Treatment at ABNIC Network of Preferred Medical Providers:
A Membership Card will be issued by ABNIC for each member covered under the Group Medical Policy. The card must be presented in person each time., before receiving any treatment at any clinic, hospital and/or pharmacy.
The deductible amount per visit should be paid by the patient to the appointed Clinic or hospital, as mentioned in the Schedule of benefit. ABNIC will settle all medical expenses directly to medical provider.
In case your medical providers ask for a specialized test such as MRI, CT. Scans, Endoscopies, etc. the doctor has to take prior approval before he / she proceeds with the tests. ABNIC will contact the medical provider for approval
Any treatment not covered in the policy or exceeding the policy limit will be debited to the employee.
Treatment outside ABNIC Network:
If the need arises the member may seek treatment outside ABNIC network. Treatment taken outside appointed clinic, pharmacies and hospitals in the UAE will be reimbursed by the company in a comparative fashion as per the company’s agreement with appointed clinics, pharmacies and hospitals in the UAE.
To enable us to reimburse the expenses of treatment taken outside the Preferred Medical Providers ABNIC has to be provided with the original itemized invoices, completed claim form duly filled and signed by attending physician stating the diagnosis and details of medical treatment, original prescription and medical laboratory or x-ray finding if applicable with medical report.
Reimbursement claims must be received within 90 days from the date of medical treatment
Medical Claims at ABNIC medical providers will be settled as per reimbursement procedure
ABNIC will reimburse 80% of those Reasonable and Customary charges.
Treatment outside the UAE:
To enable us to reimburse the expenses of treatment taken outside the U.A.E., ABNIC has to be provided with the followings:
- The medical claim form dully filled in by the treating doctor outside.
- The itemized original invoices with breakdown of charges.
- The findings of any investigations done such as Lab tests, X-Rays, Ultrasound…etc.
- The original prescription and the original medicines invoice.
- The medical report for surgeries.
- Discharge summary from the treating doctor/hospital in original.
Reimbursement of medical treatment based on the equivalent cost of such treatment in the UAE