Contractual Company Privileges

For life and health insurance policyholders

Piyavate Hospital provides coordination services for life and health insurance claims to facilitate medical services for patients. Staff will assist in coordinating information with insurance companies according to the relevant procedures.

The use of benefits, coverage, approval of medical expenses, and additional expenses payable by the service recipient are subject to the terms and conditions of the policy, coverage plan, supporting documents, and approval from each insurance company.

Insurance claims coordination service

Life and health insurance policyholders can contact hospital staff for advice on how to use their insurance benefits. Services may include, depending on the circumstances, the following:

• Initial authentication
  The officer will assist in coordinating with the insurance company to verify eligibility and initial coverage conditions.

• Coordination for cases where no upfront payment is required
  If the insurance policy meets the Fax Claim, Cashless Claim, or Direct Billing criteria, the hospital will coordinate with the insurance company according to the relevant procedures. Approval, however, depends on the insurance company.

• Coordination of rights for outpatients and inpatients
  The use of benefits for outpatient, inpatient, accident, critical illness, or other medical services is subject to the insurance plan and the terms and conditions of each individual policy.

• Preparing supporting documents for an insurance claim
  Hospitals can issue relevant medical documents, such as medical certificates, receipts, and expense reports, to be used as supporting documentation for insurance claims.

• Receiving services at a hospital's medical center
  Patients can receive treatment at the various medical centers of Piyavate Hospital, depending on their symptoms, medical needs, and the hospital's service procedures.

• Providing guidance on how to exercise your rights
  The officers provided guidance on the registration process, eligibility verification, coordination with insurance companies, and payment of related expenses.

The initial steps in exercising your insurance benefits

1. Show your ID card or passport.

2. Show your insurance card, or provide the name of the insurance company and policy number.

3. The officer will verify your eligibility and initial coverage terms and conditions.

4. Receive medical treatment according to hospital procedures.

5. The hospital coordinates information with insurance companies if necessary to obtain insurance approval.

6. The service recipient is responsible for any expenses not covered or exceeding their coverage limits, if any.

Documents that should be prepared

To facilitate eligibility verification and coordination with the insurance company, service recipients should prepare the following documents:

• National ID card or passport

• Insurance card or policy number

• Insurance claim document, if available.

• Referral letter or pre-approval document, as required by the insurance company.

• Previous medical records or test results, if relevant to the treatment.

• Other documents as requested by the insurance company or hospital.

Important Note

• Eligibility for insurance benefits depends on the terms and conditions of each policy, such as coverage limits, waiting periods, exclusions for diseases or treatments, outpatient and inpatient conditions, and required supporting documents.

• Fax Claim, Cashless Claim, or Direct Billing services are only available if they meet the policy terms and conditions and have been approved by the insurance company.

• Eligibility, coverage limits, covered items, and uncovered items are subject to the discretion of each insurance company.
  In cases where expenses are not covered by the insurance, such as tests, medications, medical supplies, medical equipment, room charges, or other services, the recipient must pay those expenses in full.

• The time required for eligibility verification and approval may vary depending on the insurance company's procedures, the type of treatment, the complexity of the condition, and the completeness of the documentation.

• Piyavate Hospital acts solely as a liaison with insurance companies to facilitate services for patients. Insurance claim approval and payment are subject to the insurance company's guidelines.

• Clients should review their policy details, coverage terms and conditions, coverage limits, exclusions, and claims procedures with the insurance company before receiving services.

• Piyavate Hospital reserves the right to modify procedures, required documents, or conditions for insurance claim processing as deemed appropriate, in accordance with hospital policy and the terms and conditions of the relevant insurance company.

Contact us for inquiries

Life and health insurance policyholders can contact the Health Insurance Service Unit at Piyavate Hospital for information regarding insurance benefits, eligibility checks, health packages, vaccine packages, and related services.

Opening days and hours:
Open daily, Monday–Sunday, from 8:00 AM to 8:00 PM.

Contact information:
Life Insurance Center, 1st Floor, Piyavate Hospital.

For inquiries, please contact:

Tel. 02-129-5555
Call Center: 1489