English to Turkish Bus/Financial Law: Contract(s) Insurance Related

Example:

'How do I arrange direct settlement for planned in-patient treatment?

You will need to submit a Treatment Guarantee Form in advance of treatment. Provided that the treatment you are seeking is covered under your plan, we will confirm the medical necessity of your treatment and appropriateness of the costs and where possible, arrange for direct settlement. '

By following the treatment guarantee process, we can ensure that your treatment will be free from financial worries, allowing you to concentrate on getting better.

NOTE: This has got nothing to do with accommodation. The exact thing I'm looking for is the title of a form that reads: 'Direct Settlement Agreement Form' from an insurance company.