Health Insurance » Claim Process

ID #1065

What documents are needed for processing claims if the treatment has been done in a non-network hospital or in a network hospital where cash less facility was not granted / availed?

Following documents are required for processing the claims on reimbursement basis:

1. Claim Form properly filled and signed by the claimant

2. Discharge Certificate from the hospital

3. All documents pertaining to the illness starting from the date it was first detected

i. Bills, Receipts

ii. Cash Memos from hospital supported by proper prescription

iii. Receipt and diagnostic test report supported by a note from the attending medical practitioner/surgeon justifying such diagnostics. Surgeon's certificate stating the nature of the operation performed and surgeon's bill and receipt

iv. Attending doctor's / consultant's / specialist's / anesthetist's bill and receipt, and certificate regarding diagnosis

v. Certificate from the attending medical practitioner / surgeon that the patient is fully cured 

4.  Details of previous policies : if the details are not already with TPA except in the case of accidents

Tags: health insurance claim reimbursement documents required for filing claim.

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Last update: 2010-12-05 06:09
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Revision: 1.1

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