Get Form - Mrc (p)

This guide provides a detailed overview of how to complete the FORM - MRC (P) online for pensioner beneficiaries seeking reimbursement under the Central Government Health Medical Reimbursement Claim Scheme. Follow the instructions carefully to ensure accurate submission.

Follow the steps to fill out the FORM - MRC (P) online.

1. Click the ‘Get Form’ button to access the online form and load it in your editor.
2. Fill in the fields for the principal card holder's name, CGHS bank ID number, and the attached wellness center.
3. Specify the validity of the CGHS card, ward entitlement type (private, semi-private, or general), and the full address of the principal card holder.
4. Provide the mobile telephone number and email address, if available.
5. Enter the patient's name and CGHS beneficiary number, as well as the relationship to the principal card holder.
6. Indicate the category of pensioner beneficiary by selecting one option from the provided choices.
7. Enter the name and address of the hospital or diagnostic center where treatment was received.
8. Specify whether the hospital or diagnostic center is empaneled under CGHS.
9. Detail the type of treatment for which reimbursement is claimed, either OPD treatment, indoor treatment, or tests/investigations.
10. Indicate if a credit facility was availed and, if not, provide reasons.
11. State whether treatment was taken in an emergency and if prior permission was secured.
12. Disclose any health or medical insurance subscribed to and the amounts claimed or received.
13. Complete the bank details, including the name of the bank, branch MICR code, account number, and IFSC code.
14. Review the declaration statement confirming the accuracy of the information provided.
15. Gather and attach all necessary supporting documents, including a copy of the CGHS card, discharge summary, and original bills.
16. Once all fields are completed and documents attached, save changes, and download the form for submission.

Start filling out the FORM - MRC (P) online today to ensure you receive your reimbursement!