Tag: specialist

Last week, bila bangun dengan keadaan panik kerana sakit dah makin teruk, tambahan klinik dan farmasi berdekatan tak ada stok ubat, I was advised to jumpa doktor pakar terus (Memang kena marah pun dengan doktor pakar sebab keadaan dah sangat teruk). But alhamdulillah dapat juga setup appointment dan jumpa specialist on the same day. So what are the steps, kalau anda covered by insurance:

1. Of course, make sure your insurance cover cost jumpa specialist dan hospital berkenaan.
2. Call untuk buat appointment dengan klinik pakar. Get the doctor name. In my case, alhamdulillah ada waktu walk-in, so I just use that time.
3. Minta ‘Referral Letter’ dari doktor klinik berdekatan. Mereka akan minta confirm if you already made an appointment. In my case, they gave me 1 hard copy of the referral letter, and they also uploaded a copy to the insurance system.
4. Untuk make sure you don’t need to pay beforehand, and let the insurance cover terus your visit and medication dengan klinik pakar, make sure to request for ‘Guarantee Letter’. Luckily my insurance app made it easy for me. I just had to follow some steps – like fill in appointment date, clinic that referred me, specialist clinic, specialist name, and attach the referral letter. This one ambil masa sikit untuk diproses – can be within 30 minutes and up to 1 hour untuk di proses.

Thankfully my office HR sangat helpful dan the insurance app juga sangat memudahkan urusan, kalau compared to dulu. Waktu panik 10:00 pagi, waktu jumpa doktor pakar 1:00 tengahari.

Just to share my experience. As maybe this post can help others, especially those who never tried to claim through company’s insurance for surgery.

Main thing you need to get to ensure that you don’t have to pay, and the insurance will pay instead. Anyway here are the main steps;

1. Check with the insurance and HR, just to confirm if the insurance will cover your case.
    
2. Go to local clinic to get the referral letter, to see the specialist.
    
3. To get the guarantee letter, first you need to fax or email the referral letter to your insurance company.
    
   Make sure you also provide the important details such as – your name, your contact, the clinic & doctor that you went to get the referral letter, and also the specialist clinic & hospital you ‪are going to visit. It is still OK if you do not know which specialist, as the insurance can help to find and assign it for you.
    
4. Go see the specialist, so they can check and diagnose your condition.
    
   The specialist clinic will generate the reports and details for the hospital to proceed with your surgery registration. From my experience, the hospital will help in submitting application for the surgery’s guarantee letter.
    
   Note: Each process or visit needs a different guarantee letter. Example: you will need one GL for specialist visit, another one different GL for surgery, another one different GL for any follow-ups with the specialist… etc.
    
5. Make sure your guarantee letter has been approved before proceeding with the surgery. Else, the hospital will easily request for hundreds of ringgit for admission fees.
    
   If there is some problem arises, or your request for guarantee letter is being rejected, please contact your agent or HR representative to help you talk to the insurance’s representative.

All the best! :)