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GulfCare Claims Process and Procedures

Within UAE: Within the GulfCare Networks


For Out-Patient Treatment
When you visit a Network Provider, you are required to carry your GulfCare medical card with you and present it at
the providers reception on arrival. The receptionist may also ask for further identification. You will need to pay your
deductible. Therefore treatment should be cashless.
For Inpatient & Day case Treatment
All In-patient & Day case treatment requires written PRE-APPROVAL. Within the UAE a Network Provider should
be used where possible and the Network Provider will obtain pre-approval on the Insured Persons behalf and will
complete the relevant claim form on the Insured Persons behalf.

Within UAE: Outside the GulfCare Networks


Please refer to the Reimbursement Claims Submission Procedure below, if you attend a non-network Provider
within the UAE.
Please ensure to obtain written pre-approval from the Insurers for all elective In-patient and Daycase
procedures. Failing to do so will result in denial of your claim.

Outside UAE - For Outpatient & Inpatient & Day case Treatment
(Within your Region-of-Cover)
For Out-patient Treatment
If you are travelling outside the UAE, please take a GulfCare Claim Form with you. Please refer to the
Reimbursement Claims Submission Procedure below.
For Inpatient & Day case Treatment
All In-patient & Day case treatment requires written PRE-APPROVAL. Please contact Marsh Help Desk in Dubai
on the below numbers to guide you through the process / procedure for In-patient & Day case Treatment. Direct
Billing will be arranged wherever possible. Please refer to the Reimbursement Claims Submission Procedure
below, in case Direct Billing arrangements cannot be made.
However, in EMERGENCY situations please proceed to the nearest medical provider and call the NAS Helpline if in
UAE or the CEGA Helpline if in the Rest of the World as soon as practical or at the very least before discharge
(The numbers are printed on the back of your card).

Reimbursement Claims Submission Procedure


You will be required to pay for your treatment at the clinic/ hospital immediately.
You will need to take a GulfCare Claim Form to the clinic / hospital with you, have it completed by the medical
practitioner, and submit it with the following Original documents to Marsh.
Official receipt for consultation and other services
Breakdown of Charges
Results of Lab Tests, X-rays and other examinations performed
Doctors Prescription
Itemized Pharmacy Bill
Itemized Hospital Invoice and official receipt of the total amount paid (in case of In-patient & Day case
Treatment)
Detailed Hospital Discharge Report (in case of In-patient & Day case Treatment)
You will need to ensure that the GulfCare Claim Form is correctly completed and signed by yourself and also
signed and stamped by the attending Medical Practitioner.
You will receive reimbursement of eligible claims within 21 days of submission of complete documents.
Please note that claim forms must be submitted within 90 days from the date of treatment. Failing to
do so, will result in the denial of your claim. Please note that incomplete claim forms can result in delay in
the processing and settlement of your claim.
Claim Re-submission period for incomplete reimbursement claims:
The resubmission of additional documents requested by the Insurer must be within 150 days from the start/ date
of treatment and failing to do so will result in the denial of your claim.
Helpline Numbers:

NAS 24 hour Helpline based in the UAE:

8003311 or 02 6940700

International 24-Hour Assistance Service: +44-1243-621-074 (if phoning from outside the UK)
(CEGA, United Kingdom)
01243-621-074
(if phoning from within the UK)
In case of any further assistance, please contact: Marsh Employee Health & Benefits Help Desk,
Easa Al Gurg Tower 3, Riggat Al Buteen, P.O. Box 1019, Dubai, UAE.

Marsh TOLL-FREE: 800-MARSH


Telephone: + 971-4-223 7700 / Facsimile: + 971 4 223 6777
Email: Helpdesk.Dubai@marsh.com