Claiming Health Insurance? You Will Need These Documents

All a health policyholder wants today is his hospital and claim journey to be super smooth. But, there are many obstacles that can come in the way of a seamless health claim experience. 

In this blog today, we’ll talk about proper documentation as one of the hassles in a smooth claim process.

Many times, health claims get rejected due to missing or incorrect documents. This poses a great disappointment for any insured. 
I’m sure you don’t want to be the disappointed one!

So, read below the important documents required for a smooth health claim process. 

Documents Required for a Reimbursement Claim

List of documents required in a reimbursement claim is longer than that of a cashless claim. 

• Claim Form: A duly filled claim form is a must! Errors in this form may lead to a query from your insurer or even claim rejection.
  You can easily get this form from your insurance company’s website.
  
  
• Valid Identity Proof for KYC: Proof of identity is an important document to affirm that the patient and policyholder (or policy member) are the same person. It can be an issue if your name on the submitted ID proof doesn’t match with the one on your policy card or claim form and other hospital case papers.
  So make sure to not make any errors while filing these papers.
  
  
• Policy Card: A copy of your policy card with details like policy number, name of the insured, address has to be submitted.
  
  
• Doctor’s Prescription Advising Hospitalization: This is an essential proof justifying the need of hospitalization against the diagnosed ailment or disease. So, never miss out on submitting consultation papers by your doctor.
  
  
• Indoor Case Papers: Indoor case papers or ICPs are complete treatment records of the patient with details of daily progress, nursing chart and notes of observations made by all visiting doctors right from admission until discharge. Get a copy of this from your hospital to file your reimbursement claim. This gives the insurance company a complete picture of the hospitalization journey.
  
  
• Final Bills: Of course we’ll talk about money when we’re talking about insurance and claims. Your final bill has a break up of all expenses incurred on your treatment along with the total amount against which you raise a claim from your insurance company.
  
  
• Pharmacy Bills: Have all the bills of expenses incurred on medicines and other pharmaceutical products to be submitted along with the other documents.
  
  
• Discharge Summary: This document has the summary explaining the reason for patient admission, brief of procedure done or medication given at the hospital. This is also a common document used by other healthcare professionals looking at the patient’s case for further care and analysis. You cannot miss on submitting this paper while filing your claim.
  
  
• Lab Reports: Before starting a treatment, there are several tests that a patient is advised to take to properly diagnose the problem. In fact, tests are also undertaken during and after treatment to see the progress. Submit all lab test reports supporting your treatment.

You have to submit all these documents (or any extra supporting document demanded) while filing the claim. Your health insurance provider will verify these and then transfer or reimburse the claim amount back to your account. 

Documents Required for a Cashless Claim

Documents required for a cashless claim is much less than that in a reimbursement claim. All you require is:

• to sign pre-authorization form which is pre-filled by the hospital on the basis of details shared by you,
• valid identity proof,
• policy card details.

Unlike a reimbursement claim in which you have to submit all the above stated documents yourself after collecting from the hospital - a cashless claim facility offers much convenience. 

In case of a cashless claim facility, the hospital you’re admitted in sends all medical documents and bills to your health insurance provider. 
So, you don’t have to worry!

The next time you file a claim, do remember the list of documents required while dealing with health insurance claims.

Stay tuned to our blogs for more awareness and information so you never get stuck in your health claim journey!