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How to File a Claim

A simple guide to navigating cashless and reimbursement claims with ease. We're here to support you every step of the way.

Cashless Claims Process

This process allows you to receive treatment at a network hospital without paying upfront, as the hospital bills your insurer directly.

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Pre-Authorization

Obtain pre-authorization from your insurance provider for planned treatments. This can be done through the hospital or directly with your insurer. Ensure all required documents are submitted at least 48 hours before treatment.

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Admission & Treatment

Get admitted to a network hospital and undergo the necessary medical procedures or treatments. Present your insurance card and ID proof at the time of admission.

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Claim Submission

The hospital submits the claim directly to your insurance provider with all necessary medical records and billing details.

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Settlement & Discharge

The insurance provider settles the claim directly with the hospital. Patient may only need to pay for non-covered items or any applicable deductibles.

Reimbursement Claims Process

With this process, you pay for your treatment upfront at any hospital and then submit the bills and documents to your insurer for repayment.

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Treatment and Payment

Pay for your medical treatment out-of-pocket at the hospital. Keep all original bills, receipts, and payment proofs safe for claim submission.

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Document Collection

Gather all necessary documents including bills, receipts, discharge summary, medical reports, diagnostic test results, and doctor's prescriptions.

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Claim Filing

Submit the claim form along with all required documents to your insurance provider within the stipulated timeframe (usually 15-30 days from discharge).

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Processing & Reimbursement

The insurer reviews your claim and processes the reimbursement. You'll receive the approved amount directly to your bank account within 15-30 days.

Required Documents Checklist

For All Claims:

  • check_circle Duly filled and signed claim form
  • check_circle Original bills and receipts
  • check_circle Discharge summary
  • check_circle Medical investigation reports
  • check_circle Doctor's prescriptions
  • check_circle Payment receipts (for reimbursement claims)

Frequently Asked Questions

Typically, you'll need original bills, receipts, discharge summary, and medical reports. A claim form from the insurer is also required. Check the required documents checklist above for complete details.

Claim processing times vary by insurer but generally range from 15 to 30 days for reimbursement claims. Cashless claims are usually approved within hours for emergencies and typically within a day for planned procedures.

If your claim is rejected, first understand the reason from the insurer. You can then rectify the issue (e.g., provide missing documents) and re-submit the claim. Our team can help you with the appeals process if needed.

Tips to Maximize Claim Success

Follow these best practices to ensure smooth claim processing

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Complete Documentation

Ensure all information on the claim form is accurate and complete with supporting documents.

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Timely Submission

Submit your claim within the stipulated timeframe to avoid rejection due to delays.

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Verify Coverage

Verify that the treatment is covered under your policy before undergoing it.

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Seek Expert Help

Don't hesitate to reach out to our team for guidance and support throughout the process.

Need Help With Your Claim?

Our expert team is here to guide you through every step of the claims process. Contact us for personalized assistance.

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