Annex 12 – List of Medical Facilities

HOSPITAL / OUTPATIENT FOR THOSE AGENCIES REGISTERED UNDER CIGNA HEALTH INSURANCE

Data as of  13 June 2021

1 = Direct payment to the provider for inpatient care (including outpatient surgery).

2
 = Direct payment to the provider of outpatient care. Click on the provider name to verify as from which amount direct payment for outpatient care is possible.

3
 = Price agreement (e.g. preferential rates, discounts on specific services, prompt payment discounts, etc.). Please note this does not necessarily imply that the full amount of the invoice(s) will be accepted.

NAMELOCATION123
Siloam Hospitals - BalikpapanBALIKPAPAN✓✓ 
R.S. Ibu Dan Anak Hermina - PasteurBANDUNG✓  
R.S. Ibu Dan Anak Hermina - BekasiBEKASI✓  
R.S. Ibu Dan Anak Hermina - BogorBOGOR✓  
Siloam Hospital - Jantung DiagramBOGOR✓✓ 
Siloam Hospitals - Lippo CikarangCIKARANG✓✓ 
Bali Royal HospitalDENPASAR✓✓✓
Kasih Ibu HospitalDENPASAR✓✓ 
Siloam Hospitals BaliDENPASAR✓✓ 
R.S. Ibu Dan Anak Hermina - DepokDEPOK✓  
Global Assistance Medical CentreJAKARTA ✓ 
Global Doctor Clinic JakartaJAKARTA ✓✓
Good Practice ClinicJAKARTA ✓ 
R S Pondok IndahJAKARTA✓  
R.S. Gading PluitJAKARTA✓✓ 
R.S. Ibu Dan Anak Hermina - Daan MogotJAKARTA✓  
R.S. Ibu Dan Anak Hermina - PodomoroJAKARTA✓  
R.S. MedistraJAKARTA✓✓ 
R.S. Pantai Indah KapukJAKARTA✓  
R.S. Premier JatinegaraJAKARTA✓✓ 
Rumah Sakit Siloam AsriJAKARTA✓✓ 
Siloam Hospitals - Kebon JerukJAKARTA✓✓ 
Siloam Hospitals MRCCCJAKARTA✓✓ 
True Care Medical & Dental ClinicJAKARTA ✓ 
Siloam Hospitals - JambiJAMBI✓✓ 
Siloam Hospitals KupangKUPANG✓✓ 
BIMC - Bali International Medical CentreKUTA✓✓ 
BIMC Hospital Nusa DuaKUTA✓  
Siloam Hospital - MakassarMAKASSAR✓✓ 
R.S.Ibu Dan Anak Hermina- TangkubanprahuMALANG✓  
Siloam Hospitals ManadoMANADO✓✓ 
Rumah Sakit Siloam Dhirga SuryaMEDAN✓✓ 
Siloam Hospital SriwijayaPALEMBANG✓✓ 
Siloam Hospital - PurwakartaPURWAKARTA✓✓ 
Siloam Medika SamarindaSAMARINDA✓✓ 
R.S. Hermina Pandanaran- SemarangSEMARANG✓  
R.S. Ibu Dan Anak Hermina - SukabumiSUKABUMI✓  
R.S. Premier SurabayaSURABAYA✓✓ 
Siloam Hospitals - SurabayaSURABAYA✓✓ 
R S Premier BintaroTANGERANG✓✓ 
Siloam Hospitals - Lippo VillageTANGERANG✓✓ 
Annex 11 – List of UN Examining Physicians adn UN Stress Consellor Annex 13 – Agency Admin/ HR Focal Point