Medical Report Health Insurance Coverage Scheme Of Foreign (SPIKPA)

Introduction

All foreign workers in Malaysia are required to have an insurance policy Hospitalization & Surgical Insurance Scheme Foreign Workers (SKHPPA) admission for treatment and surgery in hospitals Ministry of Health through the Health Insurance Scheme Foreign Workers (SPIKPA). Implementation SPIKPA is for cashless, where each foreign worker who admitted to MOH hospitals not pay any deposit or submit a letter of guarantee from the insurance company. Foreign workers only need to present a valid passport for the confirmation process in the hospital register counter.

1. Third Party Claim Administrafor (TPCA)

Claims of foreign workers hospital bill will be made by hospitals to insurance companies concerned by the Third Party Claim Administrafor (TPCA) by submitting the hospital bill and medical report. After complete documents obtained, the insurance company will pay the hospital bill and medical report to the hospital concerned. Accordingly, the patient’s medical report for foreign workers who are covered under SPIKPA shall be provided by the Medical Officer prior to payment made Medical Report. Medical Report shall be submitted to the TPCA together with the number of patients of foreign workers for the purpose of claims / payment of medical treatment and costs of providing medical report to the insurance company concerned.

Medical fees and Medical Report will be paid by the insurance company to the Revenue Unit, Hospital and subsequently manage the repayment provision of medical report to the Medical Officer concerned. Flow Chart Preparation of Reports Medical Officer.

Medical and Procedure repayment Report as Appendix 1 and Appendix 2 Medical Report preparation procedures and repayment for medical officers is only applicable to patients of foreign workers covered under SPIKPA.

2. Terms – Conditions Refund Claim Preparation Medical Report (BTPL)

Terms – Conditions for repayment provision Expert / Foreign Workers Insurance Protection Scheme(SPIKPA):

1. Form BA.KKM / TPL completed after the completed Medical Report
2. For application in the format of the part iii form CH 1/2010 which has been completed and approved by the Director of the Hospital. Repayment of medical report subject to the limitations of the basic monthly salary ½ Medical Officer / Medical Specialist.
3. Finance Division, Ministry of Health approved the payment does not exceed ½ of the basic monthly salary medical officer.

2.1. Documents Required To Make A Claim:

1. Form BA. KKM/ TPL completed after the Medical Report is prepared (Annex 3)
2. Format Form CH 1/2010
3. Letter of approval of the Finance Division, Ministry of Health
4. Photocopy of identity card and a copy of the Bank Account Certificate (for Officers first made the claim)

3. Medical Report Charges

The fees charged to applicants for a medical report as set out in the Fees (Medical) Order 1982 and the Fees (Medical) Amendment 2003 – For foreigner.

Schedule of Charges

* Depending on the complexity of providing medical reports.

Charges for Foreigners are double the national charge in accordance with Article 3.4. Multiple Charges (Schedule H Part 2, 3 and 4) under the Fee Order (Medical) Amendment 2003 New Charge for Foreign Patients.

References

1. Surat Pekeliling Bahagian Kewangan Bilangan 1 Tahun 2014 – Garispanduan Pelaksanaan Perintah Fi (Perubatan) (Kos Perkhidmatan) 2014
2. Akta Fi 1951 – Perintah Fi (Perubatan)(pindaan) 2003.
3. Pekeliling Ketua Pengarah Kesihatan Malaysia Bil 16/2010 – Garispanduan Laporan Perubatan di Hospital – hospital dan Institusi Perubatan
4. Surat Edaran Bahagian Akaun Bil 7 Tahun 2014 – Garispanduan Tuntutan Bayaran Balik Penyediaan Laporan Perubatan Bagi Pegawai Perubatan Pakar
5. Buku Jadual Fi Perubatan Warga Asing Secara Berperingkat Bagi Perintah Fi (Perubatan) (Kos Perkhidmatan) 2014