FAQ's
1WHAT DOES MY HEALTH PLAN COVER?
Your plan covers consultations, diagnostics, and treatments. For specific coverage details (e.g., surgeries or medications), contact the call center or review your policy document.
2WHAT IF THE HOSPITAL REFUSES TO ATTEND TO ME?
Contact the call center at 02013300300 immediately for assistance. We will intervene to ensure care at the hospital or provide alternative care options.
3HOW DO I SIGN UP ON YOUR NETWORK OF PROVIDERS?
Send a proposal letter to hmo@oceanichealthng.com
4HOW DO I REPORT COMPLAINTS OR PROVIDE FEEDBACK?
- Call Center: Call 02013300300 for immediate assistance.
- Email: Send complaints or feedback to hmo@oceanichealthng.com (available 24/7).
- Survey Forms: Participate in customer surveys to share your experience by using this link.
- Email: Send complaints or feedback to hmo@oceanichealthng.com (available 24/7).
- Survey Forms: Participate in customer surveys to share your experience by using this link.
5HOW DO I GET REIMBURSED FOR OUT-OF-POCKET EXPENSES?
- Planned Care: Call 02013300300 before receiving care to get a reimbursement code.
- Emergency Care: In emergencies, contact the call center within 24 hours to obtain a reimbursement code retroactively.
- Reimbursement Process: Submit the following documents to initiate processing:
• Filled reimbursement form
• Detailed medical report
• Evidence of payment
• Breakdown of care
• Reimbursement code issued by the call center.
- Emergency Care: In emergencies, contact the call center within 24 hours to obtain a reimbursement code retroactively.
- Reimbursement Process: Submit the following documents to initiate processing:
• Filled reimbursement form
• Detailed medical report
• Evidence of payment
• Breakdown of care
• Reimbursement code issued by the call center.
6WHAT HAPPENS IN AN EMERGENCY OR ACCIDENT IF NONE OF YOUR HOSPITALS IS NEARBY?
You can access care at any hospital close to you, but we advise you to contact the call center within 24 hours to ensure proper documentation and support.
7HOW DO I VERIFY ENROLLEES?
We recommend using the portal, through mails and/or phone calls to our customer care lines.
8HOW DO I GET A PRE- AUTHORIZATION CODE?
We recommend using the portal, through mails and/or phone calls to our customer care lines.
9HOW DO I SUBMIT MONTHLY CLAIMS?
With the use of portal. Kindly contact the Customer care if you require further directions on how to enter your claims on the portal.
10WHAT HAPPENS IF I GO TO THE HOSPITAL AND I AM TOLD THAT THE SERVICE I REQUIRE IS NOT COVERED?
Kindly verify from your plan sent to your HR. You may also contact the Oceanic Health 24-hour Call Centre for verification/ clarification.
11WHAT HAPPENS IF I AM DISSATISFIED WITH THE QUALITY OF CARE FROM A HOSPITAL?
Kindly formally inform us using any of the above-mentioned channels. This would enable us to investigate the case and adequately address the issue. You would also be allowed to change hospital, should you prefer.
12WHAT IS YOUR COMPLAINTS PROCESS?
We welcome your feedback on all aspects of your experience with Oceanic Health and our network of providers. If you have a complaint, kindly inform us via our 24-hour Call Centre or send a mail to hmo@oceanichealthng.com you can also contact your Oceanic health relationship manager to enable us resolve your complaint as efficiently as possible.
13CAN I CALL THE CALL CENTRE ANYTIME?
Yes, the Call Centre is accessible 24 hours a day, 7 days a week.
14WHICH HEALTH CARE PROVIDERS DOES OCEANIC HEALTH HAVE?
Our network has healthcare professionals that provide a wide variety of services. From primary care providers like general practitioners (GPs) to secondary care specialists like dentists, physiotherapists, pediatricians, ophthalmologists and E.N.T practitioners etc. Some providers may provide both primary and secondary care services.