KUALA LUMPUR — The Healthcare Partners Protocol & Solutions Committee (HPPSC) has implemented several initiatives to improve communication, transparency and operational efficiency among doctors, hospitals, insurers and takaful operators, with the aim of enhancing the overall patient experience in Malaysia’s healthcare ecosystem.
One of the key initiatives is the establishment of a dedicated “doctor-to-doctor” hotline by insurers and takaful operators (ITOs), which has been operational since April 30, 2026.
The hotline allows medical practitioners to communicate directly with the medical advisory teams of insurers and takaful operators to discuss claims enquiries, treatment pathways and the use of new medical technologies or drugs.
HPPSC said the initiative is expected to improve mutual understanding between healthcare providers and insurers, resulting in faster resolution of claims-related matters and better patient care.
The committee has also introduced a more transparent governance framework for the review and appeal processes involving healthcare providers participating in cashless facilities under medical and health insurance and takaful (MHIT) products.
The framework is designed to ensure fair assessment, consistent decision-making and stronger engagement among stakeholders while supporting prudent healthcare spending and the long-term sustainability of the healthcare financing ecosystem.
In efforts to improve claims management efficiency, HPPSC is developing clinical protocols and best practice guidelines to help insurers assess treatments that may fall outside existing Clinical Practice Guidelines issued by the Ministry of Health.
The initiatives also include developing recommendations for evaluating emerging medical technologies such as robotic surgery, genetic testing and new cancer treatments, as well as aligning cancer drug lists with the Health Ministry’s prescribed formulary.
HPPSC will also work towards streamlining the Guarantee Letter (GL) issuance process to facilitate quicker approvals and better coordination among insurers, third-party administrators, hospitals and medical practitioners.
Life Insurance Association of Malaysia (LIAM) Chief Executive Officer Mark O’Dell said the initiatives demonstrated what could be achieved through collaboration between all parties in the healthcare ecosystem.
He said the measures would strengthen communication, improve operational efficiency and enhance transparency while ensuring Malaysians continue to have timely access to affordable and sustainable medical and health insurance and takaful coverage.
Malaysian Medical Association (MMA) representative Dr Gunalan Palari @ Arumugam Palari said effective patient care depended on strong cooperation among healthcare providers and healthcare financiers.
He said the doctor-to-doctor hotline reflected a collective commitment to ensuring patients receive timely, appropriate and coordinated care.
The MMA, Association of Private Hospitals of Malaysia (APHM), LIAM, Malaysian Takaful Association (MTA) and General Insurance Association of Malaysia (PIAM) reaffirmed their commitment to continued collaboration to strengthen the sustainability, transparency and efficiency of Malaysia’s healthcare financing ecosystem.
HPPSC, co-chaired by MMA and LIAM with the support of PIAM and MTA, brings together healthcare providers, insurers, takaful operators and third-party administrators, with observers from the Ministry of Health and Bank Negara Malaysia. —Bernama
