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1 Presented by MyClient Planning Solutions Sdn Bhd
Insurance Programme for Students of CURTIN UNIVERSITY Presented by MyClient Planning Solutions Sdn Bhd

2 Medical Benefits Structure * Inpatient Hospitalization
COVERAGE Medical Benefits Structure * Outpatient Clinical * Inpatient Hospitalization Group Term Life AIA

3 Medical Benefits Structure
Coverage – Medical Benefits Structure Medical Benefits Structure * Outpatient General Practitioner (GP) * Inpatient Hospitalization (GHS) AIA

4 Coverage : Outpatient Clinic with Member ID Card
Must be used when seeking care at any Panel GP Clinics Front Back If you lose your Member ID card, inform StudentServices Department immediately There will be a RM10 replacement fee except in cases of loss with police report or faulty card (cannot be read by EDC Terminal) You can get waiver of RM10 replacement fee if you submit request online via 4

5 Visiting Panel GP Clinic
Member presents member ID card & passport / IC Member seeks treatment Member AIA Panel GP Clinic Clinic staff swipes Card at EDC terminal EDC Printout Member to sign and keep a copy for records Benefits / Limits verified & approved EDC terminal linked To AIA Note: Max 1 visit per day. NO limit per visit EDC Printout Member to pay Benefits / Limits verified & rejected You can only visit a non-Panel clinic in an Emergency or there are no Panel GP Clinics within a 5 km radius of your location. Log on to for the Directory of Panel GP Clinics Always check with your Student Services Department for Monthly Directory updates 5

6 Sample EDC Printout Name of Clinic Name of Clinic Patient Name
DATE/TIME : 08 JUNE :55 MERCHANT ID : TERMINAL ID : BATCH NUM : INVOICE UM : CARD NUM : PAY AIA CORPORATE SOLUTIONS POLIKLINIK ABC TAN YEN YEN ABC COMPANY 08/01/ TRAN# DIAG:1028/0 MC: 0 DAY CONSULTATION 15.00 MEDICATION INJECTION LAB TEST X.RAY PROCEDURE TRANSACTION AMT: 70.00 TOTAL BILLED: (PATIENT TO PAY) 10.00 SIGNATURE X __________________________________ Name of Clinic Name of Clinic Patient Name Patient Name Membership Num Company Name Visit Date Visit Date Transaction Code Diagnosis Code MC Days Bill Itemization Total Transaction Amount (billed to AIA) Total Billed Amount Amount Payable by Patient (RM10) 6

7 International Students Local Covered Students
Coverage – Medical Benefits Outpatient General Practitioner (GP)–PANEL CLINICS Categories International Students Local Covered Students Outpatient GP Care Routine Consultation Medication Injection Diagnostic Lab / X-Ray Procedures Outpatient Surgical Procedures AIA PANEL CLINICS Out-patient GP care (NON PANEL) Out-Patient Specialists care Not Cover, Only for emergency Not Cover only for emergency VALID WITHIN MALAYSIA ONLY Definition of Emergency: "Emergency" shall mean treatment needed in the event whereby immediate medical attention is required within twelve (12) hours for injury, illness or symptoms which are sudden and severe failing which will be life-threatening (eg. accident and heart attack), or lead to significant deterioration of health. Employee Benefits

8 Hospital Doctor’s Consultation
Student – Panel Hospital Doctor issue “Pre-Admission Order Form” for schedule Hospital Admission Member to Hospital admission counter to sign & pre-arrange admission procedure 48 hour prior to schedule admission. Hospital will fax Pre-Admission forms to AIA to request for LOG /admission deposit AIA will fax LOG* to the Member’s Hospital for covered services based on entitlement Hospital Doctor’s Consultation Hospital* Follow-up Call to AIA Member Serives at Toll free no / 70 At Government Medical Centers/Hospitals - Pay first, retain itemised bill & receipt and submit claim to AIA Insurance for reimbursement of covered services. *Pre-Admission Assessment Form (PAAF) must be duly completed by the attending doctor prior to requesting a LOG for an admission / Day care procedure. Member

9 Student – Discharge @ Panel Hospital
AIA will process for covered services based on entitlement Prior discharge, hospital will forward hospital final bill + Doctor’s report to AIA for covered services. Benefits / Limits verified & approved Member discharge & pay excess / non-covered item(s), if any & hospital will bill ING for covered service Benefits / Limits verified & rejected Member to pay At Government hospital / non-panel Hospitals - Pay first, retain ORIGINAL itemizd bill(s) & receipt (s) including deposit receipt . Submit claim to AIA for reimbursement of covered services.

