保险问答

1、我不知道自己的保险公司是否与上海星晨儿童医院有直付协议，我该怎么做？

I don’t know if my insurance company has Direct Billing Agreement with XXX,what should I do?您可以在官网查阅直付保险目录，如果上面没有查阅到您的保险公司，还可以在就诊前先联系我们工作人员再次确认。

A: You can check the direct billinginsurance list on our Corporate Websites. If you do not find your insurer inthe list you can always contact our staff for confirmation.

2、我的保险在上海星晨儿童医院没有签订直付协议，怎么办？

If my insurance don’t have any Directbilling agreement with XXX, what can I do？

如果是门诊，您需要自己支付费用，然后自行向保险公司申请事后理赔。如果是住院，为了给您提供最大的便利，我们会努力先联系保险公司索取预授权和担保函，但是如果保险公司拒绝提供，您还是需要自己支付，我们会提供发票和所需病历资料给您用于事后理赔。

A: For outpatient services, you need to payfirst and submit claim to insurer for reimbursement. For inpatient services,providing you with most convenience, we would try to contact your insurer toseek pre-authorization and GOP(Guarantee of Payment) for the hospitalization,but, if your insurer refused to provide, you will be required to settleoutstanding bill before discharged. We will issue the hospital invoice with fullymedical reports for you to submit reimbursement claim.

3、就诊时，我是否需要携带保险卡和身份证件？

Do I need to take my insurance Card and IDcard/Passport？

是的，由于不同的保险公司的要求不一样，我们建议，请携带您的保险卡和购买保险时使用的身份证/护照，您也可以咨询我们的工作人员。如果您的孩子需要医疗服务，还请带上孩子的出生证明以便确定法定监护人。

A: Yes, as different insurance may havedifferent requirements, we would suggest, please bring your insurance card andID card/Passport, which should be the one you used to purchase of theinsurance. You can also consult our staff before your visit.If your child needs medical service，please also bring her（his）birth certificate to determine her（his）legal guardian.

4、通过保险直付，也就意味着我们看病，无需支付现金？

With a Direct billing arrangement, does itmeans “nothing ” out of my pocket?

根据您保单内容，有些项目可能达到最大的保险额度/津贴，或者存在有共担、免赔额和自费项目。对于保险不承保的这部分，在您离开医院之前，必须结清。如有任何问题，请及时联系客服或者保险部。

A: According to your benefit, some mayincur maximum coverage / allowance, copayments, deductibles and self-payingitems. For any uncovered portion, it must be paid at the hospital prior to yourdischarge. For any enquiries, please feel free to contact our Customer Servicesor Insurance Department.

5、我有保险，如何办理住院手续？

I have insurance, how should I deal withthe admitting procedure

请携带以下资料至客服前台办理住院： 1保险卡 ；2有效身份证件/护照/证明身份的文件 ；3医生开具的入院证明； 4完整填写保险理赔资料，并签字确认 ；5支付押金。

A:Please bring below documents to receptionfor admission:

1: Present your insurance membership card

2: Present your ID card / passport /Identification documents for verification

3: Get the Admission Letter from yourdoctor

4: Fill in the details of patient’s part in the claim form and endorse yourconfirmation

5: Pay a certain amount of deposit

我们的工作人员会联系您的保险公司，索要住院担保函。然后，在您办理出院时，根据你的担保函内容，退还押金。

Our staff will contact your insurancecompany for the GOP and return your deposit when you discharge.

6、如果保险公司在我出院前，仍未出具住院担保函，怎么办？

What if I cannot get my Guarantee ofPayment (GOP) even at discharge in the end?

您需要在出院前支付全部费用。我们会提供账单/发票和相关医疗报告，以便您向保险公司索赔。

A: You will be required to settle alloutstanding amounts upon discharge. We will then issue the hospital invoicesand related medical reports for you to claim reimbursement back from yourinsurer.

7、如果我有一些关于保险或者直付服务方面的问题，怎么办？

Who should be the contact if I have problemin insurance or direct billing services?

您可以联系我们的保险部或客服部

客服部

电话：400 090 6161

邮箱：claims@star-kid.com

A: Your can contact our insurancedepartment or Customer Services Department

Customer Services Department:

Tel: 400 090 6161

Email: claims@star-kid.com