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AIA confidential and proprietary information. Not for distribution. Disclaimer: These presentation slides have been prepared by AIA Bhd. solely for use.

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Presentation on theme: "AIA confidential and proprietary information. Not for distribution. Disclaimer: These presentation slides have been prepared by AIA Bhd. solely for use."— Presentation transcript:

1 AIA confidential and proprietary information. Not for distribution. Disclaimer: These presentation slides have been prepared by AIA Bhd. solely for use during this presentation only and may not be reproduced or redistributed without the written consent of AIA Bhd. These slides serve only as a guide in the selling concept of the products mentioned. In the actual selling process, the customer's needs, affordability and preference must be considered to deliver fair value to the customer. The detailed product benefits and cost must be explained to help customers make informed decisions. Only AIA Bhd. authorized sales materials are to be used when prospecting. The contents have been summarized to suit presentation needs. For actual definitions, descriptions and exclusions, please refer to the actual policy contract. Presented by MyClient Planning Solutions Sdn Bhd Insurance Programme for Students of CURTIN UNIVERSITY

2 AIA confidential and proprietary information. Not for distribution. Please refer to the Disclaimer Notice on the first page of these slides. AIA2 Medical Benefits Structure * Outpatient Clinical * Inpatient Hospitalization Group Term Life COVERAGE

3 AIA confidential and proprietary information. Not for distribution. Please refer to the Disclaimer Notice on the first page of these slides. AIA3 * Outpatient General Practitioner (GP) * Inpatient Hospitalization (GHS) Coverage – Medical Benefits Structure Medical Benefits Structure

4 AIA confidential and proprietary information. Not for distribution. Please refer to the Disclaimer Notice on the first page of these slides. Must be used when seeking care at any Panel GP Clinics 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 aia@MyService- Corporate. 4 Front Back Coverage : Outpatient Clinic with Member ID Card

5 AIA confidential and proprietary information. Not for distribution. Please refer to the Disclaimer Notice on the first page of these slides. Visiting Panel GP Clinic 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 AIA@MyService for the Directory of Panel GP Clinics Always check with your Student Services Department for Monthly Directory updates Clinic staff swipes Card at EDC terminal Benefits / Limits verified & rejected EDC Printout Member to sign and keep a copy for records EDC Printout Member to pay Benefits / Limits verified & approved Member Member seeks treatment EDC terminal linked To AIA Note: Max 1 visit per day. NO limit per visit AIA Panel GP Clinic 5 Member presents member ID card & passport / IC

6 AIA confidential and proprietary information. Not for distribution. Please refer to the Disclaimer Notice on the first page of these slides. Sample EDC Printout Name of Clinic Patient Name Membership Num Company Name Visit Date Transaction Code Total Transaction Amount (billed to AIA) Amount Payable by Patient (RM10) DATE/TIME: 08 JUNE 13 11:55 MERCHANT ID: 000000000000000 TERMINAL ID: 12376925 BATCH NUM: 000001 INVOICE UM: 000003 CARD NUM: 8000146803440373 PAY AIA CORPORATE SOLUTIONS POLIKLINIK ABC TAN YEN YEN 75090710508202 ABC COMPANY 08/01/2006 TRAN# 000771 DIAG:1028/0MC: 0 DAY CONSULTATION15.00 MEDICATION25.00 INJECTION10.00 LAB TEST10.00 X.RAY10.00 PROCEDURE10.00 TRANSACTION AMT:70.00 TOTAL BILLED:80.00 (PATIENT TO PAY)10.00 --------------------------------------------- SIGNATURE X __________________________________ Total Billed Amount MC Days Diagnosis Code Bill Itemization Name of Clinic Patient Name Visit Date 6

7 AIA confidential and proprietary information. Not for distribution. Please refer to the Disclaimer Notice on the first page of these slides. Employee Benefits7 Coverage – Medical Benefits Outpatient General Practitioner (GP)–PANEL CLINICS CategoriesInternational StudentsLocal Covered Students Outpatient GP Care Routine Consultation Medication Injection Diagnostic Lab / X-Ray Procedures Outpatient Surgical Procedures Covered @ AIA PANEL CLINICS Covered @ AIA PANEL CLINICS Out-patient GP care (NON PANEL) Out-Patient Specialists care Not Cover, Only for emergency Not Cover Not Cover, only for emergency Not Cover 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.

8 AIA confidential and proprietary information. Not for distribution. Please refer to the Disclaimer Notice on the first page of these slides. Student – Admission @ Panel Hospital At Government Medical Centers/Hospitals - Pay first, retain itemised bill & receipt and submit claim to AIA Insurance for reimbursement of covered services. AIA will fax LOG* to the Members Hospital for covered services based on entitlement Hospital Doctors Consultation 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 Hospital* Follow-up Call to AIA Member Serives at Toll free no. 1300 8888 60 / 70 *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 Doctor issue Pre- Admission Order Form for schedule Hospital Admission

9 AIA confidential and proprietary information. Not for distribution. Please refer to the Disclaimer Notice on the first page of these slides. Student – Discharge @ Panel Hospital 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. AIA will process for covered services based on entitlement Prior discharge, hospital will forward hospital final bill + Doctors report to AIA for covered services. Benefits / Limits verified & approved Benefits / Limits verified & rejected Member discharge & pay excess / non-covered item(s), if any & hospital will bill ING for covered service Member to pay

10 AIA confidential and proprietary information. Not for distribution. Please refer to the Disclaimer Notice on the first page of these slides. Employee Benefits10 During an Emergency Emergency – An illness or injury that is life or limb threatening which needs immediate medical attention. Hospital, A&E Accident & Emergency > Pay & Claim OR Panel Non-Panel > Pay & Claim Any GP Clinic Hospital Member

