Our Services
Medical Claim Processes Redefined
Excellent and Safe
Employees need appropriate, excellent and safe medical care
Appropriate Billing
Ensure appropriate billing and prevent over-servicing
Support
Administrative support to monitor clinic visits, billing and payment
Reduce MCs
Management of medical sick certificate – reduce undeserving MCs
Reduce Wastages
Reduce over medication, duplication and reduce wastage
Wellness Care
Employee Transformation & Wellness Care to Increase Productivity
Levelling Health Care Costs
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24 Hour Cashless service at panel clinics and hospitals
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Collate bills to minimize payment processing
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Manage membership database seamlessly
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Detailed data analytics to drive cost cutting solutions
We Do Things That Matters
Consistent
Fixed Consultation
Fixed Medication
Analytics
Appropriate Billing
Administrator Support
Quality Services Delivery
More than 3,500 Clinics and 700 Hospitals
Wide network of panel clinics reaching across peninsular Malaysia, Sabah & Sarawak
24 Hour Call Center
Our 24 hour call center is staffed with individuals who have experience in the medical industry. With dedicated support hotline
Strictly No Commissions
e-MAS has a strict no commissions policy. We do not take commissions from clinics or any other medical providers. We follow the most ethical practices to ensure appropriate billing without affecting service delivery.
Online System
The e-MAS Care Plus system allows clinics to verify patient eligibility in real time and submit claims immediately after treatment. This system also has 3 levels of abuse prevention.
Urgent GL TAT
Upon receipt of complete documentation, all GL requests are treated with urgency and GLs issued promptly
Service Actions
Outpatient Service Actions
The e-MAS medical review team routinely observes medical trends of coming out of claims. Using this analysis, the medical review team, will provide their medical opinion on how medical treatments can be better managed
Inpatient Service Actions
All admission requests are evaluated for their medical necessity. When an admission is found to be avoidable, the Medical Review Team provides the necessary advice to the patient. The patient however makes the ultimate decision.
Service In Action
Hospitalisation Process Flow
1. Patient Visit e-MAS Hospital
Nationwide panel hospital
Referrabl letter for non-emergency
Direct acess for emergency/accident conditions
24/7 hotline 1-300-88-3627
Tips:
Know your doctor
Ask for second opinion
Always ask your doctor is surgery can be avoided.
2. Hospital Register Patient
- Registration counter will request for your MyKad / e-MAS card
- Hospital to contact e-Mas to verify patient, eligibility and entitlement
- You may call e-MAS if facing any delay
Tips:
- Hospital Response Time: subject to number of patients waiting for admission
- e-MAS Response Time: Immediately upon receipt of phone call
3. Hospital Fill Admissions Claim Form
- Verification completed
- Admission claim form to be filled by hospital and treating doctor
- Patient to provide consent by signing form
- Completed form to be sent to e-MAS hospital via email
- Patient may call e-MAS if facing any delay
Tips:
- Hospital Response Time: subject to number of patients waiting for admission
- e-MAS Response Time: 30 to 45 minutes from receipt of complete documentation.
Caution:
Make sure to know the treatment plan prior to avoiding the consent Hospital may request for Deposit as per Hospital Policy.
4. e-MAS Medical Review
The e-MAS Medical Review Team (MRT) will perform the following verifications.
- Dignosis verification
- Treatment plan verification
- Patient safety factor
- Patient communication
5. e-MAS Guarantee Letter
- MRT approval for Admission
- Patient Administration Team Issue GL
- GL sent to Hospital Admission Counter
- Patient can proceed for Admission with their known and trusted Doctor
6. Patient Recovery
Treating Doctor will provide appropriate treatment.
With the GL issued, the hospital will provide you the necessary treatments as per your policy terms and conditions
Discharge Process Flow
7. Patient Ready for Discharge
- Patient has recovered
- Doctor Approved Discharge
- You, patient notify e-MAS via whatsapp at:
018 788 3627
Provide:
- Patient Name
- NRIC / Passport No
- Hospital Name
- Mention: Ready for Discharge
8. Hospital Patient Discharge Process
- Doctor approves discharge after patient review
- Hospital prepares itemized bill
- Doctor signs discharge claim form
- Hospital to send final bill and all reports and documentation for verification purpose to e-Mas to request for Final Guarantee Letter (FGL)
9. e-MAS Bill Review
- Complete Discharge Documentation received
- Excess Amount Calculated
- Excess notice sent to Hospital
- You, Patient Pay Excess at hospital before going home
- Response Time: 30 - 60 Min
10. e-MAS Bill Review & Final Guarantee Letter Issuance
- Hospital bill reviewed by Medical Review Team
- Investigation completed (if any)
- Bill verified, no double billing for unnecessary charges
- Final GL issued to Hospital
- Response Time: Subject to response time from hospital and case complexity. Within 1-3 working days.
Advisory Services
2nd Medical Opinion
How medical treatments can be better managed
Medical Bill Audit
Audit of medical claims are essentially performed to prevent and control overcharging by medical practitioners and establishments
Dental
Pharmacy Dispensing
Tigas Dispensing
- Approximately 60% of Outpatient Expenses are for medications
- Tigas Dispensing provides an avenue to reduce cost of medications by as much as 20%
- Tigas dispensing leverages the Tigas Network of Pharmacies Nationwide to dispense medications at the most affordable prices
Tigas Dispensing - Implementation Flow
Communication
Communicate new dispensing flow to all employees.
Identification
Identify long term patients and brief them on requesting repeat prescription from doctors.
Prescription
Patients request repeat prescription from doctors at clinics.
Dispensing & Counselling
Pharmacy will prepare medications for delivery Pharmacist will manage patient adherence by providing consults.
Claims
Pharmacy will submit all claims via e-MAS Claims System
