myMetLife User Guide:
Transcription
myMetLife User Guide:
e-Services User Manual For Insured Members TABLE OF CONTENTS: 6 16 LOG IN HOME PAGE 19 My Benefits 23 My Claims 40 Network 42 Services 54 FREQUENTLY ASKED QUESTIONS E-SERVICES A State Of The Art Online Portal e-Services is a state of the art online portal that will allow Agents to view and manage policies. KEY FEATURES • Portfolio Inquiry: Member and dependent details BENEFITS • Complete coverage, benefits & beneficiary information • Coverage details and Table of Benefits • Submit cash claims • Claim Summary • Monitor claims and pre-approvals • Change Beneficiary • Edit profile information • Dependent Addition • Search for medical providers • Dependent Termination • Download forms • Photo and Document upload • Print / request for certificates • Request for temporary / replacement Medical Cards REQUIREMENT S Minimum System Requirements The minimum requirements to access the e-services portal • Internet Explorer 7 or higher • Ensure that your Pop-up blocker disabled 4 LOG IN 5 LOGGING IN Accessing our website through the Individuals pages Visit www.metlife.ae Go to “Access eServices” Click on “Login to e-Services” 6 LOGGING IN Accessing our website through the Business pages Visit www.metlife.ae Click on “Login to e-Services” 7 LOGGING IN Directly accessing e-Services website: www.eservicesgulf.metlife.com Enter your Username & Password then click on “Login” (continue on page 11) Click here if you are a new user (Continue on page 9) Click Here if you forgot your password or if your account is locked 8 LOGGING IN New User Once you click on “New User” a window will pop up, Select your access type: Agent Broker Insured member Policyholder Then click on “Register” 9 LOGGING IN Registration Step 1 Tips that help you during the registration process. 1 1 2 2 Enter your Certificate Number 3 Enter your date of birth 4 Click on “Submit” 3 4 Enter you Policy Number NOTE: The Policy and Certificate numbers are available on your Medical Card 10 LOGGING IN Registration Step 1 (continuation) After clicking on submit, the system will show: • Your Name and • Your Employer Review your Member Name and Employer If your Member Details are correct, click on “Register” NOTE: If your member Details are not correct, please contact your HR Department 11 LOGGING IN Registration Step 2 (continuation) Enter your email address in both fields (as your user ID) Read the Terms and Conditions before acknowledging then click on “Register” Once you click on “Register”, you will receive your password by email Click on the link on the email to proceed to log in 12 LOGGING IN First time Login Log in using your username and the password provided to you by email after registration 13 LOGGING IN New Password Once you login, the system will automatically prompt you to create a new password and set-up a secret question. Once this activity is completed, you can log in again with your new password PASSWORD RULES: Do make sure you’ve selected a password that is of a length between 8-13, is alphanumeric (A-Z, a-z, 0-9) The in-built security features of the e-Services portal ensure that any information that you access of transmit via this portal is secure and not compromised 14 LOGGING IN Contact & Bank Details Enter your personal information, your address & contact details Select your preferred mode of payment If mode of payment selected is “Wire Transfer”, you need to enter your bank details NOTE: The page will be automatically pre-populated if you have already provided this information 15 LOGGING IN Contact & Bank Details Enter your sponsor information like sponsor type, Sponsor ID, Sponsor contact number and email, Your residing and working location and Your salary details Click Here to know more about each of these fields Click “Submit” 16 HOME PAGE 17 HOME PAGE Toolbars 1 2 1 To answer any inquiry you may have 2 To send us an email for inquiries, clarifications or suggestions 3 To view or edit your address, contact information and change password 3 4 4 Toolbar with a selection of services Access of Offers and Special Features 18 HOME PAGE Toolbar Selections MetLife’s e-Services is a central hub, In which you can find all the required forms and templates to manage your policy, generate certificates, and much more… 19 What are you covered against? Do you want to see your beneficiary(ies) information? MY BENEFITS Who are the dependents registered under your policy? And what are their benefits? My Benefits allows you to view your dependents details, all your coverage benefits and your Beneficiary (ies) information. 