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Panel Clinic & Dental Guidelines

The document provides guidelines for using the 'Optimal Health 1111' mobile application and member web portal, detailing registration, clinic search, medical claims submission, and checking entitlements. It includes steps for visiting clinics, submitting reimbursement claims, and utilizing customer service features. Additionally, it outlines exclusions for medical coverage, ensuring members understand what is not covered under their plans.

Uploaded by

yashivan
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
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0% found this document useful (0 votes)
37 views24 pages

Panel Clinic & Dental Guidelines

The document provides guidelines for using the 'Optimal Health 1111' mobile application and member web portal, detailing registration, clinic search, medical claims submission, and checking entitlements. It includes steps for visiting clinics, submitting reimbursement claims, and utilizing customer service features. Additionally, it outlines exclusions for medical coverage, ensuring members understand what is not covered under their plans.

Uploaded by

yashivan
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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MEMBER MOBILE APPPLICATION GUIDELINE

Optimal Health~1111
You may register with
our apps,“Optimal
Health 1111”
in Apple App Store or
Google Play Store
• Register anytime
• Name = As Registered
• National ID = As Registered
• Date of Birth = As Registered
• Gender = As Registered
• Email = Your Preferred Email
• Mobile No = Your Preferred
Number
• Password = Your Preferred
Password
STEP TO SEARCH PANEL CLINIC IN APPS

Steps:
1. Click on “Panel Provider “
icon
2. On Provider Type column,
click on the drop-down list
to see type of provider.
Choose clinic.
3. Select state.
4. If you looking for 24hours
clinic, tick on 24hours box.
5. Click “Search” or “ Get the
Nearest” button
GP CLINIC VISITATION PROCESS
Present your virtual card / floppy
card and NRIC to the panel clinic Date & Time
Merchant ID
Terminal ID:
Batch No:

1 Patient Registration 2 Eligibility Verification Card No:


Card Type:

Date & Time INQ


Merchant ID
Terminal ID: Medilink Test Card
Card No: 000000-00-0000
Card Type: Medilink
27-JAN-2013 09:11
Confirmed Valid Member
PAY
LAST HISTORY OF VISIT
Medilink Test Card Clinic Billing V. DATE ICD# MC-DAYS
000000-00-0000 Counter 01.06.18 549 1
Medilink
27-JAN-2013 09.11 Claims Submission 4 3
Diag: xxxx/xxxx MC: x days
Total Billing: RM Valid Member ****Nothing Follows***
Total Approved: RM proceed to seek
cashless medical
Patient to Pay: RM
treatment

Sign: ………………………..
****Nothing Follows***
STEP TO REGISTER WHEN VISITING CLINIC VIA QR CODE

1. Click on the QR CODE icon at


the bottom of the main screen
(left).
2. Select patient name
3. Click “Scan” button to scan
clinic QR CODE. Usually, clinic
will display the QR CODE at the
door or at the registration
counter.
STEP TO REGISTER WHEN VISITING CLINIC VIA QR CODE

4. Scan the QR Code


5. Click “YES” to
proceed.
6. Click “OK” to
complete. Apps will
send data to clinic
for registration.
MY ENTITLEMENT

How to check your


entitlement?
Step:

1. Click on “My Entitlement


Benefit” icon.
2. Select patient name either
the principal or dependent.
MY ENTITLEMENT

3. Click “View
Coverage” button
to view your
entitlement.
4. Choose your
coverage to view
your limit.
MY MEDICAL CLAIMS

Function : Members can


check medical claim
utilization.

