Coverage at Heartology
What to Confirm
before Your Visit.
Check the terms that apply to your membership and services. The information on this page helps you prepare the paperwork.
A partnership is not claim approval. Coverage, benefit limits, and the costs you pay follow your policy and the insurer's decision.
Benefits and Limits
Service coverage and benefit limits in your policy.
Service Network
Whether the hospital network matches your membership.
Prior Approval
Whether a referral or authorization is needed before services.
Out-of-Pocket Costs
Costs that are not covered or that exceed your benefits.
Administrative process
Understand Your Claim Process.
Through the Asuransi Sinar Mas Online app, members can check their Simas Card, health insurance coverage, and claim progress, and upload claim documents. The membership card can be shown as the original or a soft copy.
Here is a general overview. The final procedure and documents follow your policy and service terms.
Cashless Process
Confirm Your Policy Coverage
Ask whether the planned service is included in your policy benefits and network.
Prepare Your Card and ID
Bring your member documents and any referral or prior approval if required.
Complete the Administrative Check
The Heartology team helps confirm coverage with the insurer. Approval follows your policy terms.
Understand Any Remaining Costs
Ask for an explanation of any costs that are not covered or that you pay yourself.
Reimbursement Process
Check the Claim Terms
Confirm benefits, submission deadlines, and the document list directly with your insurer.
Prepare to Pay for the Visit
With reimbursement, you pay for the visit first according to the service administration.
Keep the Requested Documents
Prepare receipts, itemized bills, and the medical documents requested for your claim.
Submit Your Claim
Follow the insurer's submission channel and terms. Reimbursement depends on the claim assessment.
Visit preparation
Documents to Prepare.
Use this list as a reminder. The administration team or your insurer may ask for additional documents.
0 of 3 reminders checked
This list is your own preparation note, not a verification. You do not need to send photos of documents for an initial question.
About and contacting the insurer
Contact Asuransi Sinar Mas (ASM).
PT Asuransi Sinar Mas is a general insurance company within the Sinar Mas group, providing cover for individuals, families, and businesses, from motor vehicles, homes, and travel to health. Its health products include individual plans such as Simas Sehat Gold and the Simas Sehat Corporate group health plan. The company also has a sharia business unit and is licensed and supervised by Indonesia's Financial Services Authority (OJK).
For policy benefits and claim status, contact PT Asuransi Sinar Mas directly.
Plaza Simas - Jl. K.H. Fachrudin No. 18, Tanah Abang, Jakarta Pusat, DKI Jakarta 10250, Indonesia
The insurer's contacts are separate from the Heartology help team. Links to the insurer's site open in a new tab.
Frequently asked
Questions before Your Visit.
Does cashless mean all costs are covered?
Not always. Covered services, benefit limits, and the costs you pay follow your policy and the insurer's approval.
Is a health checkup package part of my insurance benefits?
Checkup coverage differs between policies. Confirm the package and tests with your insurer before you schedule.
I use a company or TPA card. Who should I contact?
Start with the instructions on your member card or your company's HR department. The Heartology team can help explain the administrative process for your visit.