Process for Direct Billing

GUIDELINES FOR DIRECT BILLING INSURANCE 

STEP 1: Present a valid insurance card and ID card or Passport. If the patient is a child, please kindly present a copy of the Birth Certificate or Passport.

STEP 2: Read this Guideline carefully and sign the Consent form.

STEP 3: Use the medical services of CarePlus Clinic.

STEP 4: The Insurance Department of CarePlus Clinic will conduct the payment guarantee procedures with your insurance company (and/or its representative) based on the diagnostics and treatment carried out.

STEP 5: Upon a payment confirmation receipt from your insurance company (and/or its representative), you will be asked to sign the claim form and other related documents before your departure from the clinic in order to complete the direct billing procedures between CarePlus Clinic and your insurance company (and/or its representative).

STEP 6: If payment guarantees cannot be obtained from your insurance company (and/or its representative), or there are service exclusions not covered by your insurance, then:

a/ You may need to settle the payment directly with CarePlus Clinic in cash, card payment or via other acceptable payment methods. In this case we shall provide you with the billing and medical documents that may be necessary for you to claim with the insurance company (and/or its representative).

 b/ You may be asked to provide guarantee deposits (in cash or via credit card), as per our company policies.

Cases for health insurance claims denial: 

As an experienced healthcare provider, we would like to share with valued customers about common cases for health insurance claims denial:

• Diseases are available before being insured;
• Congenital & genetic diseases;
• Chronic diseases (chronic respiratory diseases, endocrine diseases, cardiovascular diseases, chronic osteoarthritis, chronic renal failure, chronic hepatitis…);
• Weight treating and management;
• Venereal diseases and its complications;
• Psychosis, mental disorder, moral disorder and neurological disorder;
• Self-injury, suicide, or alcohol-related diseases caused by heavy drinking or abuse of drugs, solvents, or any other addictions;
• Take a rest, periodic health examination or general health screening, or unnecessary treatments;
• Health screening, immunization, consultation (marriage, family, balanced diet, adjustment or psychological adaptation), audiometry, refractive error, eye surgery for refractive errors;
• A disability caused by war or from the events of war;
• Family planning, impotence or infertility treatment
• HIV and/or HIV-related diseases, including AIDS;
• Dental services (except for acceptance in advance); 
• Maternity services (except for acceptance in advance);
• Engage in any illegal activities;
• Vitamins, minerals, supplements, functional foods, pharmaceuticals, etc.
• Other cases depending on each insurance company.