保险直付是指客户持有保险机构有效的高端医疗健康保险卡,在合作医疗机构接受诊疗服务后,保险保障责任范国内的医疗费用由保险机构和医疗机构进行直接结算,客户无需现场支付。
Direct billing refers to the process whereby a medical provider bills an insurance company directly for services within the scope of coverage rendered to a policyholder possessing a valid insurance card, and no payment is required from the policyholder.

直付服务是高端医疗健康险的核心服务之一,保险公司与医疗机构签订合作协议,客户在合作的医疗机构看病不需要支付保险福利内的费用(如果保险计划有自付额除外),保险公司会直接和医疗机构结算,无需客户再向保险公司提交理赔申请和相关资料。
Direct Billing is one of the core services of high-end medical insurance. Patients who receive outpatient treatment do not have to pay for medical expenses (except for any deductible) and wait for a refund. Instead, the insurance company and medical institution will settle the bills directly.

部分保险公司的客户需在接受治疗前提供保险公司担保函。
Guarantee of payment is required before treatment for the insurance providers below.


  • STEP 01

    确认福利:客户提前确认保险计划直付范围
    Benifit confirmation: please make sure you medical insurance coverage and direct billing service before the appointment.

  • STEP 02

    预约:和祐健康公众号/400热线/保险公司
    Appointment: Heyou We-chat official account or 400 hotline or your insurance company

  • STEP 03

    门诊直付
    Out-patient Direct Billing Service.

    保障范围内费用免直付,签字即离院
    No copay for benefit coverage, just signature for discharged.

  • STEP 04

    证件准备
    Documentation:

    初诊携带:身份证件+有效期内保险卡或电子凭证
    Initial visit: ID card and valid insurance card or electronic certificate

  • STEP 05

    住院无忧
    In-patient Service

    2-3个工作日预授权担保,免押金入院
    Pre-authorization within 2-3 days, no deposit

  • STEP 06

    结算:医院与保险公司直接结算
    Check-out: payment is processed direct billing between the hospital and your insurance company, which with your signature.

As long as I have high-end commercial medical insurance, can all the expenses for my medical treatment at your hospital be paid by the insurance company?
Firstly, your insurance company needs to have signed a direct payment cooperation agreement with our hospital. For details, please refer to the cooperation list below; Secondly, the scope of your medical treatment is within the coverage of your insurance benefits, and finally, your medical expenses are medically necessary. Those who meet the above three criteria can be paid by the insurance company.
My insurance was purchased by the company for me, how do I know what my insurance benefits cover?
We have professional customer service personnel. You only need to provide us with your identity information and insurance card information, and our customer service personnel will contact the insurance company to inquire about your insurance benefits.
My insurance broker said that some projects require pre authorization to be applied for first. What is pre authorization?
Pre authorization refers to the requirement for the hospital to prepare pre authorization materials (patient insurance card, identification documents, medical records, etc.) and send them to the insurance company for pre review before the insured receives a certain treatment. After the review is approved, the insurance company will issue a written approval letter (i.e. guarantee letter).
Here are some common pre authorization projects:
(1) Large scale imaging examinations such as CT, MRI, PET, etc;
(2) Hospitalization, including hospital delivery;
(3) Outpatient surgeries requiring anesthesia, electrotherapy, chemotherapy, radiation therapy, blood or peritoneal dialysis;
(4) Outpatient therapeutic treatment, including psychological, rehabilitation, traditional Chinese medicine treatment, etc
(5) Purchase or rent non disposable durable medical equipment, including but not limited to insulin pumps and their supporting devices;
(6) Purchase or lease durable medical equipment (including but not limited to protective gear, wheelchairs, insulin pumps and their supporting equipment, etc.)
(7) Medications or vaccines exceeding RMB 5000/8000 per dose (depending on the specific requirements of the insurance company)
I have high-end commercial medical insurance. What do I need to bring to see a doctor?

You need to bring your ID card or passport, as well as your insurance card, with you when you come for medical treatment.

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