Get Bill Cum Receipt

Filling out the Bill Cum Receipt online is a straightforward process that allows users to efficiently document hospitalization expenses. This guide provides step-by-step instructions to assist you in completing the form accurately and enhancing your experience.

Follow the steps to complete the Bill Cum Receipt online.

1. Click ‘Get Form’ button to obtain the form and open it in the document editor.
2. In the first section, enter the hospital name and address where treatment was received.
3. Provide the bill number for reference, and include the PAN number, if applicable.
4. Record the admission IP Number along with the date and time of admission.
5. Enter the patient's details, including their name and address.
6. Specify the cashless issued amount for the hospitalization.
7. In the hospitalization details section, fill out the NSP code and the hospital PIN code.
8. Document the bill date and time, service tax number, and bed number.
9. Record the discharge date and time, along with the member ID or card number for insurance.
10. Provide the patient's contact number for any follow-up.
11. Indicate the name of the insurance company covering the expenses.
12. In the bill summary section, list the particulars and specify amounts for each category like room rent, nursing services, medicine, and others as applicable.
13. Calculate the net bill amount after discounts, cashless authorized amount, and service tax.
14. Detail the payment receipt section, including the amount received, mode of payment, and the date of payment.
15. Finally, ensure the patient signs and the hospital's authorized signatory includes their seal for verification.

Complete your documents online today for an efficient experience.