Get Please Use The Attached Claim Form To File Your Hearing ... - Medico

Filing a claim for hearing aid coverage can seem daunting, but by following the steps outlined in this guide, you can ensure a smooth submission process. This guide will walk you through each section of the Medico claim form, providing useful tips to complete your application accurately.

Follow the steps to successfully complete your claim form.

1. Click the ‘Get Form’ button to access the claim form. It will open in your browser, allowing you to review and fill it out online.
2. Begin with the claimant’s proof of loss section. Fill in the insured’s name, date of birth, policy number, address, social security number, and telephone number. Ensure that all information is accurate to avoid processing delays.
3. Next, the audiologist or ortologist must complete their section. This includes their name, license number, and the dates of the most recent hearing aid test and prescription. Additionally, indicate whether a hearing aid is required and the percentage of hearing loss for each ear.
4. In the section designated for the hearing aid dealer, provide the name of the hearing aid center and the type or model of the hearing aid purchased. Make sure to include the total cost for the hearing aid appliance.
5. Fill out the dates of service and other relevant details for the claim, including the type of service and diagnosis codes. Remember to include physician or supplier signatures where necessary, as this validates your submission.
6. Review the authorization section carefully. It requires signing and dating, authorizing Medico Insurance Company to access relevant information. Ensure you and any relevant representatives sign where indicated.
7. Finally, check that all fields are complete and accurate. You can then save your changes, download the completed form for your records, print the document, or share it as required.

Ensure your claims are filed correctly by completing the online form today!