Get Reimbursement Claim Form - Ses-zambia

This guide provides a clear and supportive approach to filling out the Reimbursement Claim Form - SES-Zambia online. Users can follow these detailed instructions to ensure that their claims are submitted accurately and efficiently.

Follow the steps to successfully complete your reimbursement claim form.

1. Press the ‘Get Form’ button to access the Reimbursement Claim Form - SES-Zambia and open it in an online editor.
2. Begin by entering your member information in the first section. This includes your group name (if applicable), membership number, and personal details such as surname, first name, date of birth, mobile number, gender, age, telephone, and email.
3. In the medical details section, select the type of treatment you received: elective, wellness, emergency, follow-up, or dental. Provide a detailed description of the symptoms or medical condition that required treatment.
4. Record the date of treatment and the country where the treatment occurred. Include all details of the treatment and medication received.
5. Choose the procedures performed by the doctor or specialist from the options provided: consultation, laboratory, radiology, or pharmacy.
6. Move to the claim details section. Complete the table with the details of each invoice and receipt, including a description of the expense or treatment, provider's name, amount charged, and invoice currency.
7. In the payment details section, select your preferred payment method, and provide the necessary banking information such as bank name, account name or payee, account number, swift/bic code, IBAN, and bank address.
8. Carefully read the declaration section. Confirm that the information provided is accurate and provide your consent by signing the declaration with your name and the date.

Submit your completed form online to ensure your reimbursement claim is processed swiftly.