20 MY BENEFITS Member details Selections to view the benefits details under your policy 21 MY BENEFITS Continuation… Click here to view benefit details (details on next page) 22 MY BENEFITS Continuation… Download detailed Table of Benefits Medical Benefits are displayed in various tabs: Comprehensive Major Medical, Dental, Optical, Maternity and Others Maximum Annual Coverage 23 Do you want to submit a cash claim from home? Do you know the status of your latest claim? Are you just retrieving your claim history? MY CLAIMS My Claims allows you to do all that! PAGE 24 PAGE 33 24 CLAIMS The Search Page There are 2 ways to look for a claim: OPTION 1: Search by entering the 18 digits “Tracking Number” NOTE: The Tracking Number is available in the acknowledgment email OPTION 2: Search through the below information: • Insured name • Benefit • Service date from / to • Claim status 25 CLAIMS Results: - Claims Summary Once you click on submit, you will get a table with a list of claims reflecting the amount claimed and approved along with their tracking numbers Click on the “Action” row to add or resubmit files Click on any of the Claim Number to see the claim details NOTE: Please go to the next page to know more about the “add” and “resubmit” features. 26 CLAIMS Add & Resubmit features Once a claim is submitted, you will have till 12:00am to submit any additional file to support your claim The option will be available once a decision is taken about the claim. It can be used to resubmit it for reassessment by uploading all supporting documents 27 CLAIMS Claims Details & Report From the Claims summary page, click on any of the “Claim Numbers” to view its details including: • Claim number • Payment mode • Service provided • Date • Approved claim amount • and more… To get / print a copy of the claim report, click on “View Claim Report” 28 CLAIMS Claim Report Templates Page 1 (view close up and summary on page 38-40) Page 2 (view close up and full summary on page 41) 29 CLAIMS Claim Report Templates: What’s in the Report Page 1 1 Report Date 2 1 3 4 2 Claim Number 3 Claim Status Header (displaying 4 Report name/address) 5 5 Policyholder Summary (displaying policy details) 6 6 Claim summary 7 7 Patient Share (displaying what needs to be paid by patient) 8 8 Contact us information 30 CLAIMS Claim Report Templates: What’s in the Report Page 1 (close up) 1 4 5 6 2 3 7 8 9 1 Date Policy came in force the 1st time 2 Last renewal date 3 Currency of country where policy was issued 4 Date service is provided 5 Date claim is processed 6 Date payment is processed 7 Maximum amount paid for this claim based on Policy T&C’s 8 Amount to be paid by patient 9 Amount claimant will receive 31 CLAIMS Claim Report Templates: What’s in the Report Page 1 (close up) 1 Date service is received the first time 1 2 3 2 Date service is received the last time 3 Exchange rate used (if applicable 4 Payment date 5 Amount paid to patient 4 5 6 6 Payment mode 32 CLAIMS Claim Report Templates: What’s in the Report Page 2 1 2 1 Claim number 2 Claim details (displaying consultation, details, amount claimed / paid / denied with the dates) 3 3 Additional remarks (if any) 4 4 Payment summary (showing amount, mode of payment & date) 5 Contact us information 5 33 2 CLAIMS Cash Claims Submission: Layout This page has 5 sections Policy Details (page 34) Contact Details (page 35) Claim Details (page 36) Payment Method (page 37) Document Upload (page 38) 34 CLAIMS Cash Claims Submission:- Policy Details This section will show you your: • Policy Number • Policyholder Name • Certificate Number • Insured Name All fields are pre-populated. Just confirm that these are your details. You can find the 10 digit Policy Number on the bottom left corner of your Medical Card NOTE: If you need to update any of your details, please contact MetLife Customer Service. 35 CLAIMS Cash Claims Submission:- Contact Details abc@d e f g . com This section will show you your: • Preferred Mobile Number & your email address All fields are pre-populated. NOTE: Details can be updated in the “Contact details” section under your Profile page 36 CLAIMS Cash Claims Submission:- Claim Details Steps to follow: 1 Select Dependent Code Name (use the scroll down option) 2 Choose the Country where you received the treatment in 3 Select the type of Medical Facility & enter its name 4 Enter the total claim amount 5 Select the claim currency 6 Choose the currency you would like us to pay you in 7 Select the Payee Name 8 Enter the Date of Service (From) 9 Enter the Date of Service (To) 1 2 3 5 4 6 7 8 9 37 CLAIMS Cash Claims Submission:- Payment Method You can receive your claim reimbursement amount through: • Wire transfer (directly into your account) or; • Check If Wire Transfer is selected, system will automatically show your account details including: • Bank name • Branch name • Account number • Swift code • IBAN NOTE: You can update your account details in your “Profile” page. All you need to do is click on the “Profile” tab to access the page. 38 CLAIMS Cash Claims Submission - Document Upload You need to share your physician’s diagnosis, report, test lab (if any) or any other document to support your claim. This page allows you to upload all your documents. 