Obviously I can only speak on behalf of my company so provided you except that all company terms and conditions can be different I’m happy to provide you with the benefit of my experience here.
NO is the answer to your first question. Many hospitals outside of the Tier 1 cities and indeed, many public hospitals within Tier 1 cities will not except direct billing arrangements for the simple reason they don’t need to. They don’t need the extra customers and they don’t want the extra work of providing credit to insurance companies that are often offshore and may or may not pay for the treatment provided – cash is king. A number of insurance companies and third party networks have had some success in penetrating the Chinese hospital system but the coverage is by no means complete. In our case, for outpatient treatment, we have the client pay and claim but for an inpatient case where the hospital will not except credit, we have a network of agents nationwide that run along to the hospital hauling a bag of cash! I have no idea why you weren’t reimbursed by your original insurer.
With reference to pre-authorisation, in our case this is only necessary if the member needs to be admitted into the hospital. In the case of an emergency the hospital will have an additional 12 hours to contact us to ensure that treatment isn’t delayed whilst trying to obtain pre-authorisation. Outside of our outpatient cashless network all outpatient treatment is pay and claim.
With reference to pre-existing conditions, again, all the companies are different. In our case, for individual plans, we impose a 2 year waiting period for all conditions that occurred in the 2 years before the plan started. We are not considering coughs, colds and other common ailments but we focus on those clients that have serious ongoing conditions that purchase insurance with the full intention of making claims significantly above their premium contribution. These clients prejudice our results and also impact the other members who through subsequent premium increases are subsiding their treatment. Once 2 clear years have passed without treatment those conditions considered pre-existing are once again covered.
With reference to available plans and premiums etc., I don’t want to turn this post into a sales pitch for our product as I believe that by providing honest opinions we are already marketing our services however if you do want more information about out products either contact me on my email.