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    This document outlines the process and documentation required for orthopedic implant surgery based on the patient's mode of payment. It lists several options for self-payment, SOCSO coverage, loan implants, Peka B40 program, and coverage by various government agencies. For each payment method, 1-3 forms are required such as a quotation form, approval letter, receipt of payment, or eligibility form. Proper documentation must be submitted to obtain authorization and reimbursement for the orthopedic implant surgery.

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    This document outlines the process and documentation required for orthopedic implant surgery based on the patient's mode of payment. It lists several options for self-payment, SOCSO coverage, loan implants, Peka B40 program, and coverage by various government agencies. For each payment method, 1-3 forms are required such as a quotation form, approval letter, receipt of payment, or eligibility form. Proper documentation must be submitted to obtain authorization and reimbursement for the orthopedic implant surgery.

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    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
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    Download as docx, pdf, or txt
    11 views1 page

    PL

    Uploaded by

    hanz
    This document outlines the process and documentation required for orthopedic implant surgery based on the patient's mode of payment. It lists several options for self-payment, SOCSO coverage, loan implants, Peka B40 program, and coverage by various government agencies. For each payment method, 1-3 forms are required such as a quotation form, approval letter, receipt of payment, or eligibility form. Proper documentation must be submitted to obtain authorization and reimbursement for the orthopedic implant surgery.

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    © All Rights Reserved
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    of 1

    Diagnosis establish by Orthopedic Specialist

    Operative Conservative

    Mode of payment

    Self-payment Hospital Implant SOCSO Peka B40 Loan implant (Ext fix)

    1 Quotation Form Borang Hijau Online Inspire Perkeso 3 Quotation Form Borang Pinjaman
    +cop MO (PKSP/KKM-01/VER1.0 Form Alatan Perubatan
    /2020 PekaB40 Online Form
    Borang Persetujuan 1 Quotation Form Deposit Payment
    Pembelian Implant #Approval letter Letter Offer Form
    Receipt (RM500) by
    (HSBAS/ORTO/PP4.1 (3copy) Eligibility (1st Stage)
    Unit Hasil

    # Receipt of Payment Approval (2nd Stage)


    (3copy) # Local Order (3copy)

    Zakat/Tabung Kronik TBP (>rm3000) JPA


    Kedah (<rm3000)

    3 Quotation Form Quotation Form (3


    IC Kedah (TKK)-non
    quot) + SSM
    muslim Borang Hijau
    (PKSP/KKM-01/VER1.0 Borang Permohonan
    1 Quotation Form
    /2020) Implant + letter head +
    Borang Hijau cop pakar
    Borang C Pindaan
    (PKSP/KKM-01/VER1.0
    2019 Borang Perubatan
    /2020)
    1/09
    Borang Putih
    Borang Putih
    (HSBAS/KSP/PP4.15) Permohonan
    (HSBAS/KSP/PP4.15)
    Kelulusan
    Copy Xray patient Belanja/Perkhidmatan
    + cop HOD

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