First of all please clarify if your plan is issued by Aoril in France or April Thailand. Many people end up getting MyHealth Thailand and mistakenly think it is April Global.
You need pre-approval for hospitalization unless the total cost is under US $2,000 (likely only with day surgeries). With that obtained, they will pay the hospital directly. Most private hospitals will arrange all this for you. Allow a week to 10 days for it unless it is an emergency admission. In case of emergency the hospital needs to notify April at once and they will process a Guarantee of Payment that same day. Depending on the hospital and what immediate treatment is needed, you might be asked to give a refundable credit card deposit until it arrives.
When they pay the hospital directly the only things excluded are your deductible (if you have one) and the cost of discharge medication. For discharge medication as well as post op outpatient care you have to submit receipts. If you went through a broker, they may handle all this for you, mine does.
As for me I have had 3 claims in the 4 years of my policy:
1. Emergency admission after an accident which required 2 surgeries and about 2 weeks in hospital. Hospital called April while I was still in the ER. This was a Sunday morning. Guarantee of Payment came through in about 4 hours. As I needed immediate surgery the hospital requested, and I gave, a credit card payment of about US $4,000. This was refunded that same day when the GOP came in. Total hospital bill came to US $25 000 (this was in Cambodia so priced in USD) and everything except my $500 deductible was paid by April to the hospital. I then had an additional $3, 000- 4,000 or so in outpatient follow up. These I paid first and April fully reimbursed.
2. Epidural injection for lumbar spine problem as well as pre and post care (including MRI) were paid as it was considered a day surgery. I did not get pre-approval as the procedure cost was under the threshold, and I was in a lot of pain and did not want to wait. Since I did not have pre-approval I had to pay first and get reimbursed after. About 36k baht for the procedure and another 30-40k in pre and post care (including Xray and MRI). Fully reimbursed except for the deductible. I could have avoided the prepayment of the 36k had I gotten pre-approval but as not an emergency would have taken about a week.
3. Decompression surgery on lumbar spine -- got pre-approval and hospital was paid directly. About 350k baht. After care as outpatient was maybe 5-10k more reimbursed based on receipts
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