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

  1. 24 Hour Cashless service at panel clinics and hospitals

  2. Collate bills to minimize payment processing

  3. Manage membership database seamlessly

  4. Detailed data analytics to drive cost cutting solutions

Image

Our Services

Out Patient Services

Cashless Out Patient Care Services
G P Family Physician Clinics Specialists Clinics in Hospitals

Hospitalization Services

Professional Review of Admissions
Issue GL for Insurers & Corporates Hospital Billing Audit Services

Wellness Screening

Targeted Wellness Screening on Site Vaccination Services Mental Health Assessment

Medical Examination

Medical Examination Commercial Drivers License For Insurance Companies

Consultance for EB

Employee Health Benefits Focus on Patient Safety

Second Opinion & Emergency

2nd Opinion Services Emergency Medical Assistance & Evacuation

Migrant Workers Consultancy

Migrant Worker Audit Occupational Safety Solutions

First Aid Factory Clinics

Set-Up & Manage In Plant First Aid Centre In Plant Quick Care Clinics

We Do Things That Matters

Consistent

Fixed Consultation

Fixed Medication

Analytics

Appropriate Billing

Administrator Support

Quality Services
Delivered With

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

Medical Opinion

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

Medical Evaluation

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.

Hospitalisation Process Flow

1. Patient Visit e-MAS Hospital

  • Nationwide panel hospital
  • Referral letter for non Emergency
  • Direct access for Emergency & Accident condition.
  • 24/7 hotline 1-300-88-3627

Tips:

  1. Know your doctor
  2. Ask for second opinions
  3. Always ask your doctor if 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:

  1. Hospital Response Time: subject to number of patients waiting for admission
  2. 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:

  1. Hospital Response Time: subject to number of patients waiting for admission
  2. 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:

  1. Patient Name
  2. NRIC / Passport No
  3. Hospital Name
  4. 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.

Second Medical Opinion

Image

How medical treatments can be better managed

Medical Bill Audit

Image

Audit of medical claims are essentially performed to prevent and control overcharging by medical practitioners and establishments

Dental

Image

Pharmacy Dispensing

Tigas Dispensing

Image
  • 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

Need More Information?

Checked Out

Support

Need Any Help
Contact Us

Our Panel Clinics Display This Logo

Image

Address

Eximius Medical Administration
Solutions Sdn Bhd (e-MAS)
Level 2 MMA Building
124 Jalan Pahang
53000 Kuala Lumpur
Malaysia

Talk to us

Telephone: +603 4041 3627
Facsimile:   +603 4041 8627
Whatsapp: +6018 788 3627

Legal

Download Our Mobile Apps | e-MAS Sihatku

Image
Image