Get India Form Mrc (s)

Filling out the India Form MRC (S) online is an essential process for individuals seeking medical reimbursement under the Central Government Health Scheme. This guide provides a user-friendly and step-by-step approach to ensure that you successfully complete the form without any confusion.

Follow the steps to accurately fill out the India Form MRC (S) online.

1. Click ‘Get Form’ button to access the form and open it in the editor.
2. Enter the name and designation of the Principal CGHS card holder along with their CGHS Ben ID number and employee code number. Provide the ward entitlement, full address, and mobile telephone number with email address if available.
3. Fill in the patient's name and their CGHS Ben ID number. Specify the relationship of the patient to the Principal CGHS card holder.
4. Provide the name and address of the hospital, diagnostic centre, or imaging centre where the treatment was received.
5. Indicate whether the hospital or diagnostic imaging centre is empanelled under CGHS.
6. Select the treatment type for which reimbursement is being claimed, such as outpatient treatment or indoor treatment.
7. State whether the treatment was taken in an emergency.
8. Confirm if prior permission was obtained for the treatment.
9. Indicate if subscribed to any health/medical insurance scheme and provide the amount claimed or received.
10. Detail any medical advance taken and specify the total amount being claimed for outpatient treatment, indoor treatment, and tests/investigations.
11. Record the name of the bank, branch MICR code, SB account number, and IFSC code relevant to the reimbursement.
12. Submit the declaration confirming the truthfulness of the statements made and the dependency of the person for whom the expenses were incurred.
13. Finally, ensure to attach all required documents, such as photocopies of the necessary cards, discharge summaries, and original bills for the reimbursement amount claimed. Once everything is complete, save your changes, and download or print the form as needed.

Complete your India Form MRC (S) online today for a seamless reimbursement process.