10 OR During an Emergency Panel Non-Panel > Pay & Claim Hospital, A&E
Any GP Clinic Panel Non-Panel > Pay & Claim OR Hospital Hospital, A&E Accident & Emergency > Pay & Claim Member Emergency – An illness or injury that is life or limb threatening which needs immediate medical attention. Employee Benefits

11 International Students Local Covered Students
Coverage – Medical Benefits Inpatient / Hospitalization Categories International Students Local Covered Students In-Hospital Care Hospital Room & Board (Max. 120 days) 100 Intensive Care Unit (Max. 20 days) 350 Hospital Supplies and Services As Charged Surgical Fees Anaesthetic Fees Operating Theatre Charges In-Hospital Physician’s Fees (Max. 120 days) Malaysian Government Hospital Daily Cash Allowance (Max. 120 days) 30 Hospital Service Tax (on eligible room & board charges paid 6% …..cont /- Employee Benefits

12 Coverage – Medical Benefits Inpatient / Hospitalization
…..cont /- Categories International Students Local Covered Students Ambulatory Care P100 Pre-Surgical/Medical Diagnostic Services (within 60 days prior to admission) As Charged Pre-Surgical/Medical Specialist Consultation (within 60 days prior to admission) Second Surgical Opinion Post Hospitalization Treatment (Max 60 days following discharge from hospital) Day care Procedure (surgical / medical) Emergency Outpatient Accidental Treatment (within 24 hours up to max 60 Days) 2,500 Ambulance Service (Emergency & Non-Emergency) 250 Accidental Dental Treatment (within 24 hours up to max 14 days) 500 Employee Benefits

13 Coverage – Medical Benefits Inpatient / Hospitalization
Categories International Students Local Covered Students Ambulatory Care Medical Report Fee Reimbursement (applicable for In-hospital Care & Ambulatory Care) 80 Emergency Out-Patient Treatment (max per disability from 10pm – 8am) 100 Basic Overall Limit Per Student Per Year 20,000 Definition of Emergency: "Emergency" shall mean treatment needed in the event whereby immediate medical attention is required within twelve (12) hours for injury, illness or symptoms which are sudden and severe failing which will be life-threatening (eg. accident and heart attack), or lead to significant deterioration of health. Employee Benefits

14 Coverage – Medical Benefits Inpatient / Hospitalization
Categories International Students Local Covered Students Extended Benefits Compassionate Allowance 2,000 Long Term Care Benefits Kidney Dialysis Chemotherapy 10,000 Employee Benefits

15 What’s Not Covered Cosmetic surgery or treatment
Experimental procedures Substance abuse Private nursing care Sexual dysfunction or infertility Pregnancy Alternative therapies Psychotic, mental or nervous disorders Congenital or hereditary illnesses Routine physical examination Refractive errors Employee Benefits

16 Important Notes DEPOSIT
TREATMENT PERSONAL PERSONAL DEPOSIT Some hospitals may require personal deposits (on top of deposit granted by AIA) upon admission to pay excess or non-covered Item(s) under the policy. This deposit is refundable upon discharge. Please refer to your Student Services Department for detailed information on your benefits AIA

17 Things to be avoided during hospitalization
Important Notes Things to be avoided during hospitalization Examples of non-covered items : extra food admission kit / discharge pack telephone calls, laundry unrelated tests, drugs vitamins & supplements AIA

18 Important Notes A GP clinic is under the conduct of a registered medical practitioner who provides primary care and specializes in family medicine. Your policy recognizes treatment at GP clinics ONLY. A Specialist Clinic is a clinic with in-depth diagnosis or treatment on Diseases of specific parts of the body. Outpatient Specialist Treatment is EXCLUDED. ING

