Get Kvs Medical Reimbursement Form

Filling out the Kvs Medical Reimbursement Form online can streamline the process of claiming medical expenses for eligible employees. This guide provides a clear, step-by-step approach to accurately completing the form, ensuring that you meet all necessary requirements.

Follow the steps to successfully complete the Kvs Medical Reimbursement Form.

1. Click ‘Get Form’ button to obtain the Kvs Medical Reimbursement Form and open it in your preferred editor.
2. Begin by filling in your name and designation in the designated fields. Ensure that the information is accurate and reflects your current role.
3. Enter the name of the Vidyalaya. This is essential to identify the institution associated with your claim.
4. Provide the date of receipt of your claim in the Vidyalaya and in the Regional Office (R.O.). Accurate dates help in tracking the claim process.
5. If applicable, indicate the name and address of your spouse's office. This information is essential if your spouse is employed.
6. Specify whether your spouse is receiving any medical allowance or reimbursement from their department.
7. Indicate if you have received any reimbursement from other sources for this treatment.
8. Clarify whether the patient is wholly dependent on you and confirm that the declaration is available on the records.
9. Include a written representation describing the circumstances under which you sought treatment in a private hospital. This should be attached as a separate sheet.
10. Check if the CS 32 form (Form for claiming refund of medical expenses) is attached with the submission.
11. Attach the emergency certificate issued by the hospital and the discharge certificate as required.
12. List the names of the diseases treated along with the duration of the treatment provided.
13. Document the distance from the location of illness to the nearest government hospital and to the private hospital where treatment was administered.
14. Specify the total amount of the claim being submitted.
15. Include the amount that has been admitted for payment after the pre-audit process conducted by the Financial Officer or Deputy Commissioner.
16. Indicate whether the hospital providing treatment is recognized by the Central Government Health Scheme (CGHS) and note the relevant order or letter number and date.
17. Provide any recommendations from the Principal regarding the genuineness or admissibility of your case as per the established rules.
18. Review all entries for accuracy before finalizing.
19. Once everything is complete, save your changes, download the form, print it out, or share it as needed.

Complete your Kvs Medical Reimbursement Form online today to ensure a smooth claims process.