What is Changing?
IHP Malaysia will replace Fullerton Malaysia for all Bupa Global TPA Services in Malaysia from 01 January 2025.
One of the key reasons for this change is that IHP Malaysia is better positioned to assist you, as they are based in Malaysia as well.
What is a TPA
TPA is an entity that provides administrative services for insurance companies and policyholders, especially in relation to healthcare claims and benefits. TPAs act as intermediaries between insurance companies, healthcare providers, and insured individuals.
To ensure coverage, TPAs handle pre-authorization requests, which are necessary for certain medical procedures or treatments.
What do I need to know to seek treatment in Malaysia?
Members seeking medical treatments from any Medical Provider in Malaysia from 01 January 2025 are to locate their preferred Provider from the Bupa Global Facility Finder website –
- Go to – www.bupaglobal.com/en/facilities/full-list
- Scroll down and select “Malaysia”
- The list of IHP Malaysia Panelled Medical Providers will be shown.
- Present your BUPA membership card to the medical provider at admission, and request that they secure a Guarantee of Payment (GOP) from IHP Malaysia
For those who have previously been acquitted of using BUPA with Fullerton as TPA, the process is similar. The only change is to ask your medical provider to secure a Guarantee of Payment (GOP) from IHP Malaysia instead of Fullerton.
For Outpatient (OP) Cashless Services
It is recommended that members call the Medical Provider for a medical appointment in advance
(3-5 days where possible) for a faster approval process. If a member walks-in instead, the expected waiting time for a cashless approval may take at least 1 hour.
Please follow this registration process at their selected Medical Provider:
- If they are calling for a medical appointment in advance, please give their Bupa Membership details, and request for the specific OP session (e.g. Consultation, Follow-Up, Rehabilitation, Health Screening etc);
- Before visiting the Medical Provider, please ensure they have all their medical records available and bring it along for the session;
- If they walk-in or arrive for their scheduled Medical Appointment, Show their Bupa Membership Card at the Insurance / Registration Counter (Physical Card or MembersWorld eCard), and submit their relevant Medical Records (as required), likefor complex cases (e.g. cancer cases, rehabilitation, previous surgeries etc). The
Medical Provider will coordinate with IHP Malaysia for a cashless approval relating to their OP visit;
For OP Cashless Services – Rehabilitation (Physiotherapy, Speech Therapy etc.) & Oncology Treatments
Members are required to provide all the necessary medical records to justify medical necessity for these services with the Participating Medical Providers. A medical treatment plan must be developed by the member’s treating physician or medical staff, which will be submitted to Bupa Global via IHP Malaysia for an Approval. Once the approval is given for a specific number of sessions, any extended session.
For Inpatient (IP) / Daycase Cashless Services
Hospital Pre-Admission Requirements
Members are expected to complete an OP specialist review, and any IP or Daycase / Day Surgery can only be recommended by their treating specialist(s). The participating medical provider will coordinate with IHP Malaysia for the required approvals.
Actual Day Hospital Admission Requirements
Members are to furnish their Bupa Membership details and be informed on their possible non-coverable obligations to pay on discharge.
For Emergency Medical Services
Depending on the circumstances, if any member requires urgent medical attention, the member
is to admit in any nearest in-Network Medical Provider with a supporting Emergency Department
Facilities (e.g. Hospitals).
If the member is unable to identify themselves, including from the member’s close contacts (e.g.
family, friends, colleagues etc.) with Bupa Membership details at the point of admission in any
Medical Provider, unless there is any other means to do so, the member is expected to self-pay
and claim directly on MembersWorld.
If the member can identify themselves with Bupa membership details, the Medical Provider will
immediately seek an urgent approval from Bupa Global via IHP Malaysia.
Who Should Members Contact if They Have any Questions or Require Assistance?
Malaysia Contact at +60 3 6207 4710 (Landline)
Please note the following:
- Please hold onto the line and do not drop the call.
- As there may be high volume of callers seeking assistance globally, and during peak periods, callers may need to wait at least 15-20 minutes before speaking with a Customer Service representative.
- Give their Bupa Membership Number, Date of Birth, confirm their Full Name as per Registered Membership, Date of Treatment and Medical Provider Name