19 Important Notes Non-emergency cases, if LOG is not arranged in advance within 48 hours, please pay first and submit your claim to AIA For emergency (i.e. life & limb threatening) cases, AIA will give immediate approval to the hospital. Pre-Admission Assessment (PAAF) form needs to be signed by member and completed by your attending doctor and hospital needs to submitted to AIA call centre before we could proceed to issue LOG. Long term medications will only be issued on monthly basis. Claims must be submitted to student centre for submission to AIA within 30 days from the date of consultation or service. AIA

20 Reimbursement Claims ( “Pay & Claim basis” )
1. Outpatient Clinical (Complete Member Outpatient Claim Form) * Non-panel clinic emergency claim * No panel clinic within 5 km of your location * Panel clinic closed * Emergency outpatient treatment at hospital Accident & Emergency (A&E) unit * Waiting for new / loss of AIA member ID card 2. Inpatient Hospital Admission (Complete Member Hospitalization & Surgical Claim Form) * Non-panel Hospitals admission * Government Hospital admission * Pre –Specialist & Post (follow up) hospitalization Employee Benefits

21 Documents Required for medical Claim
In the event you have to pay first for your Outpatient GP, or Emergency/Accidental Outpatient Treatment @ Accident & Emergency Unit of a hospital, please submit the followings to AIA Itemized bill(s) with breakdown of charges Original bill(s) & Receipt(s) including deposit receipt AIA Claim Form (obtain from shared folder) Please indicate the reason for Pay & Claim in the claim form Employee Benefits

22 How to Submit a Claim Payment & Notification on member claims
Place Claim Form & attachments to Students Services Dept Receipt and Itemized Billing Fill in AIA Claim Form. Claim Form Attach Original Receipt & itemized Billing & sign the Claim Form. Issue cheque to member . Benefits / Limits verified & approved Documents returned Benefits / Limits verified & rejected AIA processes claims. Reimbursements for complete claims will be credited into members account within 21 calendar days from date of receipt. All claims will be reimbursed according to benefit entitlements, subject to the 13th MMA Fee Schedule. Employee Benefits

23 Non-Reimbursement Claims
Outpatient Clinical * Panel clinic claim without the use of the AIA member ID card * Claim from non-panel clinics in a non-emergency * Outpatient Specialist Treatment Inpatient Hospital Admission * Non-covered or excluded services, treatments and medication Employee Benefits

24 Faulty / Loss of ING Member ID Card
Report your loss/ faulty card to your student services department immediately. Your panel GP claims will not be reimbursed if you do not report your loss. There will be a RM10 replacement fee except when a reported loss is accompanied with a police report or you have a faulty card (cannot be read by EDC terminal) If you need medical care and you have not yet received your replacement card, please pay first and submit your claim. Employee Benefits

25 Interactive Voice Response (IVR) service
Step by step guide to the information / services provided For service Call /70 Press 1 Status of Letter of Guarantee (LOG) / Referral Letters Select Press 2 1 for English 2 for Bahasa Room & Board entitlement Press 3 Press Request to re-fax of LOG 1 If you are AIA Member or HR 2 If you are Specialist Centre 3 If you are GP Clinic Staff Press 4 Balance of Utilization Key-in Membership Number or IC or Passport Number Press 5 Letter of Guarantee (LOG) request & benefits enquiries Note: For claim and any other enquiries, please call /70 at extension no For enquiry member ID and member status at the following extension  8205 or 8213 or 8235 or 8285 from 8.30am to 5.00pm from Monday to Thursday and 8.30am to 4.30pm on Friday 25 AIA

26 Coverage Group Term Life Total & Permanent Disability Death 26 AIA

27 Coverage : Group Term Life
Category Group Term Life (GTL) Death Permanent Total Disability (PTD) due to natural causes Permanent Partial Disability (PPD) – Subject to Schedule Accidental Personal Accident International Students RM20,000 Each Not Applicable 27 Employee Benefits

28 THANK YOU


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