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    Call Report

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    lim keat seng
    This document is a hospitalization guarantee letter from MiCare Sdn Bhd to Salam Shah Alam Specialist Hospital guaranteeing payment of RM2500 for medical expenses for patient Lim Keat Seng admitted on 25 March 2024 for cervical spondylosis myelopathy. The guarantee is valid for one admission only and does not cover certain non-medical items and expenses excluded under the patient's insurance policy.

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    Call Report

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    This document is a hospitalization guarantee letter from MiCare Sdn Bhd to Salam Shah Alam Specialist Hospital guaranteeing payment of RM2500 for medical expenses for patient Lim Keat Seng admitted on 25 March 2024 for cervical spondylosis myelopathy. The guarantee is valid for one admission only and does not cover certain non-medical items and expenses excluded under the patient's insurance policy.

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    This document is a hospitalization guarantee letter from MiCare Sdn Bhd to Salam Shah Alam Specialist Hospital guaranteeing payment of RM2500 for medical expenses for patient Lim Keat Seng admitted on 25 March 2024 for cervical spondylosis myelopathy. The guarantee is valid for one admission only and does not cover certain non-medical items and expenses excluded under the patient's insurance policy.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    26 views1 page

    Call Report

    Uploaded by

    lim keat seng
    This document is a hospitalization guarantee letter from MiCare Sdn Bhd to Salam Shah Alam Specialist Hospital guaranteeing payment of RM2500 for medical expenses for patient Lim Keat Seng admitted on 25 March 2024 for cervical spondylosis myelopathy. The guarantee is valid for one admission only and does not cover certain non-medical items and expenses excluded under the patient's insurance policy.

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    HOSPITALISATION GUARANTEE LETTER

    Our Ref : HLBBOPIP03240103 Issued By : nuratirah


    Issue Date : 25 Mar 2024 Insurer : HONG LEONG BANK

    To Hospital : SALAM SHAH ALAM SPECIALIST HOSPITAL Admitting Diagnosis : Cervical spondylosis myelopathy (post
    operation)
    Admission Date : 25 Mar 2024 Admitting Doctor : FARID FIKRI SHUKRI

    Policy No : GL202019844751
    Policyholder Name : HLBB
    Patient Name : Lim Keat Seng
    Patient NRIC : 841103085243

    Guarantee Amount : RM2500.00


    Daily Room & Board : – Strictly to follow Published Room Rate
    Bill To : MiCare Sdn Bhd C/O Hong Leong Assurance
    Berhad (94613-X)
    MiCare Sdn Bhd hereby guarantees to bear the medical and surgical expenses for the above treatment incurred by the aforesaid patient at your
    hospital during the specified date.
    This guarantee letter is valid for ONE ADMISSION ONLY.

    This guarantee does not cover the following items and shall be borne by the patient:
    1. Excess daily Room & Board charges.
    2. Television, telephones, tele - services, radios or similar facilities, admission kit/pack, lodger, laundry, personal laundry, cafeteria services, extra
    food and beverages, ID Tag and other in eligible non medical items.
    3. Vitamins, supplements or any drugs not related to the treatment of the admitting diagnosis and supply of drugs exceeding the Follow Up expiry
    dates.
    4. Allergic test or any tests and investigations not related to the treatment of the admitting diagnosis.
    5. Admission for diseases excluded under the policy.
    6. Charges in connection with outpatient treatment, medical check-up or routine tests, mental illness, pregnancy related illness (such as childbirth,
    caesarean delivery, abortion, miscarriage, and prescriptions thereof), cosmetic surgery and congenital abnormalities.
    7. Any registration fees, medical record fees, outpatient dept fees or facility fees is not payable.
    8. Aid, braces, appliances, glasses and refractive equipment, use or acquisition of external prosthetic appliances, hearing aids implanted
    pacemakers and prescriptions thereof.

    Please Note:
    1) Patient understands that the coverage guaranteed in this Initial Guarantee Letter will be subjected to terms and condition of the policy and
    MiCare Sdn Bhd reserves the right to retract coverage if subsequent information obtained does not fulfil the terms and condition of the policy.
    2) If the total bill for this admission exceeds the eligible expenses, hospital to contact MiCare Sdn Bhd immediately at 03 7839 7813
    for further review. We will not accept excess charges without further reference to MiCare Sdn Bhd.
    Please fax the itemized bill to following number to obtain the Payment Notice before discharging the patient:
    +603-7847 4304 (24 Hours Fax Line)

    Please bill and post the original itemized bill, Guarantee Letter, and Authorized Claim Form duly completed to:

    MiCare Sdn Bhd (ASO)


    NO.22, BLOCK A, JALAN ASTAKA U8/84, SEKSYEN U8 BUKIT JELUTONG, 40150 SHAH ALAM, SELANGOR.
    (Attention: Claims Department)

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