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APRIL Outpatient Direct Billing Panel Network (Hong Kong)

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APRIL Outpatient Direct Billing Panel Network (Hong Kong) APRIL Outpatient Direct Billing Panel Network (Hong Kong) Page 3: General Practitioners Page 58: Specialists Page 90: Physiotherapy, Diagnostic Imaging & Lab Centre INTRODUCTION AND TERMS OF USE APRIL’s Outpatient Direct Billing Network is designed to provide our members with a service that makes claiming for outpatient services quick and convenient. When members with a valid APRIL Member Card use clinics within our network, APRIL will settle eligible medical expenses incurred directly with the medical provider. Only members with outpatient benefits can use direct billing services. Please note that Moratorium policies are not eligible to this service. Use of this list is governed by your Policy’s Terms and Conditions and is also subject to the guidelines, exclusions and remarks listed below. Download our Easy Claim app on your smartphone to search and locate healthcare providers within our Asia network: With the app, you can: Search a healthcare practitioner by name, location or specialty. Check whether you are eligible for direct billing in the displayed facilities To verify your eligibility for direct billing, log in to the app and click on the “E-card” button: • If the code “DB” is displayed on your card, you are eligible for direct billing within our whole Asia general network. • If the code “PNW” is displayed, you can enjoy direct billing within our Panel Network. Reminder Members with outpatient benefits should have access to this service, however, if you have not used our Outpatient Direct Billing Network before, or have any problems using the Network, please call us at +852 2526 0505 (Hong Kong) or email your questions to [email protected] Inpatient Direct Billing For inpatient treatment, APRIL can arrange direct billing if proper notification and documentation are provided and subject to the hospital’s agreement. If you would like APRIL to arrange direct billing for inpatient services, please inform your hospital and notify APRIL at least 5 working days prior to admission or for a planned surgery/procedure/operation. Emergencies If you have an accident or emergency and urgently need APRIL to guarantee your expenses, please call APRIL Assistance whose contact details are printed on the back of your member card. Maternity 1 Direct billing for outpatient maternity benefits may also be arranged within our network, but only with ONE PROVIDER per policy year (per pregnancy) in order to keep track of applicable sub-limits. Once you have decided on your sole provider within the network, please inform APRIL and we will provide a Letter of Authorization with a benefits balance for you to present to the clinic for record keeping. Eligible Outpatient Direct Billing Services The following outpatient services may be direct billed to APRIL: • General Practitioner consultation • Specialist consultation • Laboratory investigation • General X-ray • Prescribed medications obtained at the clinic on the same day of consultation Diagnostic procedures such as CT scan, MRI, Ultrasound, Mammography or other investigations for chronic conditions as well as inpatient and outpatient surgery require pre-authorization which can be obtained by completing Section C of the Medical Claim Form and submitting it to APRIL for approval. For information on how to access direct billing, please refer to the claim instructions included in your member pack or contact APRIL Claims Department whose contact details are printed on the back of your member card. Exclusions* The following is a summary of conditions that are NOT ELIGIBLE for outpatient direct billing: • Pre-existing Conditions where coverage has not been expressly granted by APRIL. • Routine medical examinations or check-ups. • Cosmetic surgery and reconstructive surgery. • Tests or treatment related to fertility, impotence or erectile dysfunction, contraception, sterilization, birth defects and congenital conditions. • Pregnancy or childbirth including pre-natal and post-natal care (except where agreed in writing by APRIL). • Prostheses and corrective devices. • Test or treatment of psychiatric, psychological, mental or nervous disorders. • Test or treatment for illness/injury as a result of excessive consumption of alcohol or narcotics or similar drugs or agents. • Sleep disorders • Learning difficulties, behavioral or developmental disorders or venereal disease. • Test or treatment in connection with Human Immunodeficiency Virus (HIV) related Illness including Acquired Immune Deficiency Syndrome (AIDS) or AIDS Related Complex (ARC). • Experimental or pioneering medical and surgery techniques. • Refractive defects of the eye, such as nearsightedness and astigmatism, spectacles, monocles or contact lenses. • Dentistry. *See the Exclusions within your Medical Policy for full details. The following APRIL Outpatient Direct Billing List applies to: • Members holding a valid membership card with a PNW & DB Code. • Members having outpatient benefits with 20% co-insurance that restricts direct billing access to the Panel Network below. The following participating clinics are available to these members: The availability of outpatient direct billing and benefits are subject otherwise to the terms and conditions and benefits schedule of the policy. Please refer to your policy for specific coverage. Remarks • Providers may change from time to time. Please check with APRIL for the latest listings. 