Processing
Outpatient Claims in Hong Kong
Outpatient Healthcare claims will normally be settled by the policyholder at the treating medical facility. You will typically pay the healthcare provider after receiving treatment and then submit a claim for reimbursement to the insurance company.
Once the outpatient claim has been received, and approved as eligible under the policy, the insurance company will then reimburse you the full cost of treatment minus any applicable deductibles.
However, many Hong Kong health insurance companies have extensive Direct Settlement networks which streamline the process of receiving, and paying for, outpatient medical treatment in Hong Kong. A direct settlement network is usually a group of healthcare provider with which the insurance company has payment agreements.
If you are receiving medical treatment with a healthcare provider included in your HK medical insurance plan’s direct settlement network all you need to do is provide your policy details to the receptionist and the insurer will liaise directly with the facility to arrange payment of the treatment costs. You will still be responsible for paying your deductible to the healthcare provider, but all remaining expenses will be settled directly.
