Pre-Authorization or Prior Authorization

1. Some treatments, investigations, and prescription medications may need to request pre-approval from the insurer if the cost exceeds certain thresholds or the procedure is deemed to be as not medically necessary. Usually, the turn-around time takes 48 hours but, in some circumstances, it may take longer hence, it can’t be avoided that the appointment will be re-scheduled.
2. In emergency cases, our medical staff will go on with the treatment. In case like this, you will be requested to deposit a certain amount while the case is still under review.

Payment process: Direct billing or Pay and claim

Pay and claim

1. Outpatient coverage depends on your insurance policy; it is possible that some insurances policy is not eligible for direct billing and you will be requested for “pay and claim”. In this case, you will be responsible for your reimbursement process.
2. In some circumstances that you will “pay and claim”, you may notify our Insurance coordinator if you need a claim form and medical report.
3. You will then submit the documents to your insurance along with your original receipt so they can get reimbursement.

Cashless Service

1. In “cashless” payment, we will gather all the relevant documents and submit the claims to the insurance company. However, you are still required to sign the invoice.
2. Depending on your insurance policy, you may need to pay deductibles, copayment or coinsurance and excess as other insurance policies have limits.
3. Our insurance coordinator will aid in providing information to our medical staffs and patients regarding the amount covered by the insurance and the excluded expenses or out-of-insurance coverage responsible to be paid by the insured.
4. Insurance companies has exclusions depending on the member’s policy. Most insurance excludes pre-existing condition, cosmetic or plastic surgery, and special medicines such as Vitamins, Dietary supplements, and weight loss medication. To determine your policy inclusions and exclusions, you should consult your insurance provider.

No existing Pre-arrangement/Non-contract Insurance

1. If there’s no direct billing contract between Vejthani Hospital and your insurance company, you will be directed to pay for your treatment up front, then request reimbursement directly from your insurer afterward.