REIMBURSEMENT REQUIREMENTS

In order to ensure quick settlement of reimbursement claims please find below the documents required:

The following are the type of reimbursement that you can initiate


Outpatient Reimbursements


Required documentation / information


  • Fully filled and signed claim form by both claimant and doctor
  • Original consultation receipt with all costs clearly broken down if the amount payable covers more than one visit and/or any procedures.
  • Original receipt for the purchase of drugs or laboratory tests including a breakdown of the costs for each
  • Copy of the prescription from the doctor
  • Copy of any laboratory requests from the doctor
  • Copy of any other requests for diagnostic services, scans or X-ray
  • Fully completed bank account details form


  • Inpatient reimbursements


    Required documentation / information


  • Fully filled and signed claim form by both claimant and doctor
  • Original receipts for the payment done.
  • Discharge summary or medical report
  • Itemized bill for services billed
  • Fully completed bank account details form

  • Overseas Reimbursement claims – Outpatient


    When a client is travelling outside the country for leisure / treatment has to notify the insurance in writing failure to do so in case a claim arises it will not be honored.

    Required documentation / information


  • Fully filled and signed claim form by both claimant and doctor
  • Original receipts for the payment done.
  • Original receipt for the purchase of drugs or laboratory tests including a breakdown of the costs for each
  • Copy of the prescription from the doctor
  • Copy of any laboratory requests from the doctor
  • Copy of any other requests for diagnostic services, scans or X-rays
  • Fully completed bank account details form


  • Overseas Reimbursement claims – Inpatient


    When a client wishes to travel outside the country for treatment must notify and seek approval from APA.

    Required documentation / information


  • Fully filled and signed claim form by both claimant and doctor
  • Original receipts for the payment done.
  • Discharge summary or medical report
  • Itemized bill for services billed
  • Copy of the approval issued by APA
  • Fully completed bank account details form

  • Last Expense Reimbursement claims


    Required documentation / information


  • Death certificate
  • Copy of Identity card for the deceased.
  • Letter from Employer confirming the death for corporate clients
  • Notification of death either from Hospital or mortuary
  • Fully completed payee bank details / copy of Identity car
  • TERMS & CONDITION


    Duration of claim


    All claims will be considered for settlement if they are forwarded fully documented and received within 60 days from the date of treatment. Claims received after 60 days will be time barred and returned unpaid.

    Drugs Purchase


    Drugs dispensed by doctors are not payable. A doctor should only prescribe the drugs and the member will then buy them from a registered chemist or pharmacy. All drugs must be prescribed by a doctor. Drugs bought over the counter will not be payable.

    Consultation


    Consultation fee is payable up to the maximum limit as per the policy terms and conditions unless accompanied by a referral letter.