International health, life and income protection insurance plans for expatriates

Important procedures for using a Network Provider in Hong Kong and China

 

Membership of the Network of Providers entitles you to use our network of clinics and hospitals for treatment that is eligible under the terms of your plan. These clinics and hospitals are referred to as Network Providers.

 

Qualifying to use the Network

 

To use the Network of Providers and direct billing facilities, you must be an expatriate resident in Hong Kong or China with a Silver, Gold or Platinum Global Health Elite plan, and you must have selected the direct billing option at the point of application.

 

When you obtain out-patient treatment at a Network Provider

When you use a network provider you must present your Global Health Membership Card to the provider. The provider will verify that you are eligible for direct billing.

Don’t forget to take a claim form with you to your first consultation

You will also need to complete a claim form in respect of each separate medical condition for which you claim. You must complete Section A of the claim form, sign the declaration in Section B and the doctor you see must complete and sign Section C. NB If you live in Hong Kong, there is usually no need for the doctor to complete Section C of the claim form as the doctor will submit the information we require separately.

If you are resident in China and you have a $50 excess, you must pay the excess amount direct to the hospital or clinic.


The provider will submit the bills for your consultation and treatment, (less any excess amount you have paid) to us for settlement, together with your fully completed claim form.

Please note that you can only claim for treatment that is covered under the terms of your plan. Before you embark on a course of treatment with a network provider we strongly recommend that you call William Russell who can advise you whether the proposed treatment will be covered by your plan. If you claim for treatment that is not covered by your plan, the clinic will recover the ineligible costs from you.

 

Treatment and tests that require our pre-authorisation for direct billing

The following procedures and tests require authorisation by William Russell before the clinic or hospital can proceed with them:

  • Angiography (any type)
  • Colonoscopy
  • CT / Pet / MRI Scan
  • Chemotherapy and/or radiotherapy for cancer
  • Doppler studies
  • Echocardiogram
  • Endoscopic procedures (bronchoscopy / gastroscopy / arthroscopy / nasal endoscopy / cystoscopy)
  • EEG
  • Excretory urography
  • Hormonal tests other than routine thyroid function tests
  • Holter monitoring (24-hour ECG)
  • Hysterosalphinogography / Colposcopy
  • Mammography/Ultra Sound of breasts
  • Minor surgery (skin excisions, nail removal, biopsies etc.)
  • Physiotherapy / chiropractic treatment
  • Psychiatric treatment and/or counselling
  • Stress EKG
  • Stress Echo
  • Szintigraphy (any type)
  • Routine ultrasound (any type including prostrate)
  • The treatment of a condition that has become chronic

 

Obtaining pre-authorisation

It is a condition of the Global Health plan agreement that we only pay the above treatment costs when they have been authorised by us in advance. By in advance we mean BEFORE the treatment has taken place.

To obtain pre-authorisation, as soon as you know you need to have one of the above named treatments you must contact us on:

+ 44 1276 486460 (6am - 6pm UK-time, Monday to Friday)

If it is outside working hours contact the Assistance Service on + 44 1243 621155.

Upon receipt of your call we will immediately contact your physician to obtain a “Notification of Treatment Form” which we require before we can confirm whether or not the proposed treatment is covered by your plan, and, if it is, we will confirm this to the hospital and authorise the treatment costs. We will then arrange for the authorised costs to be settled direct to the hospital. If the proposed treatment is not covered by your plan, or if the hospital does not or cannot give us the information we require, we will not be able to pre-authorise your treatment costs and you will be responsible for paying the treatment costs yourself.

If you use a non-network provider or have not sought pre-authorisation

You are free to use medical providers who are not part of the William Russell Network. If you do so, you will have to pay the provider’s bills yourself and then submit a claim. To assess your claim we will require a fully completed claim form and the original invoices for the treatment you have received. Again we strongly recommend that you contact us before you embark on a course of medical treatment so that we can advise you whether or not your claim is eligible for benefit. Full details about how to make a claim are contained in the Global Health plan agreement.


Benefits you must pay for then claim

You must pay and then submit a fully completed claim from and the original invoices if you are making a claim for any of the following benefits. Even if you use a network provider:

- The well-being benefits

- All dental treatment

Ineligible claims 

Please note that if your treatment turns out not to be eligible under the terms of your plan, you must repay to us the amount you have claimed. If you are in any doubt as to whether the treatment is eligible, please call the helpline before you incur any costs. If you fail to repay to us any ineligible costs, we reserve the right not to renew your Global Health plan and/or to withdraw the direct billing facility.

William Russell Limited is authorised and regulated in the UK by the Financial Services Authority. Registered in England and Wales. Registration number 2687939


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+44 1276 486477

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+44 1276 486455

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“Opt for direct billing for affordable walk-in convenience so that you never have to foot high-cost medical bills up front.”