2 General Practitioners Hong Kong Island - General Practitioners Area District Provider Name Address Tel Shop B, Ground Floor, Kam Hong Kong Aberdeen Dr. Chung C.C., Joseph Fung Building, Wu Pak Street, 2552 1222 Hong Kong Aberdeen Town Health Medical Centre G/F, ,6 Tung Sing Road, 2554 4223 Rm 501, Goodview Centre, 12 Wu Pak Hong Kong Aberdeen Dr. Wong Hau Ki Charles Street 2552 2833 Hong Kong Aberdeen Dr. Cheung Po Yi Polly G/F, 104 Aberdeen Main Road 2572 2822 Shop B, G/F, Kam Fung Building, Wu Hong Kong Aberdeen Dr. Chung Chi Chiu Joseph Pak Street 2552 1222 Flat B, 3/F, On Tai Building, 1-3 Wu Nam Hong Kong Aberdeen Dr. Lee Shin Street 2814 0688 Shop G, G/F, Kam Fung Building, 171 Hong Kong Aberdeen Dr. Yeung Kai Ming Tony Aberdeen Main Road 2814 8822 Flat B, 3/F., On Tai Building, 1-3 Wu Nam Hong Kong Aberdeen Dr. Lee Shin Street 2814 0688 Hong Kong Aberdeen Dr. Wong How Ki Charles 12 Wu Pak Street 2552 2833 Shop B, G/F., Kam Fung Building, Wu Hong Kong Aberdeen Dr. Chung Chi Chiu Joseph Pak Street 2552 1222 Hong Kong Aberdeen Dr. Leung Wai Lun Ground Floor, 6 Tung Sing Road 2554 4223 Shop E, G/F, Yee Tiam Building, ,5-11 Hong Kong Aberdeen Dr. Lee Wai Ka Wo Street 2555 1221 Unit 1605-09, 16/F, Tower 1, Admiralty 2529 8668, Hong Kong Admiralty Dr. Au See Kim Katherine Centre, 18 Harcourt Road 2529 8667 Unit 1605-09, 16/F, Tower 1, Admiralty 2529 8668, Hong Kong Admiralty Dr. Cheung Sin Nga Heidi Centre, 18 Harcourt Road 2529 8667 Unit 1605-09, 16/F, Tower 1, Admiralty 2529 8668, Hong Kong Admiralty Dr. Fan Pui Kay Kenneth Centre, 18 Harcourt Road 2529 8667 Unit 1605-09, 16/F, Tower 1, Admiralty 2529 8668, Hong Kong Admiralty Dr. Ip Iong Iong Centre, 18 Harcourt Road 2529 8667 Unit 1605-09, 16/F, Tower 1, Admiralty 2529 8668, Hong Kong Admiralty Dr. Law Tin Wan Alice Centre, 18 Harcourt Road 2529 8667 Unit 1605-09, 16/F, Tower 1, Admiralty 2529 8668, Hong Kong Admiralty Dr. Lie Siu Fen Sue Centre, 18 Harcourt Road 2529 8667 Unit 1605-09, 16/F, Tower 1, Admiralty 2529 8668, Hong Kong Admiralty Dr. Siu Sheung Yan Patty Centre, 18 Harcourt Road 2529 8667 Unit 1605-09, 16/F, Tower 1, Admiralty 2529 8668, Hong Kong Admiralty Dr. Tay Jordan Centre, 18 Harcourt Road 2529 8667 Unit 1605-09, 16/F, Tower 1, Admiralty 2529 8668, Hong Kong Admiralty Dr. Tsui Wing Hang Centre, 18 Harcourt Road 2529 8667 Shop 35, Lei Chak House,,Ap Lei Chau Hong Kong Ap Lei Chau Dr. Lee Kuen, Phyllis Estate 2552 1321 3 Hong Kong Island - General Practitioners Area District Provider Name Address Tel Shop G09, G/F, East Marina Hong Kong Ap Lei Chau Dr. Leung Sze King Square,,South Horizons 2554 3233 Rm 404, Commercial Centre,Phase II, Lei Hong Kong Ap Lei Chau Dr. Ho Chi Kwan Tung Estate, 2874 8368 Shop 8-9, G/F., Yee Hing Building, 150 Ap Hong Kong Ap Lei Chau Dr. Lam Tak Wa Edward Lei Chau Main Street 2873 3099 Shop G60-61, G/F., East Marina Square, Hong Kong Ap Lei Chau Dr. Yu Wai Cho Michael South Horizons 2518 3230 Shop 35, Lei Chak House, Ap Lei Chau Hong Kong Ap Lei Chau Dr. Lee Kuen Phyllis Estate 2552 1321 Shop 310, 3/F., East Marina Hong Kong Ap Lei Chau Dr. Yik Ping Yin Square, South Horizons 2580 2232 Causeway Rm. 2602, Hang Lung Centre,,2 - 20 Hong Kong Bay Dr. Chan C.W., Alex Paterson Street 2882 8900 Causeway Rm. 2602, Hang Lung Centre,,2 - Hong Kong Bay Dr. Cheung W.K., Calvin 20, Paterson Street, 2882 8900 Causeway 22/F, Hang Seng Causeway Building,,28- Hong Kong Bay Dr. Sit Medical Centre 34 Yee Wo Street 2881 0268 Causeway Room 1101, 11/F, Capitol Centre, ,5 – 19 Hong Kong Bay Dr. Chung C.C., Joseph Jardine’s Bazaar 2552 9886 Causeway Suite 2405-06, 24/F, World Trade Centre, Hong Kong Bay Dr. Chan Lai Ka Chris 280 Gloucester Road 2890 3118 Causeway Suite 2405-06, 24/F, World Trade Centre, Hong Kong Bay Dr. Chan Wai Man Amanda 280 Gloucester Road 2890 3118 Causeway Suite 2405-06, 24/F, World Trade Centre, Hong Kong Bay Dr. Lam Ho Fai Kenneth 280 Gloucester Road 2890 3118 Causeway Unit 1606-10, 16/F, Hang Lung Centre, 2- Hong Kong Bay Dr. Chan Chun Chung 20 Paterson Street 2782 2202 Causeway Unit 1606-10, 16/F, Hang Lung Centre, 2- Hong Kong Bay Dr.
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