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AmericanBizEdu@China/1. Guides & Policy

[GUIDE] MSH Health Insurance for WKU Foreign Faculty Members

by Jeonghwan (Jerry) Choi 2022. 2. 16.
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2022. Feb. 16 from WKU HR Department

2021-2022 service manual 温州肯恩大学高端医疗服务手册.pdf
3.36MB

We would like to sort the procedure of seeing doctors in Wenzhou out again, in better for you to use the service of CPIC&MSH insurance company. You can call the insurance company's worldwide 24-hour service number +86-021-6060-5180 in any circumstance. 
 
In order to solve the language problem and provide humanistic carethe insurance company has specially assigned two hospital representatives in Wenzhou, to accompany the faculties in need when seek medical treatment. You could call the insurance company before visiting hosptial to ask if they can arrange for a hospital representative who is available to go with you. Please note that the working hours of the hospital representative are Monday to Friday 8:00-17:30. 
 
If you are using the insurance service in a city other than Wenzhou, including overseas, please consult the insurance company first to find out whether bill directly and how to settle the claim before seeking seeing doctors.
 
The following is the insurance company direct billing hospitals and non-direct billing hospitals medical treatment&reimbursement process. In order to simplify the medical treatment and reimbursement process, please give priority to the direct billing hospitals. Please read the “2021-2022 Service Manual” in attachment thoroughly again. There are more detailed instructions in it.
 
Direct billing hospitals in Wenzhou:
 
Hospital name   Address Document or ID need to bring with
First Affiliated Hospital Of Wenzhou Medical University (NO.1 Hospital) Public  Shangcai Village, Nan Baixiang Street, Ouhai District, Wenzhou.                                                    浙江省温州市瓯海区南白象街道上蔡村  Insurance card, VIP card of NO.1, Photocopy of passport or Chinese ID card
Panhealth Medical Center Private NO.888 Wenrui Avenue, Ouhai District, Wenzhou   浙江省温州市瓯海区温瑞大道888号 Insurance card, Photocopy of passport or Chinese ID card
Step of seeing doctors in every direct billing hospitals
  • First Affiliated Hospital Of Wenzhou Medical University (No.1 Hospital) 
  1. Call insurance company to make an appointment +86-021-6060-5180;
  2. Visit the reception of VIP Department (No. 5 Building) in NO.1 Hospital on time;
  3. Present insurance card, VIP Golden card, photocopy of passport or Chinese ID card to the staff in reception;
  4. Request a Claim Form from reception, and fill out part A then sign;
  5. Visit doctor in VIP Department(No. 5 Building) or General Department, the doctor will complete part B on Claim Form then sign;
  6. Back to the reception of VIP Department (No. 5 Building). Sign the invoice or Part B of the Claim Form to confirm that the expenses and medical information are correct. Pay any applicable co-pays. Leave the completed documentation to the reception;
  7. Hospital will bill MSH directly.
  • Panhealth Medical Center
  1. Call insurance company to make an appointment +86-021-6060-5180;
  2. Visit the Medical Center on time;
  3. Present insurance card, Photocopy of passport or Chinese ID card to the staff in reception;
  4. Request a Claim Form from reception, and fill out part A then sign;
  5. Seeing doctor, the doctor will complete part B on Claim Form then sign;
  6. Sign the invoice or Part B of the Claim Form to confirm that the expenses and medical information are correct. Pay any applicable co-pays. Leave the completed documentation to the reception;
  7. Medical Center will bill MSH directly.
Step of seeing doctors in non-direct billing hospitals
These hospitals could not make appointments in advance for foreigners, need to come there with passport and make appointments. The appointment may not on the same day you come. 
  1. Seeing doctors and pay all medical expenses first;
  2. Collect and keep all receipts, itemized bills, medical records/discharge summary, prescriptions,medical diagnosis or medical report;
  3. Download the Claim Form from insurance official website (www.mshasia.com) and fill it out - Part A;
  4. Send all documents to the insurance company email (cpic-service@mshasia.comwithin 180 days;
  5. The reimbursement will take 8 working days to complete if there is no problem of all document provided. 
 
 
 
*It would be better to call the insurance company to arrange a hospital representative if you go to a non-direct billing hospital. They will pay the medical expenses in advance and then apply directly to the insurance company for reimbursement. There is no need for you to pay the medical expenses and claim reimbursement. 
 
Pre-authorization
All insurance members must receive Pre-authorization prior to undergoing certain non-emergency procedures and treatments listed below. Members must verify that they will be reimbursed for expenses incurred from medical treatment, and confirm ahead of time that the procedure or treatment will be covered under their policy. Members that fail to obtain pre-authorization prior to the treatment will be held liable for paying an additional co-pay of 40% of the entire cost of the procedure.
  • Hospitalization, including baby deliveries; 
  • Outpatient surgery requiring general anesthesia;
  • Chemotherapy and radiation treatments;
  • Hemodialysis and Peritoneal dialysis treatment; 
  • Emergency Medical Evacuation;  (within 48 hours of occurrence)
  • Emergency Dental Treatment;  (within 48 hours of occurrence)
  • Purchase or rental of Durable Medical Equipment (DME) including but not limited to insulin pumps and supplies; 
  • Medications or immunizations in excess of RMB 8,000 per refill. 
The Pre-authorization does not guarantee full reimbursement. The health insurance policies are only designed to reimburse claims that are “medically necessary”. In order for a treatment, service, or drug to be “medically necessary”, it must:
  • Be essential in treating the patient’s injury or illness; 
  • Not exceed the amount of care needed to provide safe and adequate treatment;
  • Be prescribed by a physician; 
  • Not be experimental or investigative. 
Please feel free to contact insurance company (cpic-service@mshasia.com) or Bessie (luhong_hu@wku.edu.cn) in HR when you have any problems. 
 
