Dental Visitation Workflow

Member call CSR of CSR Inova Care CSR call the provider to Member presents dental
check member’s make an appointment and insurance card & ID card to
Inova Care to make
send authorization and provider for obtaining
the appointment eligibility on system
dental form to provider treatment

Provider call Inova Care CSR (021)

Member go back
Member to pay excess 2964- 5200 / 08001333111 (Toll Free) Treatment provided to
home amount (if there are non- to asking for authorization member
coverable items/benefit) to determination (if there a revision) based on authorization
provider before member go back home

Member presents dental insurance

Member directly come card & ID card to provider for
to provider obtaining treatment

Internal Use
Only
 Dental Claim Submission Workflow (Provider)
After the treatment, provider
send the files, such as:
PT. INOVA CARE INDONESIA (CLAIM DIVISION)
DAYS
1. Copy of Patient ID Card Claims must be sending with a
maximum of 30 days from the date
2. Copy of Patient Dental Insurance Card
of treatment
3. Authorization Determination
4. Original Receipt
5. Substantiation of Diagnostic
Examination
6. Complete claim submission that has
been signed by patient and dentist
7. Substantiation of Dental
Reference (If Any Inquiry)
Claim Submission can be sent to:
Gedung Menara Jamsostek, Menara Utara Lantai 3
Jl. Gatot Subroto No. 38 Kav. 71-73,
Kuningan Barat, Kota Jakarta Selatan,
Daerah Khusus Ibu Kota Jakarta 12710
Call Center: 021-2964-5200
Internal Use
Only
 Dental Claim Submission Workflow
(Internal)

Claim analyst Claim analyst Finance division

division receive
Provider receive
division issues for processes the
the complete the approved final payment to provider the payment
files from dental expenses (14-30 working days)
provider

Internal Use
Only