Aon Care Frequently Asked Questions

Transcription

1 Aon Care Frequently Asked Questions (A) General (B) Group Hospital & Surgical (GHS) (C) Group Outpatient Clinical (D) Group Outpatient Specialist (E) User Guide to Aon Care Mobile App (F) User Guide to Aon Care Member Portal (A) General (1) What is Aon Care? Aon Care is an employee health and well-being management solution that combines the power of innovation and integration to deliver greater flexibility, improved cost management, world class quality and convenience to employers and members. Aon Care is an initiative of Aon, in collaboration with Fullerton Healthcare Group in Singapore. (2) How is Aon Care going to benefit me as a Member? As a member of Aon Care, you will; enjoy superior level of customer service (24/7 concierge hotline) gain access to an extensive and high quality clinic and hospital network locate GP panel clinics on the go via mobile apps experience streamlined claims administration processes for all insured medical claims access innovative member technology (Web-based Member Portal, with Online claims submission capability) (3) Am I required to make copies of the claim forms and receipts/supporting documents upon submission to Aon Care? Yes, you are encouraged to make copies for your own reference. (4) I did not keep a copy of the form submitted to Aon Care. If Aon Care claimed that they did not receive it, what should I do? In the event where there is genuine loss of documents, you may request for duplicate copies of bills/receipts from hospital/clinic/specialist centre and re-submit with a completed claim form to Aon Care for assessment. We encourage members to make a copy of any documents submitted to Aon Care for your own reference. You may be required to sign a Letter of Undertaking. 1

2 (5) When is the deadline for me to submit my claim? Claims are to be submitted no later than 30 days from the incurred date. Forms that are submitted beyond the 30 days deadline may be considered on an exceptional basis and valid reasons for late submission is required. (6) How do I know if my claims submission to Aon Care is complete? What is Aon Care s procedure of requesting additional document from me? Aon Care Centre will review the claims documents that are provided with a receipt. Should there be additional document required from you, Aon Care Centre will send you an /formal letter indicating that additional information/document is required for claims assessment. (B) Group Hospital & Surgical (GHS) (1) Must I sign the Medisave Authorization Form upon admission at the hospitals? Yes, you are required to sign the Medisave Authorization Form in order to prevent any huge cash outlay in the event that the hospitalization bills get too high. (2) If the claim is payable under my insurance plan, will you reimburse the amount back to my Medisave account? Yes, it will be reimbursed back to your Medisave account. (3) Is hospitalisation incurred overseas covered? Yes. The GHS policy provides a 24-hour worldwide coverage, and the amount claimable is subjected to the member s benefits entitlement in his or her local currency. (4) Do I pay first and claim later or can Aon Care issue a Letter of Guarantee (LOG) to the hospital? For any planned surgery at the Singapore hospitals (restructured or private hospitals), please get the attending doctor to complete a Pre-Certification Form at least 5 working days prior to your admission to the hospital. This form can be downloaded from the Aon Care portal. Please send the duly completed form to Aon Care Centre for review. Upon assessing the form, Aon Care Centre will approve or reject the Letter of Guarantee (LOG) issuance based on member s benefits entitlement. For members without a portal access, please call Aon Care Centre to initiate the LOG request. Upon discharge, any incurred amount in excess of the LOG issued will be made payable by you first. After which, you can seek reimbursement under the insurance plan by submitting the finalized hospital bills, together with the GHS claim form to Aon Care for assessment. LOG is not applicable at GP clinics, specialist clinics, rehabilitation hospitals, nursing hospitals and all overseas hospitals. For any emergency cases, LOG will be issued under the Insurer s LOG followed by an eligibility confirmation and a waiver of Pre-Certification Form. A Pre-Certification Form has to be submitted when the patient is in hospital confinement. 2

3 (5) Will Surgical Schedule of Fees apply if I m being referred to a private hospital / overseas hospital for my surgery? Yes, it will apply as long as the surgical procedure is done at private hospitals/all overseas hospitals. (6) For claims submission, must the hospital bill be final and itemized? Yes. Final hospital bill will reflect the final amount incurred by you and the amount deducted from your Medisave account and/or Medisave-approved Shield plan. The final hospital bill will provide a breakdown of the cost of services/treatments rendered to you, which is necessary for assessing the payable amount. (C) Group Outpatient Clinical (1) Is clinical visit at polyclinics covered? It is covered as-charged on reimbursement basis. (2) Are visits at 24-hours clinics available? Visits at 24-hours clinics are only applicable if the 24-hours clinic is listed under the panel listing (please take note that the operating hours are listed on the panel listing. Surcharge may be applicable, and they will not be reimbursable under the policy). (3) Why is surcharge incurred due to visits outside the normal operating hours of the clinic excluded under Outpatient Clinical? The intent of an Outpatient Clinical plan is to reimburse medical expenses. Surcharge is deemed to be an administrative fee, hence not reimbursable under the policy. (4) Any Aon Care panel clinics in overseas? Aon Care has a few panel clinics located at Johor Bahru, Malaysia. You may access Aon Care panel listing from or through Aon Care mobile app. (5) I did not produce my Aon Care Card to visit a panel clinic. How can I claim? If you forget to bring your Aon Care Card when visiting a panel clinic, you will have to pay for the medical treatment rendered, and submit the claim for reimbursement to the Non-Panel limit (if it is applicable under your policy). You must present your Aon Care Card to enjoy cashless visits. (6) The clinic charged me for a referral letter to the specialist. Can I claim for this? Charges for referral letters or any non-medical supplies are strictly not reimbursable. (7) When can I start using my Aon Care Card? You can use your Aon Care Card at the panel clinics on the day that you are made eligible (for example, your first day of employment or upon employment confirmation). 3

