Get Kotak Health Care - Claim Form Part B.cdr - Kotak General Insurance

Filling out the Kotak Health Care - Claim Form Part B is an essential step in the claims process for health insurance. This guide will provide you with clear, step-by-step instructions to help you complete the form accurately and efficiently online.

Follow the steps to complete the online claim form.

1. Click ‘Get Form’ button to obtain the claim form and open it in your preferred document editor.
2. Begin by entering the hospital details in the specified fields. This includes the name of the hospital, hospital ID, and type of hospital, ensuring accuracy in block letters.
3. Next, provide the details of the patient admitted, including their name, gender, date of birth, and age. Make sure to match the provided data with hospital records.
4. Specify the admission and discharge details, including the type of admission (emergency, maternity, planned, etc.), date of admission, date of discharge, and any necessary timelines.
5. List the details of the ailment diagnosed using ICD 10 codes. Provide descriptions for the primary diagnosis, additional diagnoses, and any co-morbidities present.
6. Indicate whether pre-authorization was obtained and provide the relevant authorization number. If it was not obtained, state the reason clearly.
7. Fill out the claim documents submitted checklist, making sure to include all necessary supporting documentation required for a smooth claims process.
8. If applicable, provide additional details in the case of a non-network hospital, including the hospital address, registration number, and available facilities.
9. Finally, read the declaration carefully, input the date and place, then save your changes. You can now download, print, or share the completed form as needed.

Complete your claims process efficiently by filling out the Kotak Health Care - Claim Form Part B online today.