Direct Billing Facility is a boon for the insurance policy holders. To render truly customer centric services, we have entered into strategic tie up with all the quality hospitals, diagnostic centers, clinics, laboratories across the Globe.
WAPMED’s wide provider network across the region, gives members freedom to choose any provider on the network to take treatment, without making any payments (other than nominal charges as per the terms & conditions of the policy). WAPMED issues a Letter of Guarantee to the provider for services covered under the benefit plan. The process of issuance of letter of guarantee begins with the receipt of the Admission Request Note and accomplishes with the communication of the decision of Authorization to the concerned. With the complete information on Pre Authorization form, the approval is issued immediately, whereas the turnaround time varies according to the nature of deficiency and queries raised by WAPMED on case to case basis.
Continued Stay Review process
After an authorization is given for high value claim and whenever and additional request for extension of amount is received, our Doctor in the Pre auth department gets in touch with the Treating doctor or/ and the administrator in charge to know the course of further treatment with respect to the patients present condition.
Discharge Planning process
Network kit provided to the Providers has the details on the procedure to be followed at the time of discharge of the WAPMED members. Broad guidelines are as follows.
- For the covered and eligible services (specified in the Provider protocol), the provider extends credit to
the member and the bills are forwarded to WAPMED.
- For services not forming part of authorized service, Member makes the payment to the provider.