We have patients from all over the world, either living here or just enjoying some holiday and most of them didn’t hope or expect to have any medical issues during their stay or even less being faced with the medical expenses that come along with this. But many of these patients luckily anticipated such by having a health care insurance that can cover medical expenses while staying abroad.
Few of those insurances work on “pay and claim-self” basis only in which case we will assist our patients wherever possible to provide all documentation necessary to claim for reimbursement. But most of them are able and willing to establish direct billing between insurance and healthcare provider in order to ease any financial burden for their insured.
Bangkok Hospital Pattaya has a large team working in the International Insurance Department. This team is dedicated to, free of charge, assist our patients in contacting their insurer(s) or intermediaries such as alarm centers or TPA’s (Third Party Administrators) to check patients’ benefits or coverage, to pre-authorize medical investigations and/or treatments and to seek a “Guarantee of Payment” for any covered medical expenses, a document in which the insurer or third party declares to be (fully or partially) responsible for the payment of the patient’s medical expenses.
Over time we have established direct billing arrangements, formal or informal, with more than 1,200 different worldwide insurers and with more than 150 assistance companies / cost containment companies / TPA’s who can pay medical expenses on behalf of overseas insurers.
- Upon receiving your insurance documents and passport, a medical report and price estimation, we will, with your consent, notify your insurance company about your case and ask them to send us a confirmation of coverage (“Guarantee of Payment”).
- We regularly update the insurance / assistance company by sending them medical and financial updates. Where applicable we will also keep them up-to-date regarding travel dates (and the probability that the patient will / will not be fit-to-fly by that planned return date) or all other problems that your admission may cause.
- When your treatment is almost reaching the limit of the coverage confirmed until then, when there’s changes in your investigation / treatment plan, … we will contact your insurance company again to update the information and if necessary adjust the Guarantee of Payment accordingly.
- After our first notification, your insurance / assistance company will check a number of things:
- Validity of your insurance policy, your length of stay abroad …
- Medical condition / proposed treatment: covered by policy regulations? Any exclusions due to pre-existence? …
- Estimated Costs / Deductibles / Personal Expenses / Policy Excess? Co-insurance? Co-pay? Stop Loss? …
- Even though your assistance company may be open 24/7, sometimes they will need to contact your insurance company, your GP, your embassy, … offices / companies that may only be open during regular office hours. This can cause some delays, especially at weekends, public holidays … If they have to find out about pre-existing conditions in your medical records at your local hospital, GP, … this may take a long time.
- After all details as above have been checked with a positive outcome, your insurance / assistance company will send us a Guarantee of Payment, a declaration saying that they will cover your hospital bill and pay this amount to the hospital directly.
- Hardly ever these Guarantees of Payments are ‘blank checks’ to the hospital as one can understand. They are usually limited until a certain date and/or for a certain amount and/or for certain treatments/diagnoses/… Whenever we are (almost) reaching those limits, we will request extensions, together with explanation (usually by medical report) why that extension is needed.
- Personal expenses (as extra meals, extra newspapers, private phone calls, …) are (almost) always not covered and to be paid by yourself. Some insurance policies also have certain deductibles, amounts of excess (amounts above policy limits), co-pay, …, amounts that obviously also will have to be cleared by yourself.
- Some insurance companies will exclude certain items (e.g. sleeping medicines, psychological treatments, STD-related investigations / treatments, …). These items will also be billed to you directly.
- If there’s problems with the validity of your insurance (e.g. expired), with your travel dates (e.g. already 2 months in Thailand while your policy only covers for a 30-day stay), if your insurance considers your medical condition as pre-existing … they will send us a denial. In that case the hospital bill will remain your responsibility. In that case, we will provide you with the original invoice and medical reports so you can try to get reimbursed should you not agree with insurance / assistance company’s decision.
- Usually your main treating doctor will see you a last time in the morning. He will then also prescribe the home medication for you and set an appointment date for follow-up. A medical discharge summary will be made. After that, your medical chart will be closed and sent to our cashier department where the billing process will be started.
- When the bill is ready and all necessary guarantees from the insurer are here, staff will bring you to the IPD cashier (4th Floor E-building) where you will be asked to sign the bill and where your personal belongings that you may have given for safekeeping will be returned. Deposits made (if any) will also be returned (or credit card payments cancelled). Payment for personal expenses, policy excesses, deductibles, co-pay, … will be requested.
- Some insurance companies only send us the final guarantee after receiving and checking the final detailed invoice (even in cases of pre-authorized treatment). In those cases, a doctor saying “You can go” doesn’t mean that you will be out of the hospital within the next hour. Depending on the time difference with your insurance company and their speed of reviewing those final details, this can take up to several hours.
- If you really cannot wait that final guarantee, you can pay the part which has not been guaranteed yet as “deposit”. In that case, we will call you as soon as the awaited final guarantee arrives so that you can come to have your deposit returned / cancelled. If follow-up is mentioned by the doctor in his discharge summary, then we will also ask your insurance / assistance company to send us Guarantees of Payments for those follow-up’s. Beware though that some overseas insurance companies don’t send Guarantees of Payments for Out-Patient visits but expect their customers to pay and claim back themselves.
- We will not contact overseas insurance / assistance companies for Out-Patient visits unless
- these Out-Patient visits are follow-up’s after and In-Patient episode (see above)
- your insurance / assistance company has a local office in Bangkok
- your insurance / assistance company has a special arrangement with us for this
- Complete insurance information must be submitted during your admission. We will not process any insurance claims once the patient has been discharged.
We have patients from all over the world from difference countries that carry a variety of insurance policies and coverage. We assist our patients to coordinate with their insurance providers in order to guarantee payment on their behalf.
To be more convenient for Health Insurance Policyholders, it is recommended to contact your insurance company to check your benefits, coverage and authorize when medical service is needed.
1. Please present the following on your arrival at the hospital
- Passport and a copy of your passport with signature
- Current medical insurance certificate or card
- A copy of your insurance policy
- And any other required by your insurance company to identify yourself
2. Our international staff will assist you to coordinate with your insurance provider / assistance company / claim agents regarding the approval of guarantee of payment for your inpatient medical expenses (excluding personal expenses).
3. The payment guarantee / confirmation will be faxed to Bangkok Pattaya Hospital normally within 24 hours if its policy covers. *However this may be delayed depending on
- Verification process of each company
- Not enough time to process the application, as the length of stay is too short
- Differences in the Time Zone, Weekends or Bank Holidays
- Pre-existing conditions or exclusions
- Terms and conditions of your policy
- Outpatient or follow up treatment
4. If there is a delay and the documents are not produced until you have been discharged which we are unable to process any insurance claim, you are required to pay the hospital bill in full by cash or credit card and then file for reimbursement directly with your insurance company.
5. You are required to pay the excess amount at the time of your discharge. There may be some expenses incurred that you are required to pay such as medical expenses or room rate that is over the limit allowed and personal expenses such as telephone calls, foreign newspapers that are beside of our complimentary, extra food or other services.
*Complete insurance information must be submitted during your admission. We will not process any insurance claims once the patient has been discharged.