普华永道索赔求文件程序合作伙伴总监

RequiredDocumentsfor /Maternity/生育（住院○○Originalcopyofmedicalexpensesreceipt/FormalInvoice*2○○○○Copyofoutpatient/emergencymedicalreportor Copyofmedicalcertificate○△Copyofdiagnostic△△○Copyofpassport/Remarks注释 △Optionalifapplicable *1:Therelevantinformationofvaccination(suchasthenameofthevaccination)mustbeindicatedonreceipt,medicalreportand/ormedicalcertificateclearly. *2:Fapiao/Invoicemustbeindicatedinsuredlegalregisteredname.FormalInvoicewithfinancialsealrequestedifhospitalorclinicislocatedinmainlandChina.发票及收据上需注明被保险人合法有效姓名。*3:RequestedifmedicalexpensesexceedRMB10,000peroutpatient CopiesofpassportsfortheprimaryInsuredandtheirdependents(incasethatapplicantisaminor). Claim 1FilltheapplicationformClaimapplicationformcanbedownloadedfromDocumentlink:'HR&ME'2Preparerequiredclaim Therequireddocumentsarelistedintheform SubmittheclaimSendtheclaimtoRebeccaJiang 9thFloor,No.8-2ChangShu9

Confirmationofreceiptwillbesentviae-mailwithin3workdaysClaimSettlementwillbesentby Ifclaimmaterialisincomplete,servicespecialistwillsendyoudocumentrequestnoticeviaE-mail.

4ClaimpaymentClaimreimbursementduewillbetransferredin2-3business若您的理赔申请获批，2-3个工作日银Allrequireddocumentsmustbesubmitted.Missingdocumentsmaycauseadelayorfailureofclaimreimbursement.以上所需理赔材料务必在提交前整理完毕，材料的缺失会导致理赔延迟或受理。Claimapplicationsshouldbesubmittedtoourcompanywithin6monthsoftheinsuredreceivingtreatment.Ifclaimsapplicationsaresubmittedafter6monthsbutwithin2yearsofreceivingtreatment,ourcompanywillonlyreimburse50%ofthemedicalexpensesinlinewiththereimbursementratioandinexcessofthedeductible.所有理赔资料必须在就诊后6个月内提交至保险公司。如超出6个月及未满2年的理赔案件，我司将按赔付比例的50%进行理赔。PleasestapleyourclaimmaterialstogetherdonotgluethemtogetherAllfapiaos/receiptsmustbeoriginals.Otherrequireddocumentsmaybecopies.发票收据需提供原Pleaseuseyournameasitiswrittenonyourpassportwhenregisteringattheclinic/hospital.Pleasemakesurethenameusedonallclaimmaterialsisthesameasthenameontheinsuredmembercensusandthatthedateontheinvoiceisthesameastheoneoncorrespondingmedicalrecords.Ifthereareanydifferences,pleaseaskthehospitaltocorrectthemandmakeanofficialstampforconfirmation.请您确认所收集的材料上姓名与申请人的姓名相符；如有误，请医院更正并盖更正OriginalfapiaosstampedwiththeofficialsealofthehospitalorclinicsarerequiredforhospitalsclinicslocatedinMainlandChina.Officialsealsofadditionalhospitals/clinicsmustbestampedonthetopofthefapiao.大陆境内必须提供含有财政章的正式有效发票，所有发票必须盖有收费章起效。OutpatientMedicalCertificateforoutsideborders(tobecompletedbyaSampleQWhataredesignatedhospitals?ADesignatedhospitalsareinstitutionswithsystematicdiagnosisprogramsandoperationfacilitiesrecognizedbylocallaw,includingforeign-investedhospitalsandprivatehospitals,aswellasVIPsickroomsofpublichospitalsandforeignguestwards.Fordirectbillingservice,pleaserefertothedirectbillinghospitallist所有具有合法资Q:Arethereanyexclusioninmy AYes.PleaseseetheExclusions”sectioninhandbook.是，本计划有除外责任，详情请参见员工手册的除外责Q:Iamanexpatriate,butIhaveaChinesename.CanIusemyChinesenamewhenIregisterinaclinic?CanIsubmitclaimsusingmyChinesename?我是一名外籍，朋友们给了我一个中文名字，我可以用我的中A:StaffareregisteredwithPingAnusingtheirlegalname(thesamenameprintedontheirofficialidentificationdocument(s)).Wesuggestthatyoutoregisterusingyourlegalname.Forlegalpurposes,allclaimdocumentsshouldberegisteredusingthesamename.所有外籍员工都是已有效证件上的姓名进行注册的，从合法性来讲，Q:IamgoingtovisitmyfamilydoctorwhoisoutsidemainlandChina.HeusuallyprovidesmewithareceiptafterthevisitCanIclaimwithoutmedicalrecords?我打算去国外家庭医生处就诊，但是医生通常只A:No.Medicalrecordsareveryimportantforclaimdepartmenttoadjustyourclaim.Wesuggestyouaskyourdoctortoprovideyouwithamedicalcertificateindicatingyoursymptoms,diagnosis,treatmentaswellasabreakdownofexpensesincurredfromtheclinicorhospital.不能，病例是理赔鉴定保险责任的重要依据。建议您Q:Aftermydoctor’svisit,Ineedtopurchasemymedicineatapharmacy.CanthisamountbeA:Yes.Pleasekeepacopyofyourdoctor’sprescriptionandtheoriginalpharmacyreceiptwiththedetaileditemslisted.Youmaysubmitthemtogetherwithyourclaimdocuments.可以，请保留医生处方复印件，连同药房出示Q：I’dliketovisitatraditionalChinesemedicinedoctor,WhatshallIpreparefortheclaim?如果我去就诊A:First,pleasemakesurethedoctorhasaproperlicenseandisregisteredatalegalmedicalinstitution.musthavetherequireddocumentslistedabove,acopyofthemedicalrecordsdetailingyoursymptomsanddiagnosis,acopyoftheprescription,andadetailedmedicalexpenselist.首先请确认医生必须含有相关医疗资质并注册在合法医疗机构下，如同以上理赔所需材料，含有主诉及诊断的病例复印件，医生处方复印件及相关费Q：Iampregnantandthehospitalisofferingmeaverygoodpackage,canIusethedirectbillingservicetopayforthispackage?我怀孕了，医院目前提供一个非常理想的生育套餐,我可以用直接垫付吗?A:Currently,directbillingislimitedtodailyvisitsonly.Fortreatmentpackages,claimmaterialsshouldbesubmittedafteralltreatmentsarecomplete.Theedetailedlistsofthepackage,medicalexpenselistsandmedicalrecordsofeachvisitarerequired.目前中间带的之间垫付仅限于当日就诊。套餐类的就诊需待所有诊疗完QWhatshouldIdoifIneedtobe A:Whenitissuggestedthatyoubehospitalized(includingforchilddelivery),pleasecallPingAnservicecenteron4008808820.Apre-authorizationletterneedstobeapprovedbyPingAnHealthForaccidentsoremergencysituations,notificationshouldbegiventoPingAnHealthwithin48hoursofreceivingtreatment.Directbillingservicecanbeprovidedinnetworkhospitals. 如果您需要住院或分娩，请在住院前致电平安热线电话QWhencanIreceivereimbursement?A:Wewillsendyouanotificati