Medical Claim Reimbursement Checklist:

Some of the documents which you will need to submit when filing for your medical claim reimbursement include:

• Duly filled out claim form of the concerned insurance company / TPA, signed and stamped by the treating doctor with beneficiary's signature.
• All official itemized invoices with the detailed service descriptions.
• Proof of payments such as official receipts, paid stamps, card payment slips, etc.
• Prescription from the treating doctor for all the medications availed and for optical items.
• All the diagnostic reports, including but not limited to Laboratory and Radiology reports.
• Referral letter from specialist consultant and progress reports (after every 5 sessions) for claims related to physiotherapy treatment/ chiropractic treatment.
• Discharge summary with operative notes for surgical procedures and all  in-patient, daycare, and emergency admissions.
• Medical Report including injury details (when, where, and how) for claims related to any kind of injuries.
• Copy of the Medical Insurance card.
• Bank Details (Mandatory)
• Copy of passport showing exit and entry stamp for the treatments done outside UAE.
• Police report (if the claim is accident-related and covered under medical policy).

Note:

For direct billing, you don’t have to submit any documents except. Present your Emirates ID/ Health insurance card to the hospital and avail coverage for their healthcare services. 

Important Notes:

• The insurance company has the right to request further documents not mentioned above  such  as detailed medical report, etiology, medical justification, etc. if required to further process the claim
• Pre-approval / intimation is required for In-Patient and Daycare treatments outside the network and outside UAE including high cost (invasive) Out-patient procedures
• All Emergency cases must be notified within 24 hours from the admission date per DHA exclusion (DHA Compliant plans).
• Claim documents must be in English or Arabic language only
• All the claim documents must be submitted within the cut-off period, as specified in the policy terms and conditions.