保險&直付理賠

保險&直付理賠 DIRECT BILLING & INSURANCE

賬務和直付保險指南

Instruction of Direct Billing

 

感謝您選擇裏奧診所的醫療服務。AG亚游官网接受由大部分主流保險公司提供的醫療保險計劃,並不斷更新保險公司名錄。本指南將為您解釋AG亚游官网將如何處理您的保險理賠,其中將包含您在裏奧診所下的賬及責任。

Thanks for choosing Leo clinic service. We accept health plans offered by most major insurance carriers. We update our list of insurance providers frequently, please call us for more information.

 

如何理賠?

How we handle insurance claim at Leo Clinic?

AG亚游官网給您的保險公司提供您每次就診的帳單明細,您將在當日醫療服務結束後被要求支付您的保險計劃中共同支付部分及免賠額,以及您保險計劃不承擔的金額。由保險公司支付的金額根據您所持有的醫療保險計劃而定。如果您對自己的保險覆蓋範圍有任何疑問,請撥打保險卡上的電話號碼進行谘詢。醫療費用的自付部分以及需現款支付的費用,可用支票、借記卡和信用卡支付。

特別提醒:裏奧診所隻為每位患者提供一家保險公司的直接結算服務。

We provide the bill details to your insurance provider for each visit. The amount of the payment depends on your health insurance plan. You may cover the co-payment or deductible. Please call the number on your insurance card if you have any questions and to get more information about your coverage. For your co-payment or for those who prefer to pay out-of-pocket, we accept checks, debit cards and credit cards.

Please note: We only accept primary insurance coverage for direct billing.

 

如果我沒有保險該怎麽辦?

No Insurance?

裏奧診所提供的醫療服務及價格適用於保險客戶及非保險客戶,非保險客戶可以聯係裏奧診所合作的直付保險機構,通過他們的官網或服務電話自行選擇您所需要的商業醫療保險產品,裏奧診所的員工不會向您直接或間接的銷售商業醫療保險。同時裏奧診所為您提供了豐富的醫療服務套餐,從而可以很程度上為您提供優惠價格。非保險客戶需要在就診治療結束後,全額支付產生的醫療服務費用。

We are providing quality and accessible medical service to both policyholder or non-policyholder with reasonable & standard service price. You may find the direct billing arrangements in place with a continually expanding list of insurance providers on the website, ask our staff if you need help. We also provide the service promotion package as preferential price for your option.

Non-policyholder will arrange the payment fully after receiving the service.

 

我的保險公司是如何支付本次就診?

How does my insurance pay for the visit ?

AG亚游官网將整理您的理賠資料其中包含您必要的就診資料,並且在您就診或治療完畢後以最快的速度寄送至您的保險公司予以理賠,盡最大努力取得您就診費用的全額支付。為此AG亚游官网需要您的協助,在您注冊登記時請您提供準確的保險信息,修正或不完整的信息將影響到您的賬戶理賠進程。如果您的保險公司拒絕支付您的費用,您將有責任全額支付您保險公司未理賠的金額。門診入院觀察和入院治療取決於您的病情及診斷。有些保險計劃要求提供轉診信及預授權或者在您保險公司特定的醫療網絡內獲取醫療服務。如果您未提供或滿足以上條件,您的保險公司將有權拒絕支付您的醫療費用。

如果您對於您的具體保險計劃存在疑慮,您可以事先詢問您公司的人力資源部、閱讀您的保險手冊或者致電您的保險公司客服電話。

保險公司有權對醫療服務費用及相關材料內容進行最終的決定。保險預核或預授權將不完全擔保您的理賠成功。

We would send the paperwork to your insurance for the settlement of claim, please help us to finish your insurance claim form with personal informationuncompleted or corrected information will infect the claim process. You may pay full amount of the uncovered cost if the claim has been declined.

Hospitalization and outpatient observation will be requested a referral letter / admission certification from doctor and a precertification from insurance with instruction. If you have any question , please communicate with your HR department and read the insurance manual or call insurance customer service.

