Surgery Application Through Insurance

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! :)

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