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Prudential Guide to Direct Payment Services for Medical Networks

1. Coverage of Direct Payment Services

1. Surgical category
- Outpatient surgery
- Daytime surgery
- Inpatient surgery
 
2. Pediatric hospitalization
 -Hospitalization for respiratory diseases
- Diarrhea hospitalization
 
3. Diagnostic image detection
- Magnetic Resonance Imaging (MRI)
- Computed tomography (CT) scan
- Positron Emission Tomography (PET CT) 
Note: Basic diagnostic items (such as X Light, ultrasound, blood tests, etc. are not included in the scope of direct payment.
 
2. Medical Process Guidelines

1
Reservation service

- Make an appointment through Prudential and call the medical network hotline at+852 2281 1345

- Make an appointment through Shenzhen New Frontier United Family Hospital by calling+852 5801 1515 or+86 4008-919191 (the hospital will assist with the application) H2P Registration code)

2
Visit the hospital for medical treatment

After the doctor evaluates the treatment plan:

- If it falls within the scope of direct payment, the hospital shall submit a pre-approval application

- If not within the scope, the customer needs to pay for the claim at their own expense or by themselves

3
Pre approval

- Hospitals submit pre-approval applications to insurance companies (for routine cases, approval is usually completed within 3 working days of receiving complete materials). For complex cases, SMS notifications are sent to extend the review process

- After approval: The hospital will notify the customer and issue an approval form

4
Receive treatment

Customers can receive treatment at the hospital with the approval form, and the service scope is subject to the first part.

5
Expense settlement

After the treatment is completed:

- Customer pays out of pocket amount (if any)

- Customer pays out of pocket amount (if any)

6
Postoperative follow-up visit

- Prudential can advance the cost of one postoperative follow-up visit: the first follow-up visit fee and medication fee (up to a maximum of 600 yuan)