4 (8) What should I do if I lost my Aon Care Card? Insured member who is using smart phone will be able to download Aon Care smart phone application which will include the member s e-card. For those insured member who does not use a smart phone, you can request for a reprint of your card by reaching out to Aon Care Centre ( OR AonCare@fullertonhealthcare.com). There is a $10 card replacement fee unless you are able to produce a police report. (D) Group Outpatient Specialist (1) Is referral letter required prior to Specialist Consultation? A referral letter is required from a certified general practitioner prior to seeing a specialist for nonemergency medical care. This process ensures that you are referred to the appropriate specialist based on the medical care and treatment recommended to you by a medical professional. Should you fail to obtain the required referral letter prior to visiting a specialist, you will not receive any reimbursement for your specialist consultation under the policy. (2) If it s an ongoing treatment at a specialist, do I still need to get a referral letter? Please let Aon Care know about your medical history by attaching a copy of your medical appointment card or a note from your specialist explaining that you are currently undergoing an ongoing treatment. (3) Is a referral letter from General Practitioners restricted to consultation at specialists of private hospitals? No, there is no restriction to this. It would be the doctor s opinion to recommend a specialist. You can choose to visit your preferred specialist or any specialists at the Government/restructured hospital as long as the specialist that you visit is of the same discipline that you are being referred to (for example, if you are referred to a cardiologist with no specific clinic stated on the referral letter, you can choose to visit a cardiologist at either Mount Elizabeth Hospital or National Heart Centre (SGH)). (4) Do I enjoy cashless visit at the specialist clinic? Cashless visits are available only at the private panel specialist clinics. Visits to the specialist at the Government/restructured hospitals will be on a reimbursement basis. 4

5 (E) User Guide to Aon Care Mobile App (1) Download the Aon Care Mobile App For Android users, download the Aon Care App via Google play For Apple users, download the Aon Care App via the App Store (2) Login Page Enter Member ID / National ID, Date of Birth and click on login 5

6 (3) View your Aon Care Card Click on Aon Care Card to view your card (4) Navigation Panel Front view of your card Click on Click to change view to view back of card Back view of your card Click on Click to change view to view front of card Click on the button circled in red to bring you to the navigation panel The navigation panel brings you to the various links on the mobile site 6

7 (5) Search and View the nearby clinics Step 1: Click on Nearby Clinics to view clinic locations Step 2: If you see this error message, please go to your privacy setting to enable location service for your web browser You should be able to view the nearby clinics on the map Search by Clinic Name and Address OR Search by Clinic Type and Region 7

8 (G) User Guide to Aon Care Member Portal (1) Visit to access the Aon Care Member Portal Home Page Member Portal Page Click on Ready? Enter your Member Portal now. 8

9 (2) Member Portal - Login Login ID and Password will be sent to your office address Upon first login, you will be prompted to change your password If you had forgotten your password, please click on Forgot your password? and a new password will be generated and to you This portal can be accessed anytime, anywhere using your smartphones, ipads, tablets, laptops and desktop computers (3) Member Portal - Home After successful login, you can view the list of information on the left hand panel 9

10 (4) Member Portal - Providers Under Providers, you can do a search by Provider Type for the different type of providers covered by your company Under Providers, you can do a search by Provider Region for the panel of GP and Specialist clinics by regions Under Providers, you can do a search by Provider Name for the panel of GP and Specialist clinics Under Providers, you can click on that specific panel clinic you wish to visit for their location, contact details and operating hours (5) Member Portal - Benefits Under Benefits, you can view all your Benefit Types Under each Benefit Type, you can view the current utilised amount & balance amount There is a summary table for the member to keep track of the overall budget 10

11 (6) Member Portal - Visits Under Visits, you can view your panel and non-panel visits records You can view your claims submission status Submitted, Approved, Rejected or Voided You can sort your claims by Record Type Panel or Non-Panel claims You can sort your claims by Record Status Submitted, Approved, Rejected or Voided (7) Member Portal Submit Claim Under Submit Claim, you can submit your non-panel claims You are required to complete all compulsory fields and provide a detailed breakdown of your claims to avoid delay for reimbursement You can attach softcopy of your claims under File Attachment You can input special notes under Remarks Click Submit button, when you complete your claims submission and an acknowledgement note will be prompted 11

12 (8) Member Portal - Documents Under Documents, you can view our Welcome Letter and benefits of the Aon Care Card You can view your Employee Handbook (if any) (9) Member Portal My Profile Under My Profile, you can view your profile and dependents information (if any) 12

13 (10) Member Portal - Change Password Under Change Password, you can change your password Please keep your password safe, private and confidential (11) Member Portal - Logout Do remember to Logout after you have login 13