forCashlessArrangementService_20161021_Final-如何申.PDF

MetLife Health-on-the-Peak Medical Plan / Benefit MetLife 「「健康至尚健康至尚」」醫療計劃醫療計劃 / 保障 How to apply Cashless Arrangement Service? 如何申請免找數安排服務 如何申請免找數安排服務 ？？ ？ ？ ?Please contact Medical Administrators International (Hong Kong) Limited (MAI) Hotline (852) 3106 7575 for reservation of Cashless Arrangement Service. 1 ?請致電 MAI 熱線 (852) 3106 7575 預約免找數安排服務 。 ?Complete Application for Cashless Arrangement Service Form (Form) (Form can be downloaded at .hk/en/customer/support-center/make-a-claim/) ?填妥免找數安排服務申請表格 (?申請表 ?) (表格 下載 : .hk/cn/customer/support- 2 center/make-a-claim/ ) ?Send Part IA Insured Information and Part II Attending Physician Statement of the Form to MAI and Part IB Credit card authorization form for shortfall collection to MetLife Limited (MetLife) with credit card copy by fax / by email at least 4 working days prior to Insured Persons hospitalization (If admission is in USA, two weeks notice is required.) ?在受保人入院前最少 4個工作天前 (如欲安排到美國住院 ，須給予至少兩星期通知 )，請以 傳真 / 電郵 分別遞交申請表第一部 份甲部 ?受保人資料 ?及第二部份 ?主診醫生報告 ?予 MAI 及申請表第一部份乙部 ?繳付差額費用之信用卡授權書 ?連同信用卡副 本予 大都會人壽保險公司 (?大都會人壽 ?)。 3 ?Fax no 傳真號碼 : MAI (852)2529 9200 / MetLife (852) 3409 8609 ?Email address 電郵地址 : MAI hospi@ / MetLife customerservices@.hk ?Once your application is successfully approved, MAI will inform you by phone or email of the confirmation and explain the arrangements regarding medical costs and its services . MAI will also send a Guarantee of Payment Letter (GO