1 All you need to do is: 4 2 3 1. Type the document 1 description 2. Select the file you wish to 2 upload by using the “Browse…” option 3 3. Click on “Add File” 4. To upload more files, click on 4 the “+” sign and repeat the above 3 steps. • To Remove / delete a file, click on the “-” sign 39 next to it CLAIMS Cash Claims Submission - Submit the Claim Once you upload your documents, the following information will appear under the upload table: Claim submission requirements Authorization Statement Disclaimers Read the above document, tick on the box and click on submit to send your request. An acknowledgement will be sent to your email 40 Having problems locating a Medical Provider near you? Use our medical provider finder tool to browse amongst our list of more than 1000 medical providers in the UAE! NETWORK The Search Provider tool helps you filter them by: • • • • • Country City Area Category Specialty 41 NETWORK How to find a Medical Provider Enter required information to find a medical provider Click “View Network List” 42 Are you looking for a Claim Form? Do you need a Certificate for the Embassy? What is the status of your Pre-Approval request? SERVICES PAGE 43 PAGE 44 MetLife e-Services ensures that all required forms and services are just a few clicks away! PAGE 46 PAGE 48 PAGE 50 PAGE 51 Now you can download forms, certificates, and monitor your Pre-approval request just by logging in! PAGE 52 PAGE 53 PAGE 56 43 SERVICES Download Forms Download Enrollment Forms (in PDF) Download the following forms (in PDF) 44 SERVICES How to Request for a Certificate Select the Type of Certificate Life Certificate: Applicable only for members who have life coverage Medical Certificate: Applicable only for insured members who have medical coverage Temporary Medical Card : Temporary card designed for new joiners who did not receive their medical cards yet (It can only be used with selected Medical Providers) Sharjah Ministry Health Certificate: Applicable only for insured members who have medical coverage. A request will be sent to MetLife to provide stamped certificate GPA Certificate : Applicable only for GPA policies JAFZA Certificate: Applicable only for policies having medical benefits and has a sub office in JAFZA. A request will be sent to MetLife to provide stamped certificate Medical Replacement Card : Temporary card designed for insured members who lost their medical cards (card can only be used with selected Medical Providers) 45 SERVICES How to Request for a Certificate Select the Type of Certificate The certificate will be immediately generated for you and your dependents You can either open it directly or save on your computer 46 SERVICES How to Request for a Certificate Select the insured followed by the required periods, the click on “Search” 1 Pre-Approval ID: Click on the Reference Number for more details (details on page 51) 2 Policy no. 3 Certificate no. 4 Dependent code 5 Name of the Insured 6 Insured ID 1 2 3 4 5 6 7 8 7 Submission date 8 Status 47 SERVICES Pre-Approval Full Details Pre-Approval ID full details 48 SERVICES Change Beneficiary Guidelines for updating beneficiary Current Beneficiary info. Click on “Edit” to change beneficiary details NOTE: The change Beneficiary function will be available only if you have a Life Coverage and the Policyholder is not the Beneficiary 49 SERVICES Change Beneficiary (continuation…) Select required option Select Rows to delete Add multiple beneficiaries Click here to save and print the Amendments 50 SERVICES Add Dependents Existing Dependent Information Click on “Add New” to add a dependent Enter Dependent Details NOTE: The following function will be available only if your HR is a registered e-Services user and has granted you access to add dependents 51 SERVICES Add Dependents Upload photo and documents if applicable Enter Sponsor details and other regulatory information Click here to know more about each of these fields Click “Save” to submit the transaction for HR approval NOTE: The following function will be available only if your HR is a registered e-Services user and has granted you access to add dependents 52 SERVICES Terminate Dependents Select dependents to be terminated Enter termination effective date Click here to submit the transaction for HR approval NOTE: The following function will be available only if your HR is a registered e-Services user and has granted you access to terminate your dependents 53 SERVICES Photo Upload Format description of the photo that can be uploaded