In health insurance, you can claim your insurance benefits in two ways. You can either avail cashless treatment from the network hospitals or get a reimbursement for the hospital bills paid by you at the time of hospitalization. 


Usually, there is a thought that the reimbursement process is very complicated and hard to get done. But that’s not the case. Once you have the documents with you, we will take care of the claim process and you don’t have to worry about it.


In this article, we will discuss how to file a reimbursement claim. 


Things to know before you file for reimbursement 


  1. File for the reimbursement as soon as you could after getting discharged from the hospital. Ideally, you should file for reimbursement within 30 days of discharge from the hospital.

  2. Make sure you have all the original documents including the medical bills to ensure a smooth claim process.

  3. Be careful while filling out the claim form and the claim amount.


What are the documents you need to file a reimbursement?


  1. Claim form (You can download it here). It is divided into two parts. Part A and Part B. (Images given below are for examples and will slightly vary based on the TPA)


    Part A should be filled and signed by the insured.


 


Part B should be filled and signed by the hospital.



  1. Canceled cheque or passbook copy. Make sure all the details such as Name, Account number, IFSC code, and Bank address are clearly visible.

  2. Any Government approved ID proof such as Aadhar card, Driving license, Passport, or Pan card. 

  3. Discharge summary provided by the hospital. The discharge summary should include details such as the medical history, details of diagnosis, treatment provided along with the date and time of admission, and date and time of discharge.

  4. Original hospital bills with bill number. Both the final consolidated bill and the breakup bill.

  5. Original payment receipt against the payment made. The receipt should include the receipt no, the amount paid, and the mode of payment, authorized by the hospital.

  6. Pre-investigation reports and investigation reports at the time of hospitalization such as blood test reports, X-rays, Scan reports, etc.,

  7. Pharmacy bills supported by Doctor prescriptions.

  8. Medico-legal certificate and FIR in case of accidents. 

  9. Implant sticker or invoice when relevant.



Now that we are clear with what are the documents to be submitted, let’s get into the process.


1. Get in touch with the customer support team at Pazcare. You can either call your dedicated Customer Support Manager or email us at support@pazcare.com


2. When our Customer Success Manager reaches out to you, send the necessary documents via email or you will get a link where you can submit all the documents online.


3. From here, the Customer Success Manager will take care of the reimbursement claim process. However, keep an eye out for all the emails from the Pazcare team or the TPA to ensure a faster claim process.



If you need any help at any stage of the process, you can call your Customer Success Manager or reach out to us at support@pazcare.com We are more than happy to help.