Health Insurance Claims Made Simple with Digit
What is a Health Insurance Claim?
A health insurance claim is the official request and process through which you can get your healthcare and medical costs taken care of by your health insurance provider. For example; if a family member is unfortunately hospitalized due to an illness, and are covered in your health insurance plan, you will need to file for a health insurance claim to go ahead with a cashless treatment, or get a reimbursement processed for their hospitalization.
Types of Health Insurance Claims
How to make a Cashless Claim?
We believe in transparency, and so you know exactly what to expect during a health insurance claim we’ve put down the complete steps of going through a cashless claim that you can opt for at any of our 5900+ Network Hospitals.
Step 1: Please inform us least two to three days before any planned hospitalization or within 24 Hours of hospitalization in case of an emergency situation.
Step 2: Show your e-health card and ask for the pre-approval form at Mediassist help desk/insurance helpdesk at the hospital.
Step 3: Fill and sign the form and submit it at the helpdesk.
Step 4: If all is okay, you can go ahead with the treatment using the cashless facility. Make sure that the treatment is done within 15 days of approval.
How to make a Reimbursement Claim?
Step 1: You need to call us within two days of your admission date. Post our call, we’ll send you a link where you can upload the soft copies of all original documents (bills, reports, etc) and bank details of your desired bank account.
Step 2: Before uploading, you need to sign all the documents yourself. You also need to write ‘For Digit Insurance’ on them. Keep all originals handy as we may ask for them if required.
Step 3: Upload the documents within 30 days from the date of discharge or when you receive the link.
Step 4: We will keep you posted for any additional requirements.
Step 5: You will receive the payment within 30 days from the receipt of the last necessary claim document.
Documents Required for a Health Insurance Claim
Whether you go for a cashless claim or reimbursement, here’s an exhaustive list of documents you may need to upload or submit while making a health insurance claim. Don’t worry, the documents differ from claim to claim but this list has everything possible. You may need only a few or all of them based on your situation.
|List of Documents||Hospital-ization Claim||Critical Illness Claim||Daily Hospital Cash Claim|
|Duly Filled and Signed Claim form|
|Medical Records (Optional Documents may be asked on need basis: Indoor case papers, OT notes, PAC notes etc.)|
|Original Hospital Main Bill|
|Original Hospital Main Bill with breakup|
|Original Pharmacy Bills with Prescriptions (except hospital supply) and investigations done outside the Hospital)|
|Consultation & Investigation Papers|
|Digital Images/CDs of the Investigation Procedures (if required)|
|KYC (Photo ID Card) Bank Details with Cancelled Cheque|
|There are some more documents that will be needed only in specific cases, such as:|
|In case of pregnancy related claims- Ante-natal Record, Birth discharge Summary|
|In case of an accident or involvement of police- MLC/FIR Report|
|In case of death or disability- Post Mortem Report, Death Certificate or Disability Certificate Original Invoice/Sticker (If applicable)|
|Attending Physician Certificate (If applicable)|