Insurance FAQ

Below is a general outline of our direct billing procedure and documents required by most insurers who have direct billing agreements with our hospital.
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Please note that the direct billing procedure may differ between insurers, so we recommend that you contact your insurer regarding their specific requirements before engaging our services.

1. Prior to engaging our services, patients should contact their insurer to verify their insurance coverage and responsibility AND request for a letter of guarantee/pre-authorization.
2. Patients should present their medical card and letter of guarantee/pre-authorization to our hospital staff upon registration.
3. Patients will be asked to fill in and sign the necessary documents, such as a medical claim form and medical voucher.    
4. Patients may also be asked to present other documents, such as their passport or HKID copy.
5. Patients must settle the amount deemed their responsibility after service, such as deductibles/copayments/fees for excluded items.      
6. Our hospital will submit invoices and necessary documents to the insurer for claims adjudication and payment.      

*Please note: if the patient’s insurer requests for additional payments as part of the patient’s responsibility following a claim assessment, the hospital reserves the right to bill the patient for these outstanding payments.

Our hospital has direct billing agreements with most local and international insurers as well as third party administrators. We recommend that you check with your insurer regarding their direct billing arrangements with our hospital (if any) or contact our Patient Business Department before engaging our services.

Patient Business Department (Outpatient) - Tel: (852) 3651-8808; Email: regdesk@hkah.org.hk
Patient Business Department (Inpatient) - Tel: (852) 3651-8805; Email: hkahpsr@hkah.org.hk

Please check with your insurer to see whether they can appoint a TPA (third party administrator) that has a direct billing agreement with us and is able to issue a letter of guarantee (LOG) on behalf of the insurer. Alternatively, you can check with your insurer whether they are willing to place a deposit and/or settle the final bill on your behalf by credit card.

The procedure depends on your insurer’s guidelines. You may be required to present your medical card or request for a letter of guarantee from your insurer in advance. Please refer to FAQ 1 for an overview of the general procedure and required documents for direct billing. To find out the detailed procedure and documents required of your particular policy, please contact your insurer or our Patient Business Department:

Patient Business Department (Outpatient) - Tel: (852) 3651-8808; Email: regdesk@hkah.org.hk
Patient Business Department (Inpatient) - Tel: (852) 3651-8805; Email: hkahpsr@hkah.org.hk

This ultimately depends on your insurance/medical benefit policy. Some policies involve a maximum coverage allowance, copayments, deductibles, and/or exclusions. You are advised to clarify with your insurer before engaging our services.

To enjoy direct billing service, a letter of guarantee must be presented before you leave the hospital. Without this letter, you are required to settle any interim bill during your stay and/or final bill before you leave the hospital. In this case, an official receipt and statement will be provided to allow you to make a claim afterwards.

Please contact your insurer for clarification of your benefits. Some insurers may require patients to pay additional fees for this arrangement while others may withdraw their letter of guarantee and refuse to pay the final bill. You are therefore strongly advised to check with your insurer before choosing a room class that exceeds your benefit limit.

Upon a patient's request, we can check with his/her insurer to confirm whether they have a direct billing arrangement with us for the patient’s particular pre-planned medical treatment. However, confirmation of a direct billing arrangement does not necessarily indicate confirmation of coverage. The final reimbursement amount ultimately depends on the patient’s policy and its terms and conditions, validity, remaining allowance, and other factors at the time of service. Westrongly recommend patients to contact their insurer directly for details.

We will only arrange direct billing with ONE insurer, so please choose one at your discretion. If you are required to pay a portion of the bill, we will issue an official receipt for the portion you paid. You may then contact your second insurer to make a claim.

As per guidelines set out by insurers, we are required to ask for your medical card at every visit to ensure your eligibility is valid at the time of service, and so that we are able to provide direct billing services promptly and accurately.

The deductible paid during your recent visits may not be reflected in your insurer's claim system yet as they may still be processing. We calculate the direct billing amount based on the latest deductible information provided by your insurer. For details, please contact your insurer directly.

Collection of deductibles and copayments may vary between hospitals based on the terms and conditions of your policy, type of treatment you receive, and other factors. Your direct billing amount is calculated according to the guidelines provided by your insurer. For details, please contact your insurer directly.

No. We provide direct billing service based on our agreement with your insurer and according to guidelines provided by your insurer. The direct billing amount does not necessarily equal the covered amount. In some occasions, insurers may inform you of your responsible amount AFTER they finish the claims adjudication process. You are therefore strongly recommended to contact your insurer to clarify your coverage details before engaging our services.

Yes, it will. The patient name stated on the letter of guarantee and the medical card must match the patient’s name on his/her identity document. In the event that the names do not match, please ask your insurer to provide written confirmation (which indicates your identity document number) to prove that you are indeed the person indicated on the letter of guarantee and medical card.

Please contact and request your insurer to issue a letter of guarantee in advance. If we receive and accept a letter of guarantee before providing medical service, we are still able to offer direct billing service. You are also advised to apply for a new medical card at your earliest convenience

According to the direct billing agreements with insurers and third party administrators, in case of emergency, our hospital will assist to contact your insurance company for direct billing arrangement. Without a letter of guarantee (LOG), you are required to settle any interim bill during your stay and/or final bill before you leave the hospital. In this case, an official receipt and statement will be provided to allow you to make a claim afterwards.