11 AIA confidential and proprietary information. Not for distribution. Please refer to the Disclaimer Notice on the first page of these slides. Employee Benefits11 Coverage – Medical Benefits Inpatient / Hospitalization CategoriesInternational 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 Physicians 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 /-

12 AIA confidential and proprietary information. Not for distribution. Please refer to the Disclaimer Notice on the first page of these slides. Employee Benefits12 Coverage – Medical Benefits Inpatient / Hospitalization CategoriesInternational Students Local Covered Students Ambulatory CareP100 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 …..cont /-

13 AIA confidential and proprietary information. Not for distribution. Please refer to the Disclaimer Notice on the first page of these slides. Employee Benefits13 Coverage – Medical Benefits Inpatient / Hospitalization CategoriesInternational 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 Year20,000 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.

14 AIA confidential and proprietary information. Not for distribution. Please refer to the Disclaimer Notice on the first page of these slides. Employee Benefits14 Coverage – Medical Benefits Inpatient / Hospitalization CategoriesInternational Students Local Covered Students Extended Benefits Compassionate Allowance 2,000 Long Term Care Benefits Kidney Dialysis Chemotherapy 10,000

15 AIA confidential and proprietary information. Not for distribution. Please refer to the Disclaimer Notice on the first page of these slides. Employee Benefits 15 Whats 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

16 AIA confidential and proprietary information. Not for distribution. Please refer to the Disclaimer Notice on the first page of these slides. AIA16 Important Notes 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. DEPOSIT TREATMENT PERSONAL Please refer to your Student Services Department for detailed information on your benefits

17 AIA confidential and proprietary information. Not for distribution. Please refer to the Disclaimer Notice on the first page of these slides. AIA17 Important Notes Things to be avoided during hospitalization Examples of non-covered items : extra food extra food admission kit / discharge pack admission kit / discharge pack telephone calls, telephone calls, laundry laundry unrelated tests, drugs unrelated tests, drugs vitamins & supplements vitamins & supplements

18 AIA confidential and proprietary information. Not for distribution. Please refer to the Disclaimer Notice on the first page of these slides. ING18 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.

19 AIA confidential and proprietary information. Not for distribution. Please refer to the Disclaimer Notice on the first page of these slides. AIA19 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.

20 AIA confidential and proprietary information. Not for distribution. Please refer to the Disclaimer Notice on the first page of these slides. 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 Benefits20

21 AIA confidential and proprietary information. Not for distribution. Please refer to the Disclaimer Notice on the first page of these slides. Employee Benefits21 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 Documents Required for medical Claim 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

22 AIA confidential and proprietary information. Not for distribution. Please refer to the Disclaimer Notice on the first page of these slides. Employee Benefits 22 How to Submit a Claim Payment & Notification on member claims Fill in AIA Claim Form. Claim Form Attach Original Receipt & itemized Billing & sign the Claim Form. Receipt and Itemized Billing AIA processes claims. Place Claim Form & attachments to Students Services Dept. 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. Benefits / Limits verified & approved Benefits / Limits verified & rejected Issue cheque to member Documents returned

23 AIA confidential and proprietary information. Not for distribution. Please refer to the Disclaimer Notice on the first page of these slides. Non-Reimbursement Claims 1.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 2.Inpatient Hospital Admission * Non-covered or excluded services, treatments and medication Employee Benefits 23

24 AIA confidential and proprietary information. Not for distribution. Please refer to the Disclaimer Notice on the first page of these slides. Employee Benefits24 1.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. 2.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) 3.If you need medical care and you have not yet received your replacement card, please pay first and submit your claim. Faulty / Loss of ING Member ID Card

25 AIA confidential and proprietary information. Not for distribution. Please refer to the Disclaimer Notice on the first page of these slides. AIA25 Interactive Voice Response (IVR) service Step by step guide to the information / services provided Press 1 Press 2 Press 3 Status of Letter of Guarantee (LOG) / Referral Letters Room & Board entitlement Request to re-fax of LOG 1 for English 2 for Bahasa 1 If you are AIA Member or HR 2 If you are Specialist Centre 3 If you are GP Clinic Staff Select Press Key-in Membership Number or IC or Passport Number Call 1300 8888 60/70 Note: For claim and any other enquiries, please call 1300 8888 60/70 at extension no. 8104. 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 For service Press 4 Balance of Utilization Press 5 Letter of Guarantee (LOG) request & benefits enquiries

26 AIA confidential and proprietary information. Not for distribution. Please refer to the Disclaimer Notice on the first page of these slides. AIA26 Group Term Life Coverage Total & Permanent Disability Death

27 AIA confidential and proprietary information. Not for distribution. Please refer to the Disclaimer Notice on the first page of these slides. Employee Benefits27 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 RM20,000 Each RM20,000 Each Not Applicable

28 AIA confidential and proprietary information. Not for distribution. Disclaimer: These presentation slides have been prepared by AIA Bhd. solely for use during this presentation only and may not be reproduced or redistributed without the written consent of AIA Bhd. These slides serve only as a guide in the selling concept of the products mentioned. In the actual selling process, the customer's needs, affordability and preference must be considered to deliver fair value to the customer. The detailed product benefits and cost must be explained to help customers make informed decisions. Only AIA Bhd. authorized sales materials are to be used when prospecting. The contents have been summarized to suit presentation needs. For actual definitions, descriptions and exclusions, please refer to the actual policy contract. THANK YOU


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