Terms & Conditions
RMA Outpatient/ Inpatient: Direct Billing General Network
INTRODUCTION AND TERMS OF USE
- RMA’s outpatient Direct Billing Network is designed to provide our members with a service that makes claiming for outpatient services quick and convenient.
- When the members with outpatient benefits and holding a valid Insurance member card use hospitals/ clinics within our network. Roy Medical Assistance will settle eligible medical expanses incurred directly with the hospitals.
Inpatient Direct Billing:
For inpatient treatment, RMA can arrange direct billing if proper notifications and documentation are provided and subject to the hospital’s agreement. If you would like RMA to arrange direct billing for inpatient services, please inform your hospital and notify RMA at least 24 hours prior to admission or for a planned surgery/ procedure/ operation.
Emergencies:
- If you have an accident or emergency and urgently need RMA to guarantee your expanses, please call RMA Assistance or contact with Travel Insurance.
Eligible Outpatient Direct Billing Services:
- General Practitioner consultation
- specialist consultation
- Laboratory investigation
- General X Ray
- prescribed medications obtained at the clinic on the same day of consultation.
Diagnostic procedure such as CT scan, MRI, Ultrasound, Mammography or other investigations for chronic conditions as well as inpatient and out patient surgery require per-authorization which can be obtained by completing claims form and submitting it to Roy Medical Assistance.
For information on how to access direct billing, please refer to claims instruction in your insurance card or contact Roy Medical Assistance.
Remarks
Providers may charge from time to time. Please check with Roy Medical Assistance