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How to complete any Form CMS 1500 Claim online:
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Video instructions and help with filling out and completing health insurance claim form nucc
Hello friends we at policy XCOM know that many of you have queries regarding health insurance claim and it's procedure no need to worry as here we tell you about the complete procedure of health insurance claim that will answer all your queries health insurance claim procedure is very simple and easy basically its of two type one is your cashless treatment where a facility that is provided by the insurance company in which policyholder get admitted and undergo the required treatment without paying directly for the medical expenses whereas in reimbursement treatment the policyholder get admitted undergo the treatment phase to the hospital and then insurance company pays back to the customer after verification has been done for both the procedures they are basically three steps one you need to intimate the TPA that is third-party administration or the insurance company then you need to get an approval for the treatment and the last claim and payment process when I am talking about claim intimation when you get hospitalized you need to communicate to the third party administration or the insurance company in case of your planned treatment unique customer need to inform the TPA and the information has to be given in two to four days in advance whereas in case of emergency the policyholder get admitted to the hospital and the policyholder family member inform the hospital about the health insurance then hospital personnel communicate to the TPA and hear the intimation has to be done within 24 hours of hospitalization to the TPA when I am talking about the approval and treatment here the TPA or the insurance me send the approval letter within 24 hours to 48 us in case of plan hospitalization to the customer or in case of emergency hospitalization approval letter is sent to the hospital life hospital in six to seven hours the documents that are required during the complete procedure either the cashless or the reimbursement customer need to have the medical test report Bills dot doctor prescriptions your health ID card your claim form or the pre-authorized form in your personal document the customer need to have the photo ID need to carry a canceled check or need to prthe NEFT or the RTGS account and the third that is your claim and the payment process here the TPA in case of your cashless hospitalization the payment is directly made to the hospital and in case of reimbursement the payment is made to the customer that is in your cash flows treatment hospital submit all the documents to the TPA and after verification tipi releases the payment and deposit the amount directly to the hospital whereas in case of reimbursement treatment the customer pays all the amount to the hospital collect all the bills and documents submit all the documents to the TPA along with the claim form and the canceled check and after verification TPA releases the payment to the customer either via check or neft