Select required entries Browse and select the photo Click on “Upload Photo” to submit the transaction for HR approval NOTE: The following function will be available only if your HR is a registered e-Services user and has granted you access to upload photos 54 SERVICES Document Upload 1 2 4 3 1 Click on “Click Here” to view the documents required for your policy 2 Select the type of document to be uploaded 3 Select required entries 4 Browse and select the document Upload the document. You will be prompted to upload more documents. If you do not wish to add any more documents, the transaction will be submitted to your HR for approval NOTE: The following function will be available only if your HR is a registered e-Services user and55has granted you access to upload SERVICES Profile Management To manage and update member/dependent information Click to change your profile password Enter bank details and claim reimbursement mode to be updated. 56 SERVICES Profile Management Choose the insured whose information is to be updated Enter insured details to be updated Enter Sponsor details and other regulatory information Click here to know more about each of these fields Click save and continue updating information for other insureds Click “Update profile” once all the information has been 57 updated. FREQUENTLY ASKED QUESTIONS 58 FAQ’S Frequently Asked Questions Who should I contact for inquiries or clarifications? For any inquiries or clarifications, you can send us an email at e-Servicescorp.gulf@metlife.ae Is my information secure? Yes. The data is secured using a 128 bit encryption using SSL (Secured Socket Layer) Please email us at: e-Servicescorp.gulf@metlife.ae My Account is Blocked, how can I re-activate it? To unlock your account, please email us at: e-Servicescorp.gulf@metlife.ae I am having trouble selecting a password. What should I do? There are guidelines to follow for creating a password. These guidelines are available in the “Password Change Screen”. If you are still facing difficulties in creating a password, please email us at: e-Servicescorp.gulf@metlife.ae 59 FAQ’S Frequently Asked Questions I am unable to login, why? There are several reasons why you may not be able to login: 1. You may have incorrectly entered your username. In case you need to double-check your username against the confirmation email you received when your account was set-up. 2. There may be a mismatch between the username and password. 3. You account is locked. If you are facing difficulties in login, please send us an email at eServicescorp.gulf@metlife.ae Please email us at: e-Servicescorp.gulf@metlife.ae During Registration, the system is asking me to enter my Bank Account details. Why? Through our newly launched Wire Transfer Capability, you now have the option to receive your claim reimbursements directly deposited to your bank account. By providing your bank details, you will be able to d=benefit from this new secure feature. If you still prefer receiving your cash claim reimbursements though cheque, kindly tick the checkbox next to “cheques”. 60 FAQ’S Frequently Asked Questions I want to cancel my access. Who do I contact? To cancel your access, please email us at: e-Servicescorp.gulf@metlife.ae The system signed me out automatically. Why? If your page remains inactive for 30 minutes, e-Services will automatically sign you out as a security measure. As with many secured web application, e-Services provides this feature in order to ensure your data is secured and protected from potential access by an unauthorized individual. Please email us at: e-Servicescorp.gulf@metlife.ae What is the secret question? The secret question is a verification question to which only you know the answer. You create the question during your first login process. The answers to these questions are used to reset your password and confirm your identity. We recommend that you do not share the answers to your questions with anyone. If I cancel my e-Services access, will my policy also be cancelled? No, your policy will not be cancelled if you decide to cancel your e-Services access. 61 FAQ’S Frequently Asked Questions Some of the Claims presented amounts are hidden, why? These amounts are called Provider Claims (or Direct Billing Claims). They represent the claims that were submitted by the Provider for the services you paid through direct billing. Some of the Claims are clickable and some are not, why? The “Clickable” claims are the Cash Claims which are submitted by you for reimbursement. By clicking on them, you can view al the details of your claim, what was approved or denied and the full amount paid. Please email us at: e-Servicescorp.gulf@metlife.ae Can I see a reason why a Claim was denied or partially paid? Yes. Just click on the Claim number to view all details about that specific claim. Can I submit a Claim online? Yes, You can submit cash claims through e-Services. All you need to do is go to “Cash Claim Submission” section to submit the claim and upload supporting documents. Please note that for some cases, we may ask for the original document(s). 