Maternity
What is EDD
Estimated Delivery Date
Dermatologist
Specialist Fee
Benefit called for Cancer patient
Oncology Benefit
Basic Dental Procedures such as Cleaning, Scaling and Polishing
Dental Treatment
Bonus
100 points
Where to cover Pre-Eclampsia?
Complication of Pregnancy
Need of TG
Occupational Therapy
24/7 nurses in a facility
Convalescent Home
Alignment of the teeth
Orthodontics
An indication of diseases
Symptoms
Where to cover medically necessary caesarian?
Complication of childbirth
Where to cover CT Scans (outpatient)?
Core Plan
Must start within 14 days of medical treatment if medically necessary, almost the same with Physiotherapy but need TG
Rehabilitation Treatment
Frenectomy
Dental Surgery
Bonus but...
You need to Dance/Sing to any tiktok trend
500 points
When to cover early pre-natal test?
When the patient is 35 and over
Celecoxib
POM
When can a patient have a cash benefit
When they were accomodated in Public Hospital
This procedure should be covered based on the treatment done to the patient
X-ray
How to reject OTC if there is no Prescribed drugs benefit in the TOB?
Excluded under terms and conditions >> Expenses relating to products that can be bougt without doctor's prescription
When to suspend a maternity claim?
When there is a TG and the delivery charges are not yet paid
What do we need to FIR for no diagnosis, but for psychiatry?
Psychology and Psychiatry >> Medical Report
Does not stay overnight and does not occupy a bed at any stage (surgery)
Outpatient surgery
Treatment of Gums
Periodontics
Bonus but....
300 points instead of 500