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 signature.
• ·      All official itemized invoices with the service details.
• ·      Payment proof 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 the operative notes (for surgical treatment) for all the in-patient, day  care, and emergency admissions.
• ·   Medical Report with injury details (when, where, and how) for claims related to any kind of injuries.
• ·     Medical Insurance card copy
• ·     Bank Details (if applicable)
• ·     Copy of passport showing exit and entry stamp for the treatments done outside UAE.
• ·      A police report in case of an accident (if covered under medical policy).

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 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 # 21
• ·     Claim documents must be in English or Arabic language only
• ·  All the documents must be submitted within the cut-off period per policy terms and     conditions.