile app HealthPass - MedNet from App Store or Google Play to view your policy details, e-card, network, track your approvals, etc…
- Present your CPR and Insurance e-card to the hospital insurance desk or reception
- Pay the deductible/co-insurance fees based on your policy terms and conditions
- Sign the claim form provided to you by the provider
What Might Happen After Your Doctor's Consultation?
- No further treatment is required
- In the event that the doctor requests admission, writes a prescription for medicine, or refers you for lab or x-ray work, the provider will submit a related approval request to the insurance company
How to Track the Status of Your Claim?
How to Deal with a Rejected Insurance Claim?
When the approval request is declined it means it will not be paid by the insurance company as per your policy terms. If you would like to proceed with the treatment then the hospital will ask you to pay for the declined amount which will not be reimbursed by the Insurance company.
What if You Do Not Get a Reply from Your Insurance Company?
If you cannot see the approval request in the HealthPass - MedNet mobile application, this means that the hospital has not sent the request to the insurance company yet.
What Is Reimbursement?
If you pay the cost of your treatment, then you can make a claim to the insurance company to reimburse the cost of eligible medical expenses. The amount paid will be based on reasonable and customary charges for the medical treatments, less any applicable deductible and/or coinsurance.
How to File a Reimbursement Claim Under Your Medical Insurance Policy?
- Submit all the required documentation through the mobile app under “Submit Reimbursement Claim” section
- Upload the required documents
- Enter the total claimed amount
- Add your IBAN number under the “Additional Information” section as follows: IBAN: xxxxxxxxxxxx
Documents Required for Filing Reimbursement Claim
- Payments receipts (cost per service to be shown)
- Claim form
- A detailed medical report including but not limited to the diagnosis, operative notes, discharge summary (if hospitalized), treatment plan, and prescription from the treating doctor as an official document
- Copies of diagnostic test results
- You must file for a reimbursement claim within 30 days from the date of treatment
- We reserve the right to request the original documents
- Your claim will be settled, and the amount will be transferred to your bank account within 10 working days from the date of submission
- In case of missing documentation, we will contact you to request the missing or additional information needed to process your claim
You can contact us on the Toll-Free call center numbers 24/7: 8000 1113 / 17566175