Get Check List For Submission Of Claim - Raksha Tpa

Filling out the CHECK LIST FOR SUBMISSION OF CLAIM - Raksha TPA is an important step in ensuring that your claim is processed smoothly. This guide provides a clear and structured approach to help you complete the checklist accurately and efficiently.

Follow the steps to fill out the checklist for your claim submission.

1. Click ‘Get Form’ button to obtain the checklist and open it in your editor.
2. Fill in the employee name, patient name, employee number, member ID number, company name, contact number, mobile number, and email ID in the respective fields.
3. Ensure to attach the checklist with your claim file as indicated in the instructions.
4. Arrange all required documents in the order specified in the checklist. This helps confirm that no documents are missing.
5. Gather and prepare your photo identity proof of the patient, ensuring it is attested by the treating doctor and the HR from the company.
6. Complete the claim form by signing it and filling in the appropriate claim amount.
7. Collect the original hospital bill along with a detailed breakdown of charges, including room rent, OT charges, and nursing costs.
8. Obtain and attach the original discharge summary, which summarizes the diagnosis and treatment received during hospitalization.
9. If applicable, include the original death summary for claims related to a patient’s demise during hospital stay.
10. Provide the original hospital payment receipt, ensuring it has a receipt number and is stamped by the hospital staff.
11. Include original payment receipts for any consultation or surgeon charges if separated from the main hospital bill.
12. For non-network hospitalization cases, provide the hospital registration number along with details on the number of beds, all on the hospital letterhead with the required authority stamp.
13. Attach the doctor's registration number on their letterhead with the necessary signature and stamp.
14. Gather original pharmacy and investigation bills, accompanied by doctor’s prescriptions and lab reports.
15. Include original prescriptions on the doctor’s letterhead, specifying dosage and duration for medications and tests.
16. Attach all original investigation reports, including images from tests conducted.
17. If applicable, submit a police FIR or Medico Legal Certificate for all road traffic accident claims, duly attested.
18. For maternity claims, include relevant gravida para living abortion or obstetric history documentation.
19. Retain copies of all submitted documents for personal records.
20. Upon completion and thorough review, save changes to the form, download a copy for your records, and proceed to print or share as needed.

Start completing your CHECK LIST FOR SUBMISSION OF CLAIM online today to ensure a seamless claims process.