Step:
1. Click on the “My Medical
Claims” button.
2. Members can choose
either to see Cashless
medical claims or
Reimbursement medical
claims.
SUBMIT REIMBURSEMENT CLAIM
How to submit your claim via
mobile apps?
Document required :
- Proof of payment receipt
- Itemized bill ( for medical bills
more than RM80)
Step :
1. Click on “Submit
Reimbursement Claim” button.
2. Select patient name
3. Click on the “Submit” button.
4. To check claim status, click on
“Claim Status” button.
SUBMIT REIMBURSEMENT CLAIM

5. Fill up all column in red


asterisk (*)
6. Click “Next” button when
complete.
7. Upload your attachment by
clicking on the camera icon or
browse file icon
8. Click “Submit” button to
submit your document.
MEMBER WEB PORTAL GUIDELINE

ECCS 4.0 MEMBER WEB PORTAL

https://medilinkmember.medibridgeasia.tech/
MEMBER
i.
ii.
Insert Username
Insert Password
WEB
iii. Insert Verification Code appear on

screen
PORTAL
iv. Click “Login”
MEMBER WEB PORTAL – FORGOT PASSWORD

If you forgot your password, Click


“Forgot Password” button.
Step:
1. Key in your registered phone
number, and click “Next”
2. OTP will send to your registered
phone number. Click “ Next”
3. Key in your new password and
click “Next”
4. Password changed successful.
Click “OK” to sign in with the
new password.
MEMBER WEB PORTAL – DASHBOARD
MEMBER WEB PORTAL –My Entitlement

Can check real-time range of


entitled Benefit, Annual Limit
and YTD Consumption.
Steps:
Click on “My Entitlement Benefit”
1. Select member details either
pricipal or dependent.
2. Select plan
3. You can view type of
coverage, limit and year to
date consumption.
MEMBER WEB PORTAL – Panel Provider

Member can search panel


clinic by clicking on “Panel
Provider” button.
Step:
1. Select provider type by
clicking at the drop-down
list button
2. Select state
3. If you want to search for
24hours clinic, click on the
24hours box.
4. Click “Search” to view
listing.
MEMBER WEB PORTAL
Reimbursement Claim Submission

• Member can submit the reimbursement claim in


member web portal.
• Fill up all the particular in asterisk (*)
• Upload your document
• Click “Submit” when complete.
MEMBER WEB PORTAL – My Medical Claims

Member can check their medical


claims by clicking “My Medical
Claims” button and choose either
Cashless or Reimbursement.
MEMBER WEB PORTAL – Online chat

You can chat with Customer


Service agent for assistance.
Step :
1. Click on the “Chat” button
2. Fill up the particular details
required
3. Click “Start Chat “ button to
proceed.
EXCLUSIONS LIST
1. Cosmetic surgery or treatment, or treatment of their complications except as
necessitated by
 accidental injuries (inclusive of double eyelids, etc, and all soaps, shampoos, vitamins.

2. Care and treatment that is experimental, investigative and not according to


accepted professional standards and care that is not medically necessary.

3. Treatment for injuries sustained while committing crime or felony, or while under the
influence of
 alcohol, narcotics, or mind-altering substance or injuries which are self-inflicted while
sane or insane.

4. Any treatment for or arising from substance abuse.

5. Private nursing care engaged by member or services for rest cure provided by
rest/nursing home for purely recuperative purposes and house calls by doctors for any
reason.

6. Care that is considered alternative therapies or not proven and accepted by the
medical community,
 e.g. Acupuncture,Food Supplements, Herbal Cures, Chiropractic, Osteopathy,
Reflexology, Vitamins and etc.
EXCLUSIONS LIST
7. Any process in determining the refractive errors of the eyes and their correction by any means.

8. Vaccinations

9. User or acquisition of all appliances (e.g Artificial limb, hearing aids, aero chambers, and
equipment for nebulizing, orthopedic pads) and the rental charges of such devices during hospital
confinement (all medically required internal surgical implants are covered).

10. Any circumcision unless medically necessary.

11. Blood or topical allergy testing or any investigation which is not directly relevant to the patient’s
presenting
problem.

12. Cases related to maternity, confinement, miscarriages or abortion.

13. Treatment and medication for congenital defects or long-term illness such as tuberculosis and
cancer.

14. Routine medical check up,blood tests, x-ray surgery etc. unless it is warranted due to accurate
illness or
accident.

15. Covid 19 test and influenza test.


• Contact Center: +603-2296 3188
(operating 24/7)
If any • Live Chat by:
complaint/query/ • www.medilink-global.com
doubt, you may • Mobile Apps → OptimalHealth1111
reach us through: • Email to
• customer_service.my@medilink-
global.com
THANK YOU

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