https://wp-api.bajajfinservhealth.in/wp-content/uploads/2022/03/MicrosoftTeams-image-6-1903x687.jpg

AAROGYA CARE

How to Fill Up Cashless Claim Form: Remember These 7 Easy Steps!

Getting claim benefits is the main advantage of a policy

There are two modes: cashless and reimbursement claim

Follow this guide to fill the cashless claim form properly

B
Bajaj Finserv Health
March 4th, 2022
9 mins read

Health Insurance is a safety net packed with a set of features and benefits. One of the most important aspects of health insurance is to claim the benefits. According to your insurance policy and financial budget, you can either make a reimbursement claim or a cashless claim. Cashless claim facility will be available against listed conditions when you are treated at an empaneled hospital. The health insurance policy has to be in your name so that you can avail claim benefits [1]. 

The process for cashless claim differs for planned and emergency treatment. In case of pre-determined treatment, you have to inform your insurer at least 4 days in advance before hospitalization. In case of emergency, contact your insurance provider to know about the nearest network hospital. Once you and the hospital fill respective parts of the claim request form, the hospital authority sends it to the insurance provider via mail or post. 

To get cashless claim benefits, you have to follow a specific procedure which involves [2]:

  • Filling up the claim form
  • Submitting the claim form along with relevant documents

After proper verification of the form and documents, the health insurance provider will approve your claim request and you will receive the claim amount with additional benefits as specified in your policy. But, if you miss to fill any important section of the form, it may lead to a claim rejection. Read on to get a better insight to the cashless claim process and a detailed guide to fill up the claim form.

Additional Read: Cashless Claim: Its Process, Documents Needed, and The Top 4 Benefits

How do you get a cashless claim form?

Your claim form is usually available at the hospital desk where you are undergoing your treatment. You can also find it online on your health insurance provider’s website.

What are the basic details you should know before filling the cashless claim form?

  • Reason for visiting the hospital (accident, injury, illness etc.)
  • Name of the insured and name of the person who will receive the services of the health insurance plan
  • Policy number

How to fill a cashless claim form? 

Your cashless claim form contains 7 sections. Each section has different details. Read on to understand what details are required in each section and how to fill them:

Details of the provider

Under this section, you have to fill in the following details:

  • Hospital/ Nursing home name
  • City, state name and landmark
  • Contact no/ Fax no/ Email ID of the hospital
  • Hospital ID (unique number of the hospital by which it is identified globally)
  • Rohini ID (this is the identification number of the hospital that is a part of the network Rohini (Registry of Hospitals in Network of Insurance)
  • TPA desk number (number of the third-party administrator that acts as an intermediary between you, the hospital and your insurance company)

Details to be filled by the insured/patient

This section covers the patient details such as:

  • Name, gender and date of birth
  • Current address and contact number of the insured patient
  • Insured card ID number
  • Occupation of insured patient
  • Policy number 
  • Employee ID and details (name of the company)
  • Name and contact details of family physician

benefits of Cashless Claim

Details about the patient’s conditions and treatment procedure – to be filled by the treating doctor/hospital

A few particulars from this section are:

  • Name and contact number of the treating doctor
  • Nature of illness/disease with presenting complains (the problem that the insured is facing)
  • Relevant clinical findings (the reported or suspected diagnosis and clinical findings)
  • Duration of the past or present ailment
  • Date of the first consultation (date on which the insured patient went to the doctor for the first time to seek diagnosis)
  • ICD 10 Code (the code applicable to the insured patient according to ICD 10 codes for diseases, signs and symptoms, abnormal findings, circumstances and external causes of diseases or injury)
  • Proposed line of treatment (indicates what kind of medical treatment the insured patient will be receiving)
  • If surgical, the name of the surgery
  • ICD PSC code (the code of medical classification used for procedural coding)
  • Details of any other treatments provided
  • Details of how the injury occurred (whether it was an accident or would you want to report to the police or not)

Details of the patient admitted – to be filled up by hospital authority

In this section, the following details of the insured patient have to be filled.

