Step 1. Intimate the TPA/Insurance Company on their Toll-Free number regarding the admission and get the claim number. Step 2. As when you pay the money, keep a copy of the receipts safely. Step 3. At the time of discharge from the hospital, be sure to collect the following: i. Detailed bill for payment made. ii. Final Payment Receipt iii. Discharge Summary: Check the Discharge Summary before leaving. Sometimes, by error, there may be a mention of a pre-existing condition which the patient never suffered. For example, there may be a sentence stating diabetes past ten years when the patient had never suffered from the same. iv. Copy of Investigation Reports- Blood test, Urine test, motion test, X-ray, MRI, CT-Scan, report where the specimen is sent for tests, and any other test reports. Make sure to collect all the test reports mentioned in the discharge summary. v. In case of accidents, collect a Medico-Legal Certificate. vi. In case any implants have been done, ask for the invoice copy of the implant. The invoice may include a plate for fracture, a stent for angioplasty, lenses for cataract surgery, etc. vii. Collect a copy of the Indoor case papers. Still, the same need not be submitted to the TPA/Insurance Company unless specifically asked. Step 4. You need to fill the complete claim form and share it with the Insurance company and all the papers, bills, Discharge Summary, and Reports and submit the same. Step 5. The acceptable amount may be credited to you, or the TPA/Insurance Company may raise a few queries. In case of questions, go to the hospital and get the details from the treating Doctor. In case you are looking to get your claim reimbursed, please download the BimaXpress App from Google /Apple Appstore and initiate a Claim Reimbursement request.
5 August 2020