62 FAQ’S Frequently Asked Questions What are the Certificates available on e-Services? Certificates are formal documents produced by MetLife – Gulf to certain entries as a proof of your coverage: 1. Medical Certificate for the UAE Residency Visa: Some Emirates in the UAE require a Medical Insurance certificate in order to issue a residency visa. You can simply request MetLife to issue a certificate for you. 1. Life Insurance Certificate: If you have a Life Insurance Coverage in your policy, you can immediately generate a Life Insurance Certificate as a proof. Please email us at: 1. Medical Insurance Certificate: This certificate acts as a proof that you have a Medical Insurance with MetLife. It may be required when applying for a visa such as Schengen. e-Servicescorp.gulf@metlife.ae 2. Medical Authorization Certificate: This certificate can be used by employees who newly joined their company at specific Medical Providers until they get their Medical Cards. The list of providers is available in the Download Forms page under Services. 1. Sharjah Ministry Health Certificate: Sharjah Ministry requires a Medical Insurance certificate in order to issue a residency visa. You can simply request MetLife to issue a certificate for you. 1. Medical Replacement Card: This certificate can be issued to employees who have lost their cards, and used a specific Medical Provider until their Medical Card is re-issued. The list of providers is available in the Download Forms page under Services. 63 APPENDIX 1 Field Name UID number UAE visa place of issuance Sponsor type Description For UAE/GCC national Available on First or Last Page of passport For Expatriates Available on Resident Visa Page in the passport Choose from below values Dubai ABU DHABI AJMAN FUJAIRAH RAS AL KHAIMAH SHARJAH UMM AL QUWAIN UAE national Dubai national GCC national Diplomat Choose from below values Resident Citizen Establishment Property Owner Description of information required for DHA 64 CONTINUATION Field Name Visa Sponsor ID Description For Members, If the value in field "Sponsor Type" is 1. Establishment, then the value will be autopopulated 2. Resident then the Sponsor's UID number should be entered 3. Citizen, then the Sponsor's Citizen File number should be entered 4. Property Owner, then the Sponsor's UID number should be entered For Dependents If the value in field "Sponsor Type" is 1.Establishment, then the Sponsor's Establishment Entity Number / Al Munshaa number should be entered 2. Resident then the value will be auto-populated 3. Citizen, then the Sponsor's Citizen File number should be entered 4. Property Owner, then the Sponsor's UID number should be entered Description of information required for DHA 65 CONTINUATION Field Name Description Please enter the 15 digits without hyphens or spaces Example: 784198012345676 Choose from below values Salary less than 4,000 AED per month Salary between 4,001 and 12,000 AED per month Salary greater than 12,000 AED per month Gross salary range(Required for Regulatory Purpose) No salary-for dependents or children that do not acquire a salary In the bulk upload templates (available under Services menu), the value should be 1 or 2 or 3 or 4 National id no Salary based on commission Description of information required for DHA Choose from below values Yes No In the bulk upload templates (available under Services menu), the value should be Y or N 66 CONTINUATION Field Name Residing Emirate Residing location Work location (Emirate) Description Choose from below values Dubai ABU DHABI AJMAN FUJAIRAH RAS AL KHAIMAH SHARJAH UMM AL QUWAIN Residing Emirate Dubai: Click Here Residing in other Emirates: please choose OTHER EMIRATES (OUTSIDE DUBAI) Choose from below values Dubai ABU DHABI AJMAN FUJAIRAH RAS AL KHAIMAH SHARJAH UMM AL QUWAIN Description of information required for DHA 67 CONTD.. Description of information required for DHA Field Name Work location Did member have insurance in the past 6 months in UAE Sponsor contact no Sponsor mail id Description Work Location (Emirate) Dubai: Click Here Working in other Emirates: please choose OTHER EMIRATES (OUTSIDE DUBAI) Choose from below values Yes No In the bulk upload templates, the value should be Y or N This is applicable for dependents who are not under the Primary member's visa. The Sponsor's contact number needs to be entered This is applicable for dependents who are not under the Primary member's visa. The Sponsor's email id needs to be entered 68