BENEFIT ENQUIRY & REGISTRATION
Step 1: Login > Case management tab > Benefit enquiry & registration.
Step 2: Enter customer’s NRIC > Click search > Choose certificate number > Click check certificate details.
OR
Step 2: Enter certificate number > Click search > Click check certificate details.
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If a pop-up message appears stating 'Unable To Offer HAS Facility' after you click on check certificate details, it may be due to:
- Surrendered/terminated cert.
- Absence of medical card coverage under that certificate.
- The medical card cannot be utilised for cashless admission in your hospital.
What hospital’s staff can do:
- If multiple certificates are available, you may check each certificate number to find the medical card certificate eligible for admission to your hospital.
- Call HAS Hotline (03-2742 4099) for assistance.
- Kindly inform customers to contact their agents for assistance.
- Hospital may advise customers to reach out to PruBSN’s Customer Service (03 - 2775 7188).
- Advise customers to refer to PruBSN’s corporate website for latest panel hospitals for specific medical card.
NOTE
Sometimes this pop-up message appears if searching using customer’s NRIC. You may try searching with the certificate number first before proceeding.
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Step 3&4: Once confirmed the customer’s details > Click proceed for registration.
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If a pop-up message appears stating 'Active Claims Found' after you click on proceed for registration:
- Please do not click Proceed first if active claim found.
- Please go to the Active Claim Listing to check if there is any existing claim before you register a new claim to avoid double registration.
- If clear, then proceed for registration.
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…CONTINUE ADMISSION REGISTRATION
Step 1 (Admission type): Select the correct admission type – Day Surgery, OP Cancer, Inpatient or OP Kidney Dialysis.
Step 2 (Admission/Planned Admission Date): Select admission/planned admission date.
Step 3 (Name of attending Dr): Select the attending Doctor. If Dr name not available, please select Dr name with same/nearest speciality. For new Consultant joining your hospital, please send email to Provider Network to add Doctor’s name in portal at least 3 days earlier.
Step 4 (Diagnosis/ICD code): Select the exact/nearest Primary/Main Diagnosis ICD Code. If more than 1 diagnosis, please select correct/nearest ICD code for PRIMARY / MAIN diagnosis.
Step 5 (Request Amount): Enter the estimated bill amount (RM).
Step 6 (Cause/Description of Injury): Enter full diagnosis.
Step 7 (Nature): Select nature of disease – accident/illness etc.
Step 8 (Document Subject): Select the document subject – admission/admission & discharge/pre-planned admission.
Step 9 (Document Description): Select PAF Part 1&2 or other relevant descriptions.
Step 10 (File Upload):
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Document required for PAL request:
- Complete PAF (Part 1 & Part 2)
- Copy of customer’s IC
- Referral letter (if any)
- All related investigation reports (compulsory)
File upload requirement:
- Mandatory to upload in File Upload 1. Separate docs can be uploaded in File Upload 2 and/or File Upload 3.
- Maximum document size can be uploaded is 20 Megabyte (MB). If failed, you may need to reduce the file size up to max 3MB only.
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Step 11 (Register): Click register. Once registered successfully, you may go to Dashboard tab to check claim’s status.
DISCHARGE
Step 1 (Dashboard Tab): Go to dashboard tab > Active listing > Click on claim number for patient who is discharge.
Step 2 (Document Subject): Select discharge.
Step 3 (Document Description): Select PAF – Part 2 (Discharge Section) & Itemised bill.
Step 4 (Top-Up/Discharge/Amended Amount): Enter the exact bill amount.
Step 5 (Discharge Date): Select the discharge date.
Step 6 (File Upload):
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Document required for FAL request:
- Complete PAF discharge section
- Complete final bill (summary & itemised)
- All investigation reports, any related documents (consignment slip, pharmacy take home sheet, etc).
File upload requirement:
- File Upload 1: Other documents like PAF, PAL, investigation reports, referral letter, etc.
- File Upload 2: Same as File Upload 1/additional upload box if required.
- File Upload 3: Summary & itemized bill only. Highly recommended in e-PDF format.
- If your hospital system unable to generate both summary & itemized bill in SINGLE e-PDF, you may upload itemized bill (e-PDF) only in FILE UPLOAD 3. Summary bill you can upload in FILE UPLOAD 1 or FILE UPLOAD 2.
- Maximum document size can be uploaded is 20 Megabyte (MB). If failed, you may need to reduce the file size up to max 3MB only.
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Step 7 (Submit): Once upload the documents > Click on submit.
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NOTE
Under this DASHBOARD tab, you can view:
1. Document to print – Letter issued from PruBSN (Click item under Print column to view the issued letter).
2. Request in Queue – Registered claims which are pending processing by PruBSN.
3. Active Claims List – Registered claims processed by PruBSN (Click the Claim No. to proceed for submission of Top Up request / Discharge).
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E-INVOICING (PAYMENT SUBMISSION)
Step 1: Go to case management tab > Click on E-invoicing.
Step 2: Enter the claim number or IC number > Click on search.
Step 3: Enter the invoice number. Please ensure the entered invoice number same as stated in final bill & the payable amount same as stated in FAL.
Step 4: Click on submit to upload the documents.
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Document required for E-Invoicing:
- FAL
- Summary bill only
- Any unsubmitted reports such as blood test, imaging, HPE, etc.
File upload requirement:
- The maximum document size to be uploaded is 3MB only.
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E-INVOICING (PAYMENT LETTER)
Go to case management tab > Payment letter > Print to view the payment letter.
E-INVOICING (PAYMENT REPORT)
Go to report tab > Payment report > Choose invoice submission date > Click on search > Export.