Regards,
 
 

Bessie Hu

Coordinator

Contact number: 0577-55870193

Wenzhou-Kean University

Hospital name   Address Document or ID need to bring with
First Affiliated Hospital Of Wenzhou Medical University (NO.1 Hospital) Public  Shangcai Village, Nan Baixiang Street, Ouhai District, Wenzhou.                                                    浙江省温州市瓯海区南白象街道上蔡村  Insurance card, VIP card of NO.1, Photocopy of passport or Chinese ID card
Panhealth Medical Center Private NO.888 Wenrui Avenue, Ouhai District, Wenzhou   浙江省温州市瓯海区温瑞大道888号 Insurance card, Photocopy of passport or Chinese ID card
Step of seeing doctors in every direct billing hospitals
  • First Affiliated Hospital Of Wenzhou Medical University (No.1 Hospital) 
  1. Call insurance company to make an appointment +86-021-6060-5180;
  2. Visit the reception of VIP Department (No. 5 Building) in NO.1 Hospital on time;
  3. Present insurance card, VIP Golden card, photocopy of passport or Chinese ID card to the staff in reception;
  4. Request a Claim Form from reception, and fill out part A then sign;
  5. Visit doctor in VIP Department(No. 5 Building) or General Department, the doctor will complete part B on Claim Form then sign;
  6. Back to the reception of VIP Department (No. 5 Building). Sign the invoice or Part B of the Claim Form to confirm that the expenses and medical information are correct. Pay any applicable co-pays. Leave the completed documentation to the reception;
  7. Hospital will bill MSH directly.
  • Panhealth Medical Center
  1. Call insurance company to make an appointment +86-021-6060-5180;
  2. Visit the Medical Center on time;
  3. Present insurance card, Photocopy of passport or Chinese ID card to the staff in reception;
  4. Request a Claim Form from reception, and fill out part A then sign;
  5. Seeing doctor, the doctor will complete part B on Claim Form then sign;
  6. Sign the invoice or Part B of the Claim Form to confirm that the expenses and medical information are correct. Pay any applicable co-pays. Leave the completed documentation to the reception;
  7. Medical Center will bill MSH directly.
Step of seeing doctors in non-direct billing hospitals
These hospitals could not make appointments in advance for foreigners, need to come there with passport and make appointments. The appointment may not on the same day you come. 
  1. Seeing doctors and pay all medical expenses first;
  2. Collect and keep all receipts, itemized bills, medical records/discharge summary, prescriptions,medical diagnosis or medical report;
  3. Download the Claim Form from insurance official website (www.mshasia.com) and fill it out - Part A;
  4. Send all documents to the insurance company email (cpic-service@mshasia.comwithin 180 days;
  5. The reimbursement will take 8 working days to complete if there is no problem of all document provided. 
 
*It would be better to call the insurance company to arrange a hospital representative if you go to a non-direct billing hospital. They will pay the medical expenses in advance and then apply directly to the insurance company for reimbursement. There is no need for you to pay the medical expenses and claim reimbursement. 
 
Pre-authorization
All insurance members must receive Pre-authorization prior to undergoing certain non-emergency procedures and treatments listed below. Members must verify that they will be reimbursed for expenses incurred from medical treatment, and confirm ahead of time that the procedure or treatment will be covered under their policy. Members that fail to obtain pre-authorization prior to the treatment will be held liable for paying an additional co-pay of 40% of the entire cost of the procedure.
  • Hospitalization, including baby deliveries; 
  • Outpatient surgery requiring general anesthesia;
  • Chemotherapy and radiation treatments;
  • Hemodialysis and Peritoneal dialysis treatment; 
  • Emergency Medical Evacuation;  (within 48 hours of occurrence)
  • Emergency Dental Treatment;  (within 48 hours of occurrence)
  • Purchase or rental of Durable Medical Equipment (DME) including but not limited to insulin pumps and supplies; 
  • Medications or immunizations in excess of RMB 8,000 per refill. 
The Pre-authorization does not guarantee full reimbursement. The health insurance policies are only designed to reimburse claims that are “medically necessary”. In order for a treatment, service, or drug to be “medically necessary”, it must:
  • Be essential in treating the patient’s injury or illness; 
  • Not exceed the amount of care needed to provide safe and adequate treatment;
  • Be prescribed by a physician; 
  • Not be experimental or investigative. 
Please feel free to contact insurance company (cpic-service@mshasia.com) or Bessie (luhong_hu@wku.edu.cn) in HR when you have any problems. 
 
Regards,
 
 

Bessie Hu

Coordinator

Contact number: 0577-55870193

Wenzhou-Kean University

 

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