(Global Elite Health Plan / Executive Health Medical Plan)

TO APPLY FOR PRE-AUTHORISATION - NON NETWORK ARRANGEMENT
1

Download and complete the Pre-authorisation form(s)

2

Prepare all the supporting document(s)

3

Submit Pre-authorisation form(s) with all supporting document(s)

4

AXA will review the application and issue a confirmation letter to you after approval

5

Start your treatment with no pressure

PRE-AUTHORISATION FORM(S)
SUPPORTING DOCUMENT(S) CHECKLIST

Please keep the pre-authorisation documentation for 6 months from the pre-authorisation completion date. AXA reserves the right to request additional information/documentation to support each pre-authorisation.

  1. Pre-authorisation Form(s)
  2. Copies of supporting document(s) such as medical reports from attending doctor on proposed in-patient treatment/surgery/diagnostic investigations/long term medication
CLAIMS SUBMISSION
  1. By email: Send the completed form(s) with all supporting document(s) to acr@aa-international.com.hk
  2. By post: Mail the completed form(s) with all supporting document(s) to the mailing address listed on the form(s).
  3. Through Financial consultant: Submit the completed form(s) and supporting document(s) to your financial consultant for assistance.
  4. By fax: Fax the completed form(s) with all supporting document(s) to Global Elite Customer Service Team at (852) 3529 1638

Contact Information

Telephone: (852) 2863 5708

Email: acr@aa-international.com.hk