Dear All,
We have highlighted some of the reasons due to which the deficiencies are raised and processing is delayed.
The below mentioned are some of the deficiencies which are commonly raised in the claims:
|
SR.NO
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DESCRIPTTON
|
|
1
|
MEDICINE PRESCRIPTION
|
|
2
|
DELAY LETTER FOR SUBMISSION OR INTIMATION
|
|
3
|
INVESTIGATION REPORTS
|
|
4
|
MEDICINE BILLS
|
|
5
|
DETAILS FROM ATTENDING DOCTOR
|
|
6
|
NEFT DETAILS/NAME NOT PRINTED
|
|
7
|
IRDA CLAIM FORM OR DOMICALLERY CLAIM FORM
|
|
8
|
INDOOR CASE PAPERS
|
|
9
|
PRESCRIPTION/VALID PRESCRIPTION
|
|
10
|
MAIN HOSPITAL PAYMENT RECEIPT WITH RECEIPT NO
|
|
11
|
DISCHARGE SUMMARY
|
|
12
|
CONSULTATION NOTE
|
|
13
|
MAIN HOSPITAL BILL (Item wise & Cost wise Breakup)
|
|
14
|
ACCIDENT / BURNS / POISIONING /FALL / RTA (FIR/MLC)
|
|
15
|
PSU PPN Declaration Form
|
|
16
|
HOSPITAL REGISTRATION NUMBER (FORM -C)
|
|
17
|
KYC/AADHAR/PAN CARD
|
|
18
|
DEMOGRAPHIC DETAILS (DESCREPANCY IN NAME/GENDER/DOB
|
|
19
|
MAIN HOSPITAL BILL
|
|
20
|
IMPLANT STICKERS
|
We request all the claimants to kindly inform the hospital before discharge that you are going to claim a Reimbursement claim and request them to give you all the relevant documents related to the hospitalization/admission. This process will help you to bring down the deficiency in your claim. Check List is already attached on the Portal for your ready reference. Also if the hospital is on the panel/network of National Insurance Co and Paramount kindly avail the Cashless facility instead of going for a Reimbursement.
Timely Intimation and Submission will also help to get your claim processed on time.
Also request all the claimant to kindly check your details on the Union Parivar and if any Discrepancy related to Name/DOB/Gender kindly get it rectified on the Portal itself immediately after the E-Card are received or check on the Portal regarding the same (YOUR DETAIL SHOULD BE THE REPLICA OF YOUR AAHDAR CARD) so in short your data should be same at Union Bank of India, National Insurance Co and Paramount TPA. If there is a discrepancy in the Data during the Cashless, the Cashless will not be honored so in this case claimant will have to come for Reimbursement.
Hope this brief communication helps you to get your claim processed on time.
Paramount Health Services & Insurance TPA Pvt. Ltd