EMPLOYEE HEALTHCARE BENEFITS MADE CONVENIENT

✓ C AS H L E S S
✓ M O R E T H AN 3 , 6 0 0 PAN E L S N AT I O N W I D E
✓ K E E P T R AC K O F E M P L O Y E E M E D I C AL B E N E F I T S
✓ AC C E S S T O 2 4 / 7 S U P P O R T

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OUTPATIENT SPECIALIST
H IG H L IGH T O F T H E D AY

INPATIENT ADMISSION

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 DO YOU NEED TO SEE A SPECIALIST?
1. Prepare Supporting Document 2. Check Panel Specialist Location
1. Prepare Supporting Documen
• Referral Letter • Using HealthMetrics mobile app/website

• / Appointment Card
• / Vaccination Schedule
• / Prescription List

3. Schedule an Appointment
• Call your preferred panel specialist to make an
appointment with specialist doctor

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HOW TO APPLY A GUARANTEE LETTER?

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 HOW TO APPLY A GUARANTEE LETTER?

Fill in the
details
accordingly

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 HOW TO APPLY A GUARANTEE LETTER?

Scroll
down

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 HOW TO APPLY A GUARANTEE LETTER?

Scroll
down

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CHECKING GUARANTEE LETTER STATUS

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SUMMARY OF OUTPATIENT SPECIALIST VISIT

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10
HEALTHMETRICS INPATIENT ADMISSION
FOREST INTERACTIVE SDN BHD
✓ P O L I C Y P E R I O D : 2 5 J U LY 2 0 2 1 T O 2 4 J U LY 2 0 2 2
✓ P R O C E S S F L O W O F H O S P I TA L I S AT I O N / A D M I S S I O N
✓ HOW TO SUBM IT YOUR CLAIM S FOR REIM BURSEMENT
 MEMBER INPATIENT FLOW

Inform and present digital card within Guarantee letter will be

Sickness/Injury Seek Treatment applied by the hospital
HealthMetrics app at admission counter
after verification

Member can leave hospital Final GL/excess letter will be Upon discharge, hospital will
after payment is made (if any) issued, member to paid for compile all medical expenses After GL issuance, member
excess (if any) and final GL will be requested able to proceed with the
by hospital admission & treatment
 Important Notes
1. Hospital may request you to place a minimal deposit in the range of RM300 to
RM1000 for an admission.
2. The amount of deposit is different from each hospital.
3. The deposit may be refunded when hospital receives the Guarantee Letter from
HealthMetrics or upon your discharge. (This is subjected to the refund
procedure of hospital).
4. Hospital may request you to pay for any ineligible or uncovered expenses.
Ineligible or uncovered expenses will be listed in your Final Guarantee Letter.
5. Please refer to your Etiqa GHS Policy for examples of ineligible or uncovered
expenses.
 PANEL VISIT
Admission/Hospitalisation Process
Walk into a panel hospital The hospital will send Proceed with the necessary
1 2 3
and present the digital card HealthMetrics to request treatment/admission after GL
via HealthMetrics app for an Initial Guarantee has been issued
Letter (GL)

Upon discharge, Final GL After issuance of Final GL, charges

4 5
will be requested from that were not covered under the
HealthMetrics by the Etiqa GHS policy, member will need
hospital to bear the cost
 NON-PANEL VISIT
Admission/Hospitalisation Process
1 Get admitted to hospital 2 After treatment, pay all 3 Submit all softcopy documents
which is a non panel/Govt hospital bills into HealthMetrics app and
hospital send in all necessary physical
documents (Claims Forms
[available in app], IC, Itemised
bills, Medical Report to HR)

HealthMetrics will process and Once the claim has been

4 submit documents to the 5 approved, finance will make
insurer provider payment to you (within 15 to 21 *Softcopy or hardcopy submission
days subject to approval) of documents - depends on the
criteria of insurer.
 PRE AND POST-HOSPITALISATION CLAIMS
1 After treatment, pay all 2 Submit all softcopy documents 3 HealthMetrics will process and
hospital bills into HealthMetrics app and submit documents to the
send in all necessary physical insurer provider
documents (Claims Forms
[available in app], IC, Itemised
bills, Medical Report to HR)

Once the claim has been

4 approved, finance will make
payment to you (within 15 to 21 *Softcopy or hardcopy submission
days subject to approval) of documents - depends on the
criteria of the insurer.
MEMBER’S APP
MEMBER’S APP – BENEFIT SUMMARY
MEMBER’S APP – SCHEDULE OF BENEFIT
CLAIMS REIMBURSEMENT - HOSPITALISATION
CLAIMS REIMBURSEMENT - HOSPITALIZATION

Member shall download

the form and completed
by the attending doctor
 CLAIM FORM

HOSPITALISATION &
SURGICAL CLAIM FORM

*Form can be downloaded from the employee app

CLAIMS REIMBURSEMENT - HOSPITALIZATION

Filled in and
authorized by
the hospital
CLAIMS REIMBURSEMENT - HOSPITALIZATION
REIMBURSEMENT CLAIMS – PRE & POST
HOSPITALIZATION VISIT

*By choosing ‘Yes’, you should be able to retrieve the admission record from our
panels before you could proceed to fill in the claim submission details.
REIMBURSEMENT CLAIMS – PRE & POST
HOSPITALIZATION VISIT

*By choosing ‘No’, you are required to fill in the service details.
REIMBURSEMENT CLAIMS – PRE & POST
HOSPITALIZATION VISIT (WITH MC)

Fill in the
MC details
REIMBURSEMENT CLAIMS – PRE & POST
HOSPITALIZATION VISIT (WITHOUT MC)
 HAVE MORE QUESTIONS?
START A LIVE CHAT WITH US! CALL OUR 24/7 HOTLINE
http://www.healthmetrics.com +603-7661 6229

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