How to fill Claim Form: Part A and Part B?
Claim form is a pre-requisite set of document that is mandatory to be filled while raising a reimbursement claim. Part A of the claim form is to be filled by the employee themselves and Part B of the claim form is to be filled from the hospital's end in case of a hospitalisation. While raising a claim for pre and post hospitalisation expenses, Part B of the claim form isn't required to be filled.
However, keeping these in mind, if the employee doesn't fill the claim form correctly then, it might result in delay in the claim initiation process. There exists some ambiguous components in the claim form which varies from insurer-to-insurer. However, understanding the basics of the claim form will be more than enough to fill it correctly each time, irrespective of the insurer.
If your TPA is MediAssist (or any other insurer or TPA such as Care, Niva Bupa etc.) then please, keep the following things in mind:
- First of all, claim form can be filled either digitally or manually, depends upon your own preference. However, please keep in mind that the details filled should be easily understandable.
- Now, under the details of primary insured, the first component is Policy No. An employee's policy number could be found on the "E-Card Details" under the Health Insurance Tab.
- Now, for SI No./Certificate No., you can leave this field since it is not mandatory to be filled.
- To understand what to fill under Company/TPA ID (MA ID) No., you can read this article to garner a better understanding on this.
- Then, for other fields, you can fill them as per the instructions mentioned on the claim form itself.
Some FAQ related to claim form and it's ambigious fields are as follows:
What is PPN Declaration Form?
In certain cases, some employees have to fill the Preferred Provider Network (PPN) Declaration Form which is known for providing cashless services in hospitals that accept their policies and prices and join the PPN. It requires hospitals to accept GIPSA rules and work on standardized rates. Those who accept this fall under the GIPSA umbrella and can be called PPN.
What information should I fill in Employee ID proof?
The employee should fill their Aadhar Card or PAN Card details here.
What if I don't have a cancelled cheque under my name?
In this case, you can use the details mentioned on your Bank Passbook such as Account No., IFSC Code etc. as long as it's clear and visible.
What if there's a delay from my end in intimating the claim?
Generally, in case of a reimbursement claim, we prefer that the employee intimates us about the claim within a week from their discharge date. However, if there's a delay of more than 7 days from the insured's end to intimate us about the claim then the insurer requests for a handwritten delay letter explaining the reason for the same from the insured's end.
If you require any help or further assistance, kindly reach out to us at care@nova-benefits.com or 04049174207.
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