Please note that the insurance will have the rights to make final decision on the service cost payment. Pre-verification & pre-certification would not guarantee the claim completion.

 

關於賬單?

About the bill ?

 

您的賬單中將體現您就診、治療或住院期間的所有合理費用及明細內容。其中將可能涉及:谘詢費,化驗,檢查,影像,治療,低值耗材,高值耗材,房費,護理費,服務費,藥品費。如您對於您的賬單存在疑問您可撥打AG亚游官网的客服熱線,或在結賬時向AG亚游官网的客服人員進行詢問。

The details of the bill will include the total cost during the period of your visiting, treatment or hospitalization. It relates consultation fee, Lab fee, exam fee, image fee, treatment fee , materiel fee , room charge, nursing fee, service fee, medication fee etc. Please ask for the explanation when you have any concern.

 

如果我的保險公司沒有與裏奧診所簽訂直付協議該怎麽辦?

Insurance with non-direct billing with Leo Clinic?

您可以在您就診前致電您的保險公司客服熱線,從而確定您的保險公司是否全部或部分支付給您在裏奧診所的醫療服務費用。假如投保的保險公司未與裏奧診所簽訂直付協議,因此您需要全額支付產生的醫療服務費用,如您投保的保險公司同意承擔您在裏奧診所所發生的醫療服務費用,AG亚游官网將為您提供您自行索賠所需要的資料,以便您保險公司提出索賠。

If your insurance has not been signed the direct billing agreement with Leo Clinic , you may call their hotline to confirm that they are willing to cover the service cost partially or fully to Leo clinic before you come to visit us. Otherwise, you may make full payment to us and we would happy to prepare whole claim documents for you to self-claim after.

 

如果此次就診是急診情況該怎麽辦?

Emergency treatment?

對於一些特殊的急診情況,裏奧診所將根據具體情況提供免費且有限的醫療救治,患者或其直係親屬將簽署裏奧診所的《急救護理責任豁免書》。

基於裏奧診所目前有限的急救醫療條件 AG亚游官网將為您提供緊急轉診服務。轉診期間所發生的救護車費用需要自行承擔。對於保險客戶,AG亚游官网將根據具體發生的急診費用向保險公司寄送理賠賬單非保險客戶,在轉診前,您需要全額支付已發生的醫療服務費用。

In case of an emergency in our clinic, we will provide limited first-aid and basic life-support you or your next-of-kin will sign the disclaimer of emergency care. Due to the suitable healthcare is not available at Leo Clinic, we will arrange the transferring to the nearest appropriate medical facility for further treatment. We will help the processing. Your insurance will pay for the whole transferring fee including the transportation cost , and you may pay for the non-covered parts. 

 As for the non-policyholder, after the emergency treatment at the clinic, full service fee would be paid by yourself before the transferring.  

如果我沒有攜帶我的保險卡或有效身份證件該怎麽辦? 

Visiting with no insurance card or valid identity certificate?

在就診時請出示您的保險卡及有效身份證件根據您保險公司的要求,出於對您隱私及保險權益的保護,AG亚游官网的客服人員將複印您的保險卡和有效身份證件,作為不可或缺的理賠必要材料之一隨其他文件寄送給保險公司申請理賠。您的保險公司有權因理賠材料中缺少保險卡或您有效身份證件而拒絕支付您本次就診的費用。如您未攜帶保險卡或有效身份證件,您該次就診將無法使用您的直付服務,您將全額支付醫療服務費用。

Based on the insurance claim principles, please show us your insurance card and valid ID for copy when check-in. Those documents are very important and necessary for protection of your privacy and the rights with interests of insurance.  Your insurance company would reject the claim if the information has not been completed and corrected. You would not be able to use the direct billing service if you do not bring your insurance card and ID with you when visit the clinic and you will make full-payout.

 

問題和建議?

Other questions /suggestion?

您的建議將對於裏奧診所十分重要,您可致電裏奧診所的服務電話或服務郵箱,AG亚游官网的客服人員將竭誠為您服務。

Your suggestion and question are very important to Leo clinic, please leave your message to us, our client service will get back to you as soon as possible.

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