Claim Procedures

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Medsave Claim Procedures

Immediate intimation to Medsave is must in case of Cashless Hospitalization or  Reimbursement Hospitalization

MEDICLAIM :-There are two types of Claims - Cashless Hospitalization and  Reimbursement Hospitalization

Cashless Hospitalization Procedure

Cashless hospitalization can be availed at only Medsave network hospitals. You can check whether a particular hospital is on network or not. Refer the guide book provided along with cards. 

There are basic pre-requisite for the hospitalization which needs to be completed  against any Mediclaim policy  :- 

Hospitalization dates should fall within policy period.

Medsave Id Card should be presented at the time of approaching any network  hospital for cashless facility.

In the event of hospitalization,  hospital needs to submit Pre-authorization request with treatment details ;Medsave
    Card No.,  clinical history,  past history and estimated cost to the nearest, 
Medsave Branch Office.

Medsave issue the letter of guarantee of payment or approval amount after checking policy period, policy type, sum 
    insured,
past history records.

But if the patient details are not according to policy conditions or incomplete information, 
Medsave can reject the 
    cashless or raise query if any further information as per
Medsave
doctors.

Note - : 1 In case of delay in cashless the insured should immediately contact Medsave call center.
            2 In case the treatment is taken at
Medsave non network hospital the insured can send the claim or treatment documents 
               as Re-Imbursement
           3 Immediate Intimation to
Medsave is  must in case of any hospitalization

Reimbursement Hospitalization

When hospitalization treatment is availed in non Medsave network hospitals it is called Reimbursement hospitalization.
For Reimbursement hospitalization General intimation required..

First option Inform the call center at Toll Free Number.-1800111142
At time of claim intimation, the patient should provide :
Medsave Id Card Number or Policy Number
Hospitalization date
Approximate treatment cost
Disease

Second option, after completion of
  Re-imbursement hospitalization the following documents are to be sent to Medsave

Download the claimform from our website or ask for the same from our corresponding branch office
All Original Bills/Cash memo breakup with diagnostic reports
Original Discharge Summary
Policy copy if possible

Note : If the claim is cashless reimbursement then all the bills should be signed by patient.


Medsave will validate your claim documents submitted by you
Orginal Bill are verified with standard tariff
Bill checking by software whether it is applicable or not. 
Policy condition checking ie policy period, hospitalization date, sum insured and past claim history.
File audit by special audit team.
If claim has query or rejected; the letter will be sent to insured.
If you want to reopen the claim [query, approved or rejected] please send the supported documents. We will process the 
   same after confirmation from the concerned insurance company.

 
 

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