1) Question:I don’t know if my insurance company has Direct Billing (DB) agreement with Matilda, what should I do?
2) Question:I have already been told that my insurer doesn’t have any Direct Billing (DB) agreement with Matilda, what can I do to avoid paying everything by myself upfront?
Answer: Please kindly ask your insurer to appoint a TPA (third party administrator) or anyone which has an agreement with us to issue the Letter of Guarantee (LOG) on their behalf.Alternatively, if they do intend to set up the Direct Billing (DB) agreement for future cases, they can deposit HKD 100, 000 into our account for us to provisionally accept their Letter of Guarantee (LOG).
3) Question:My insurance representative said they already have a Direct Billing (DB) agreement with Matilda, can I just present the medical card upon admission?
Answer: Depending on your insurance policy, different insurance companies require different documents for direct billing. Sometimes it is sufficient to bring along your medical card only, but other times we may require a Letter of Guarantee (LOG) from insurance companies in order to directly bill them.
Please contact our Patient Service Centre at (852) 2849-0111 and clarify whether just bringing along your medical card is sufficient prior to your admission.
4) Question: With a Direct Billing (DB) agreement, it means “nothing” out of my pockets?
Answer: It depends on your insurance policy - some may incur maximum coverage / allowance, copayments, deductibles and self-paying items (e.g. IDD calls, guest meals). For any uncovered portion, it must be paid at the hospital prior to your discharge. For any enquiries, please kindly contact your representative to clarify.
5) Question:What are the typical procedures to register elective treatments for direct billing (DB) agreement?
Answer: 1. Prior to your admission, please confirm with your insurance company on treatment coverage and ask them for a letter of guarantee
2. Please bring along the following documents with you upon admission:a. Valid membership cardb. Letter of guaranteec. Medical claim form
3. During the registration, our staff will ask you to :a. Present your insurance membership cardb. Present your ID card / passport / Identification documents for verificationc. Fill in the details of patient’s part in the claim form and endorse your confirmationd. Endorse your name on the credit card voucher to settle charges NOT covered by the LOG (eg. deductibles, co-payments and self responsible items like lodger, laundry, telephone bills and guest meals)
6) Question: What should I tell when asking the insurer or broker for a Letter of Guarantee (LOG)?
Answer: You should provide your insurer:a. Patient’s nameb. Policy number & date of birth (DOB)c. Diagnosis. Treatment plan and proceduree. Admission date and estimated length of stayf. Estimated costg. Choice of room typeh. Pre-authorization Form from doctor-in-charge
7) Question:Who should help filling out my Pre-authorization Form?
Answer: In charge doctor should be able to help as they fully understand your individual case’s needs, diagnosis & treatment details. Matilda can help providing clinic contacts if necessary.
8) Question:My insurer needs quotations for my Letter of Guarantee (LOG), how could I get it?
Answer: For hospital charges, we can provide you with estimation after receiving your treatment details (you may directly ask your doctor for assistance).
For doctor charges quotation, please kindly contact your in-charge physician, Matilda is only collecting the professional charges on their behalf and doctor’s charge(s) at their own discretions.
9) Question:Where should they send the Letter of Guarantee (LOG) and relevant details to?
10) Question:My Letter of Guarantee (LOG) was already received by Matilda, what else do I need to bring with prior to my admission?
Answer: Please have your ID card / passport & any membership card (as necessary) ready with you for identification. You may also want to bring some personal necessities or things recommended by midwives or doctors.
11) Question:What if I cannot get my Letter of Guarantee (LOG) even at discharge in the end?
Answer: You will be required to settle all outstanding amounts upon discharge. We will then issue the hospital invoices for you to claim reimbursement back from your insurer.
12) Question:My representative said Matilda accepted their Letter of Guarantee before, why not this time?
Answer: We may deny the LOG because of several good reasons:a. The DB agreement was already expiredb. Because of unfavorable settlement history by the insurance company, we suspended the Direct Billing (DB) accountc. The company has recently undergone rebranding and restructuring, we cannot distinguish from its new faces.In any case, please turn to your insurer to contact us directly to sort out the issues.
13) Question:With your vast experience in dealing with insurance policies, can you simply tell me my coverage and which type of room I entitle?
Answer: Abiding by the privacy laws and confidential information protection, we are unable to access your individual policy details. Even corporate provided schemes are many times tailored made and differ from each other. Please seek help from your insurance representative / HR or call the helpline which is stated at the back of your membership card.
14) Question:My insurance representative said I am only entitled for semi-private room. However, I would like to stay in private room. What should I do?
Answer: You will have to pay the room, package and doctor fees differences between the two levels of accommodations. It will be collected upon discharge, and a blank credit card voucher will be required upon admission
15) Question:I have two insurance companies covering my surgery and both have direct billing agreement with Matilda. Can the hospital send my bill to both of the insurance companies?
Answer: There is only one set of original bill. The hospital will send the original bill to 1 insurance company only. You have to decide which one you would like the hospital to send.For the second insurance company, you have to claim from it directly. A copy of the bill will be given to you upon discharge.
16) Question:I am thinking of subscribing to a medical insurance scheme in Hong Kong, can I have some advice on which one to choose?
Answer: Being an independent medical service provider, Matilda is not at a proper position to recommend any over the others. Having said that we have worked very closely with most major insurers and assistance companies around the globe, you can submit the names of companies being considered so that we can tell which one we have dealt with.
17) Question:Who should be the contact for the setup of Direct Billing agreement?
18) Question:What do we need to prepare for setting up a Direct Billing agreement?
Answer: Contract draft, financial statements to substantiate credibility as well as adequate document samples:a) Membership card(s), with your company’s logo imprintedb) Pre-authorization formc) Guarantee of Payment / Letter of Guaranteed) Claim forme) Information release consent form