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Presented by MyClient Planning Solutions Sdn Bhd

Insurance Programme for Students of CURTIN UNIVERSITY. Presented by MyClient Planning Solutions Sdn Bhd. COVERAGE. Medical Benefits Structure * Outpatient Clinical * Inpatient Hospitalization. Group Term Life. Coverage – Medical Benefits Structure. Medical Benefits Structure.

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Presented by MyClient Planning Solutions Sdn Bhd

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  1. Insurance Programme for Students of CURTIN UNIVERSITY Presented by MyClient Planning Solutions SdnBhd

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

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

  4. Coverage : Outpatient Clinic with Member ID Card Mustbe used when seeking care at any Panel GP Clinics Back Front If you lose your Member ID card, inform StudentServicesDepartment 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

  5. Visiting Panel GP Clinic Member seeks treatment Member presents member ID card & passport / IC Member AIA Panel GP Clinic Clinic staff swipes Card at EDC terminal EDC Printout Member to sign and keep a copy for records Benefits / Limitsverified & 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 AIA@MyService for the Directory of Panel GP Clinics Always check with your Student Services Department for Monthly Directory updates 5

  6. Sample EDC Printout 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:1028/0 MC: 0 DAY CONSULTATION 15.00 MEDICATION 25.00 INJECTION 10.00 LAB TEST 10.00 X.RAY 10.00 PROCEDURE 10.00 TRANSACTION AMT: 70.00 TOTAL BILLED: 80.00 (PATIENT TO PAY) 10.00 --------------------------------------------- SIGNATURE X __________________________________ Name of Clinic Name of Clinic Patient Name Patient Name Membership Num Company Name Transaction Code Visit Date Visit Date MC Days Diagnosis Code Bill Itemization Total Transaction Amount (billed to AIA) Total Billed Amount Amount Payable by Patient (RM10) 6

  7. Coverage – Medical Benefits Outpatient General Practitioner (GP)–PANEL CLINICS Employee Benefits

  8. 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 Doctor’s Consultation Hospital* Student – Admission @ Panel Hospital Doctor issue “Pre-Admission Order Form” for schedule Hospital Admission AIA will fax LOG* to the Member’s Hospital for covered services based on entitlement Follow-up Call to AIA Member Serives at Toll free no. 1300 8888 60 / 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 / Limitsverified & 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. Any GP Clinic Hospital During an Emergency Panel Non-Panel> Pay & Claim OR 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. Coverage – Medical BenefitsInpatient / Hospitalization …..cont /- Employee Benefits

  12. Coverage – Medical BenefitsInpatient / Hospitalization …..cont /- Employee Benefits

  13. Coverage – Medical BenefitsInpatient / Hospitalization Employee Benefits

  14. Coverage – Medical BenefitsInpatient / Hospitalization 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. 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 submityour 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. Claim Form Receipt and Itemized Billing Place Claim Form & attachments to Students Services Dept Fill in AIA Claim Form. How to Submit a Claim Payment & Notification on member claims Attach Original Receipt & itemized Billing & sign the Claim Form. Issue cheque to member . Benefits / Limitsverified & 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 Press 1 Press 2 Press 5 Press 3 Press 4 Step by step guide to the information / services provided For service Call 1300 8888 60/70 Status of Letter of Guarantee (LOG) / Referral Letters Select • 1 for English • 2for Bahasa Room & Board entitlement 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 Balance of Utilization Key-in • Membership Number • or IC or Passport Number Letter of Guarantee (LOG) request & benefits enquiries 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 25 AIA

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

  27. Coverage : Group Term Life 27 Employee Benefits

  28. THANK YOU

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