Panel hospitals can now request for adjustment if they need to amend their claim amount that has been approved by HealthMetrics by clicking Request adjustment button on Claim Details tab.
IMPORTANT: For adjustment, once a claim status is Full approval, panel users have 30 calendar days to request for adjustment within the portal. If the panel hospitals fail to request for adjustment within the 30 calendar days, they will not be able to request it.
There are 3 steps that panel hospitals need to fill in order to request adjustment :
Panel users need to provide their “Adjustment reason. Kindly choose form the list of Adjustment reason and the adjustment final bill amount as these are compulsory fields. Click “Next” button on the right bottom to proceed the next step.
Secondly, panel users must attach a final bill that with summary and breakdown charges stated and upload any additional investigation report as their supporting documents then click the Next button on the right bottom to proceed to the last step.
Lastly, panel users need to check all the information is correct before they submit the adjustment request. If they found there’s information that they need to be corrected, they can just click Edit button then it will redirect to selected page. If panel users make sure everything is correct, they can just click Submit for approval button on the bottom of the page to submit their adjustment request.
As soon as users submitted the request adjustment for approval :
- Claim status will change from Full approval to Pending approval (adjustment) (Image 1).
- On panel dashboard, panel hospital users may view the claim in Submitted widget in Image 1.
- To review more details hospital users may click on View claim button which will redirect users to Claim Details tab.
Image 1: PANEL dashboard – Submitted
On claim details page (Image 2) - users may cancel their request for adjustment by clicking Cancel adjustment request button. A pop-up box refer (Image 3) will appear for panel users to fill in the required information then click Submit button on the right bottom.
Once request adjustment is cancelled, the claim status will change from Pending approval (adjustment) to Full approval.
Image 2: PANEL – Claim details
Image 3: PANEL - Cancel request adjustment
IMPORTANT: Panel users are only allowed to cancel and re-request adjustments up to within 30 calendar days from the first date which the claim is fully approved.
Adjustment request history will be updated on the claim timeline for panel users to easily keep track of
the record.
If request adjustment has been approved by the host - the status will change from Pending approval (adjustment) to Full approval with an adjustment icon on the claims page details.
IMPORTANT: Although the adjustment has been approved by host, if the claim is still within 30 calendar days from its first full approval date, users may still request for adjustment as shown below.
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