Direct billing at ParkwayHealth

ParkwayHealth has recently changed the direct billing procedure for out-patient treatment at medical clinics in China, but there’s no need to worry. Your specialist health insurance broker is on hand to keep you informed and provide helpful advice.

In recent months the One World Cover Client Services Team has received a number of queries regarding the changes ParkwayHealth has made to how direct billing for out-patient treatment of minor injuries and illnesses is handled. On behalf of our clients, we have requested and received clarification from ParkwayHealth to better understand how this new procedure works.

We now understand from ParkwayHealth that their clinics have introduced a requirement that patients must use either an international or local China credit card in order to gain access to direct billing with a number of insurance providers, specifically: Bupa International and ICBC-AXA Life InterGlobal. The clinics also confirmed by phone that they may consider eventually extending this practice to ALL insurance providers with whom they have a direct billing relationship.

Why the sudden change?

ParkwayHealth sees a high number of claims for treatment for which direct billing is provided at the point of sale but not covered according to the benefits of patients’ medical insurance plans, meaning ParkwayHealth then must return to the client to directly collect payment. In most instances the emails that ParkwayHealth sends to collect payment for medical treatment are ignored, and thus the clinics’ now request a credit card at the point of sale. If the condition for which treatment has been received is fully covered by your plan; then, naturally, your card will not be charged. The only instance in which you may see your card charged is if the condition for which treatment was received is not covered by your insurance plan.

In addition, we are aware that ParkwayHealth has recently encountered many problems with a very high accounts receivable, and presumably this new procedure is designed to ensure the clinics’ accounts receivable position does not worsen.

ParkwayHealth’s new direct billing procedure, step-by-step

If you are currently covered by either Bupa International or ICBC-AXA Life InterGlobal in China, then you can expect to go through the following procedure when visiting ParkwayHealth for out-patient treatment:

1. Upon entering the medical clinic, you should notify reception with which insurer you are covered for your medical insurance.

2. When informed that you are covered by either Bupa International or ICBC-AXA Life InterGlobal, the receptionist will request that you provide either an international or local China credit card, upon which a hold will be placed in the amount of Rmb100. Note your card is not charged at this time.

3. After receiving your medical treatment and moving on to the cashier to make payment and arrange direct billing, you will be provided a Credit Card Pre-Authorization Form along with the receipt for your recent treatment.

4. When ParkwayHealth has had sufficient time (typically 2-4 weeks) to review your medical treatment with your insurance provider and determine whether you are covered for your treatment according to the benefits of your medical insurance plan, the Rmb100 hold on your credit card will be removed, or you may be contacted by the clinic requesting that you pay for your recent treatment out-of-pocket, as it is not covered under your insurance plan. Note credit cards will not be charged until the transaction has been authorized by patients.

An alternative solution

Further to this, we would like to reiterate that if you are not comfortable using a credit card, it is of course possible to pay out-of-pocket for the treatment received, and then submit a claim for the reimbursement of the amount paid. Note claims are typically settled within 15 working days of the receipt of all claims documents required by the insurer.

What to do when seeking out-patient treatment

Finally, we advise our clients to always be mindful of the benefits covered under their medical insurance plans. For those who generally prefer to visit ParkwayHealth for treatment of minor injuries and illnesses, we suggest that you contact your insurance provider prior to visiting the clinic so you may confirm whether you will be covered for your medical treatment, and in turn determine whether you may expect to arrange direct billing, or will need to pay for your treatment out-of-pocket.

Please note you may find your insurer’s contact details on the back of your insurance card. And you may also refer to One World Cover’s What to Do in Emergency Situations webpage for the contact information of insurers licensed to distribute medical insurance products in China.

AUTHORS: Jonathan J. Hsieh, compliance and client services manager, One World Cover and Robert Honkisz, consultant, One World Cover.