How to apply for cashless hospitalisation / pre-approval service?

  • Updated

Regarding cashless service / pre-approval, Bowtie now offers two types of cashless services: "Hospital Cashless Service" and "Day Surgery Cashless Service." The "Hospital Cashless Service" is applicable to all Bowtie insurance products (except Cancer Fighter) and all private hospitals and hospital-affiliated day surgery centers (excluding clinics). Meanwhile, the "Day Surgery Cashless Service" is only applicable to Bowtie VHIS, Group Medical, and the designated Day Surgery Network. Please note that pre-approval is not required for physiotherapy or post-surgical rehabilitation; you can simply submit a claim directly after completing the treatment.

If the insured person suffers from an injury or illness that is not an emergency medical condition and requires medical services in a private hospital, including hospitalisation or day surgery as needed, they can apply for the cashless service. Details are as follows:

1. Hospital Cashless Service

When a doctor recommends that the insured person needs to be hospitalised, the application process is as follows:

  1. Log in to Bowtie's personal online platform and go to the claims section to pre-approval claims form
  2. Have the form filled out by the attending physician
  3. Have both the policyholder and the insured person sign the form
  4. Upload the completed pre-approval claims form through the platform

2. Day Case Surgery Cashless Service

When a doctor recommends that the insured person needs to undergo specific day surgeries or procedures (including gastroscopy, colonoscopy, wart removal, etc.) within the designated medical network, the application process is as follows:

  1. Feeling unwell / holding a doctor's referral letter
  2. Log into the Bowtie online platform to view the "Day Surgery Network List" and book an appointment with a designated doctor
  3. Show your Bowtie VHIS policy page at the clinic
  4. After the doctor confirms you need a designated day surgery or procedure, the clinic will submit a "Pre-Approval Service" request to Bowtie on your behalf
  5. Once Bowtie receives your request, you'll get confirmation via SMS and email. Within approximately 5 working days (depending on case complexity), we'll call you directly with the approval result. In the meantime, you can also log in to the Bowtie online platform to view the approval progress and result
  6. Once approved, attend your scheduled appointment to complete your treatment and enjoy cashless service

Under normal circumstances with sufficient information for review, the claims department will take about 5 working days to process the case (actual time may vary depending on individual circumstances). If there are any updates to the case, our claims specialists will contact the customer via the platform or by phone to update the approval status. In the meantime, you can check the claim progress and result on the Bowtie online platform at any time.

If the case is successfully approved, the insured person only needs to inform the hospital that they have received pre-approval and present their ID card, the approval certificate issued by Bowtie, and the admission letter issued by the hospital to proceed with the relevant medical procedures.

Upon discharge, Bowtie will pay for the approved medical expenses. However, if there are expenses beyond the pre-approved compensation amount, these will need to be paid by the insured person at the time of discharge. The relevant receipts should be kept, and a claim for the difference can be submitted to Bowtie through the online platform following the general claims procedure.

Please note that if there's a need to change the surgery date or ward class before admission, the customer will need to resubmit the pre-approval application. Additionally, some private hospitals may charge a deposit, so customers should consult with the hospital directly about this.