• Health Claims Filing Process

    We always want every convenience for you on every process, including in our product claim process.

https://www.youtube.com/watch?v=VRzY6q78wvgIt is a convenience facility provided when you are admitted to a referral hospital or an associate from Admedika without paying cash but simply by showing the participant card and identity card to the registration officer.

Cashless Claim Processing

 

 

Cashless Facility in Malaysia & Singapore

 

Cashless facility in Malaysia is available for those of you who have Sequis Q Health Platinum Plus Rider with Plan 1000 and above, and Sequis Q Infinite Medcare Rider. Singapore Cashless facility is only available for Sequis Q Infinite Medcare Rider.

Follow these steps:

1. Choose the hospital you want

A list of Sequis partner hospitals can be viewed at https://www.sequis.co.id/en/services/hospital-list or downloaded via Sequis Mobile App.

2. Easy and Fast Administration in hospitalization

a. Ways to get hospitalized service:

Registration by contacting:

- Admedika (021) 2964 7300 or

- IA (International Assistance) 1-800-22-7378 (for service in Malaysia and this number can only be used if already in Malaysia) or

- Singapore (+65) 3157 9670

 

1. Verification and registration to the hospital you choose.

2. Visit the hospital you selected after receiving confirmation.

3. Your membership card will be processed and then receive care coverage information, deposit guarantee *** and signing a statement.

b. Immediately visit the hospital by showing membership card ** and identity card.

The hospital clerk will process membership cards. You will receive care coverage information, guarantee deposit and you will sign a letter of statement.

3. Easy check out Hospital process

a. You will receive a hospital check out confirmation and the hospital staff will process the membership cards.

b. After a while, you will receive the approval receipt and sign the return form as well as completing the administrative requirements and pay the excess fees if any (in accordance with the insurance benefits held).

 

*Terms and conditions follow the Policy. The Health Services Administration in Indonesia is conducted by AdMedika and IA (International Assistance) for services in Malaysia & Singapore

**If your membership card is lost, please contact AdMedika Hotline service 24 hours.

***Deposit is the amount of funds that must be submitted to the hospital to pay for excesses that occurred during the treatment. If there’s any remaining funds or funds are not used, then the funds will be returned to the client upon return.

It is a feature provided by Sequis to ease the Insured when undergoing outpatient and inpatient throughout the hospital submitted no later than 30 days after the insured leaves the hospital.

Reimbursement Claims Procedure

* Fill out and sign the hospitalization claim form thoroughly

* Submit a Medical Certificate / Letter from Attending Physician

* Copy of the Insured Person’s valid identity card

* Submit the Statement of Approval form

* Attach original receipts and detailed invoice issued by the hospital. In the case that these two (2) original documents have been submitted to the other Insurer, they may be replaced with copy of the document that have been legalized by the hospital accompanied by a letter detailing the payments made by the other Insurer

* Attach the details of medicines from the hospital that were prescribed and consumed during treatment, including treatment abroad

* Submit the results of tests carried out during the treatment (laboratory, X-ray, anatomic pathology, ECG and others)

Reimbursement Claims Procedure for Accidents

Submit the abovementioned documents along with additional documentation, among others:

* Please attach an Accident Statement from the police in the case of a traffic accident and a letter from the workplace in the case of a work accident
* Please attach a complete chronology of the accident (including day, date and time of occurrence)


Health Claim Submission Procedures After Hospitalization

* Attach proof of purchase for medicines accompanied by a copy of the prescription
* Fill out the Claim Form
* Attaching the results of the examination together with the original payment receipt for the examination.

Forms:

Health Claim Submission Form

Health Claim Approval Form

Written Consent

Medical Certificate Form

To Ease the claim process, you can take advantage of the e-Claim facility, which Sequis provides to enable customers to make health claims with a maximum receipt of Rp 3 million per one series of treatments.


The terms of service through "e-Claim" are as follows:

1. Claim Submission Requirements

a. Claims submitted before 14.00 WIB on weekdays will be replied via email or SMS on the same day.

b. Claims submitted after 14.00 Western Indonesia Time or holiday will be replied via email or SMS on the next H + 1 business day.

2. Claim Submission Document Requirement
a. Total maximum receipts submitted Rp. 3 million per one series of treatments.
b. Required to submit claims documents as follows:
    b.1. Photocopy of Doctor's Certificate or Medical Resume or Discharge Summary
    b.2. Photocopy of Valid ID
    b.3. Photocopy of the receipt and its details

3. The data MUST be submitted at the time of "e-Claim" submission 
a. Policy Number
b. Name of the Insured / Patient
c. Account Number of Policyholder (no Account Number allowed other than Policyholder)
d. Full Name of claimant at the bottom of the message

4. Claimant Terms
a. Can be submitted by Policy Holder, Agent, Leader, or VP of the Policy
b. Agent, Leader and VP who are not from the policy must obtain written approval from the Policy Holder
c. If there is a difference between the claimant and all parties in the Policy then clarification will be made first

Claim submission can be submitted to:

eclaim@sequislife.com

WhatsApp / LiNe 082110002929

Sequis Services

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