Medical Record & Insurance Claim
What is the document required?
- To ensure patient privacy and confidentiality, MAHSA Specialist Hospital requires a complete consent and authorization form from the patient (Application Form for Release of Medical Information).
- List of Next of Kin for minor patients (patients aged below 18), patients with mental incapacity to give consent or deceased patients. The Next of Kin shall accordance to priority in sequence order:
- the patient’s spouse (if married);
- the patient’s parent or legal guardian (if not married);
- the patient’s child;
- the patient’s sibling;
- the patient’s grandparent;
- the patient’s grandchild.
What service does our medical record team provide in this hospital?
Medical Records Department provides service request of written medical report, completion of insurance form, SOCSO, EPF and copies of clinical investigation reports.
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How do patient apply for medical record service at MAHSA Specialist Hospital?
- Medical report can be apply by walk-in to Medical Report Counter, Medical Record Department, Ground Floor, Wing B, MAHSA Specialist Hospital, Jalan SP 1/3, Bandar Saujana Putra, 42610 Jenjarom, Selangor Darul Ehsan.
- Via email the application to medicalrecord@mahsaspecialisthospital.com or;
- Post and attention to Medical Record Department, Ground Floor, Wing B, MAHSA Specialist Hospital.
If patient aged 18 years and above?
- Completed Application Form for Release of Medical Information;
- A copy of patient’s IC or Passport (front and back).
If patient aged below 18 years?
- Completed Application Form for Release of Medical Information (Signed by parent or legal guardian)
- A copy of patient’s IC or Passport (front and back);
- A copy of patient’s parent or legal guardian IC or Passport (front and back);
- A copy of the applicant's IC or Passport (front and back).
If requesting on behalf of patient?
- Completed Application Form for Release of Medical Information;
- A copy of patient’s IC or Passport (front and back);
- A copy of applicant’s IC or Passport (front and back).
For mental incapacity patient or deceased patient?
- Completed Application Form for Release of Medical Information (Signed by Next of Kin. Please refer list of Next of Kin).
- A copy of Deceased’s Death Certificate (Applies to deceased patient).
- A copy of Next of Kin’s IC or Passport (front and back);
- A copy of applicant’s NRIC or Passport (front and back);
- Power of Attorney (applies to requestors other than spouse e.g. official letter issued by the court or legal institutions/ Amanah Raya Berhad (ARB)/ Grant of Probate/ Letter of Administration).
How to contact the Medical Record Department in MAHSA Specialist Hospital?
How soon can patient obtain medical report?
The process will take about 30 working days from the date of recipient of required documents. Delays in the preparation of medical reports may occur due to one of the below:
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- Unavailability of doctors (e.g. doctors on leave)
- reports requested from multiple doctors
- Patient admitted to ward
How much is the medical report fee in MAHSA Hospital?
A fee shall be charged as per MMA 13th Schedule for a Medical Report and may vary according to the details and length of the report.
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How to collect the report?
You will be contacted when the medical report is ready via phone call , SMS or email (based on your preference).
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- You may collect onsite at Medical Report Counter, Medical Record Department, Ground
- Scanned copy via email or;
- Original hardcopy via Courier Services (Charges may apply)