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  • Medicash Claim Form

Get Medicash Claim Form

Once complete, please return this form to: Medicash, One Derby Square, Liverpool L2 1AB. Please include your Medicash Policy Number Mark your choices in the boxes with a cross (X) Please do not use.

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How to fill out the Medicash Claim Form online

Filling out the Medicash Claim Form online can seem daunting, but with clear guidance, you can complete it effectively and accurately. This guide provides step-by-step instructions to help you navigate each section of the form easily.

Follow the steps to complete your Medicash Claim Form online.

  1. Click 'Get Form' button to obtain the Medicash Claim Form and open it in your preferred online editor.
  2. Begin by filling out Part 1 - Policyholder Details. Enter your Medicash Policy Number, address, title (use 'person' for inclusivity), surname, postcode, forename(s), daytime telephone number, date of birth, and email address. Ensure all information is correct to avoid delays.
  3. Proceed to Part 2 - Your Claims. You will need to place a cross (X) in the appropriate boxes to indicate the claimant and the benefits you are claiming. Fill out each line for up to four receipts, including details like the benefit claimed, amount of each receipt, date, and claimant status (policyholder, partner, or child).
  4. If you are claiming for Private Medical Insurance (PMI) Excess Fees, complete Part 3. Confirm if payment has been made to the practitioner and provide their details if the claim needs to be settled directly with them. Attach a copy of your PMI statement as supporting documentation.
  5. For hospital inpatient and daycase claims, ensure that Part 4 is completed by the ward clerk. This includes details of your stay, treatment dates, and confirmation from the hospital with a stamp and signature.
  6. Review all sections for accuracy, then sign the declaration at the bottom of the form. Make sure to write clearly using block capitals in black ink without staples.
  7. Once you have completed all parts of the form, save your changes. You can choose to download, print, or share the form as needed before submitting it to Medicash at the provided address.

Complete your Medicash Claim Form online today to ensure your claims are processed efficiently.

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