  • Date and time of admission of the patient in the hospital
  • Whether it was an emergency or planned hospitalization
  • Expected number of days required for stay in the hospital (ICU or Room type)
  • All expenses during hospitalization bifurcated into room charges, operation, treatment and medicine charges

Details of past medical history – to be filled by hospital

Under this section, the hospital authority lists the following.

  • Whether the patient has previously suffered from any chronic illness
  • The exact time when the illness was diagnosed

If the insured patient is not suffering from any chronic illness, this section can be left blank.

Details to be filled in declaration

Under this section, both the insured patient and the hospital file a declaration. First, read the declaration at page 3 of the claim form carefully and sign it. Then you can sign the declaration statement in page 2. By doing so, you can be well aware about the terms and conditions, and avoid unnecessary hazards related to your claim.

Documents to be attached with the form

When you submit the form, make sure to attach the following documents:

  • Detailed discharge summary and all the bills from the hospital
  • Cash memos from the hospitals/chemists supported by proper prescriptions
  • Receipts and lab reports, supported with notes from attending medical practitioner
  • Surgeon’s certificate if an operation was performed, including both the bill and receipt
  • Certificates from attending medical practitioner /surgeon stating the patient is fully cured

Additional Read: Top 6 Medical Services Covered in a Health Insurance Plan

Always fill your claim form carefully and be aware of the terms and conditions of your health insurance plan. Make sure that the details in your form are not invalid. Else, you will have to go through more hassles to get it corrected. After filling the form, always submit your original documents like bills and medical papers. Make sure you have photocopies of all the documents submitted for record.

For affordable health insurance plans, you can browse through Aarogya Care range of policies on Bajaj Finserv Health. With comprehensive medical coverage covering both illness and wellness needs, these plans can cater to your emergency medical requirements. With the features of these plans like huge network discounts, doctor consultation reimbursements and competitive cashless claim, prioritizing your health becomes super easy and affordable too!

How to Fill Up Cashless Claim Form: Remember These 7 Easy Steps!-banner

Related Articles

View All

18 Aarogya Care Benefits that Enhance Your Health Insurance

Aarogya Care

18 Aarogya Care Benefits that Enhance Your Health Insurance

9 mins

Prepaid Health Care: 7 Benefits of Aarogya Care Health Plans

Aarogya Care

Prepaid Health Care: 7 Benefits of Aarogya Care Health Plans

7 mins

6 Reasons to Choose an Aarogya Care Personalized Health Plan

Aarogya Care

6 Reasons to Choose an Aarogya Care Personalized Health Plan

10 mins

Aarogyam A Health Test: 5 Important Things for You to Know

Aarogya Care

Aarogyam A Health Test: 5 Important Things for You to Know

14 mins

9 Major Preventive Health Check up Benefits You Should Know

Aarogya Care

9 Major Preventive Health Check up Benefits You Should Know

7 mins

Trending Articles

View All

6 Watermelon Seeds Benefits That You Should Keep In Mind

Immunity

6 Watermelon Seeds Benefits That You Should Keep In Mind

6 mins

Wolfram Syndrome: 3 Things to Learn About This Rare Disease

Diabetes

Wolfram Syndrome: 3 Things to Learn About This Rare Disease

8 mins

Prostate-specific Antigen Test: 3 Things You Should Know

Health Tests

Prostate-specific Antigen Test: 3 Things You Should Know

8 mins

18 Aarogya Care Benefits that Enhance Your Health Insurance

Aarogya Care

18 Aarogya Care Benefits that Enhance Your Health Insurance

9 mins

Isolated Systolic Hypertension: 4 Things for You to Know!

Hypertension

Isolated Systolic Hypertension: 4 Things for You to Know!

10 mins

background-banner
Mobile Frame
Download our app

Download the Bajaj Health App

Stay Up-to-date with Health Trends. Read latest blogs on health and wellness. Know More!

Get the link to download the app

+91
Google PlayApp store

CIN

U85320PN2019PLC185286

Registered Office

Bajaj Auto Limited Complex, Mumbai – Pune Road, Akurdi, Pune – 411 035

Corporate Address

Phoenix Fountainhead, 4th floor, Nagar Road, Clover Park, Viman Nagar, Pune, Maharashtra - 411014

© 2021, Bajaj Finserv Health Limited.
All rights reserved.