IAC (028) 35 11 33 33 Emergency (028) 35 11 35 00 Health Insurance Companies Cashless & non-cashless services IAC (028) 35 11 33 33 Emergency (028) 35 11 35 00 Health Insurance Companies Cashless & non-cashless services Explore payment methods and insurance claim support available for all patients. “Cashless Services” & Direct Billing Network What Does “Cashless” Mean? FV Hospital has signed a Direct Billing agreement (also called Third Party Agreement) with several insurance companies so that many services can be provided in a cashless way. If you are covered by an insurance company which is a member of our Direct Billing Network, this means that the hospital will claim to and receive funds directly from your insurance company, bringing you greater convenience and peace of mind. Check if your insurance is in our Direct Billing Network As aforementioned, depending on the direct billing policy of a patient’s insurance provider, some insurers in FV’s network cover both outpatient and inpatient services, however many only cover inpatient services. In addition, every policy includes exclusions, deductibles, and limitations of coverage which must be analysed carefully as these may include some or all aspects of a patient’s treatment at FV. In the event that this occurs they will be responsible for paying for the charges which are not covered by their insurance provider. The following are potential examples of when this may happen: If during further investigations, additional ailments are found which do not directly relate to the initial diagnosis on which the patient was admitted If during a patient’s course of treatment, the doctor’s diagnosis changes from the initial diagnosis on which the patient was admitted If it is discovered that the cause of the medical problem occurred prior to the start of the period of insurance cover If some items (consumables or medications: vitamin, supplements) are expressly stated as ‘excluded’ in the insurance policy All of these factors vary from one company and one policy to another, and FV Hospital’s insurance officers are on hand to assist patients in better understanding their policy. How Cashless Services Work Inpatient Services When a patient is admitted to FV Hospital, FV’s insurance officers will contact their insurance provider before their admission to request a Guarantee of Payment (GOP). This can usually be obtained within 4 to 48 working hours after sending the required documents to the insurance company or to its administration representative (for example a broker company). However, and particularly in case of emergency admission, FV may have to ask the patient to make a deposit which will then be reimbursed to them upon their request or at their discharge time once FV has received the GOP.Usually the insurance company will send FV Hospital a GOP approving the hospitalisation up to a certain amount and/or certain duration, with specific exclusions in accordance with the patient’s policy. A second GOP may be necessary if the patient’s hospitalisation exceeds the amount approved or is longer than expected Important: If the patient’s insurer does not provide a GOP by the time they are to be discharged, they will have to pay in full and then claim back the money from their insurer later. FV’s Insurance Office is on hand to guide patients through the claim process in this instance. Outpatient Services If a patient is visiting FV Hospital for a consultation or for other outpatient services, the billing procedure will depend on the type of card a patient holds and the scope of services (inpatient or outpatient) included in the direct billing agreement signed between FV Hospital and the patient’s insurer. Some insurers exclude outpatient services from direct billing agreements and some require that the patient co-pays. Essentially every policy is different and FV advises patients to read their policy carefully and check with their insurer, or contact FV Hospital Insurance Office should they require any clarification prior to consultation. Check if your insurance is in our Direct Billing Network When Your Insurer Is Not in FV’s Direct Billing Network Even when FV Hospital has not signed a Third Party Agreement with a patient’s insurance company, FV’s insurance officers will do their best to help patients benefit from cashless inpatient services by liaising with their insurance company or its administration representative. Direct billing is not possible for outpatient services when their insurance company is not part of FV Hospital Direct Billing Network. FV’s Discretionary Effort When possible FV Hospital will request and accept a Guarantee of Payment (GOP) from insurers that are not part of FV Hospital’s Direct Billing Network. Once the GOP is obtained, which usually takes 1 to 3 working days, FV can provide inpatient services in a cashless way. However, and particularly in cases of emergency admission, FV may have to ask the patient to make a deposit which will then be reimbursed immediately to them once FV has received the GOP.Usually a patient’s insurance company will send FV Hospital a GOP approving the hospitalisation up to a certain amount and/or to a certain duration, with specific exclusions in accordance with a patient’s policy. A second GOP may be necessary if their hospitalisation exceeds the amount approved or is longer than expected. Pay & Claim Fallback (Upfront Payment Required) FV cannot always request for a GOP, for example if the insurance company is based in a distant country with which the hospital has no existing relationship or legal recourse, such as Canada, Russia, Africa, Japan, etc. In such an instance, patients will be requested to pay a deposit, and then pay for the treatment costs incurred. Patients will also have to file a claim form with their insurer later.FV’s Insurance Office will be happy to guide and help all patients through this process. Non-Cashless Services If a patient’s insurance company is not a member of FV Hospital’s Direct Billing Network they will be required to pay like any other patient for each service they receive. The FV Hospital Insurance Officer is pleased to Gather the documents required from their insurance company. Assist you in completing your insurance claim for reimbursement. French Social Security (« sécurité sociale ») If a patient is a French resident and is covered under France’s Social Security system, they will have to pay upfront and then submit invoices to their “caisse” in France. FV Insurance Office – We’re Here to Help Email insurance@fvhospital.com Hotline (028) 35 11 33 33 Helpful Links Direct Billing Partners Check if your insurance provider is on our list. Common Exclusions from Insurance Policies Learn about medical expenses not covered by insurance. Documents Typically Required by Insurers Essential medical records required by insurance providers for claims.
