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Individual Health Insurance Plans
ManipalCigna Health Insurance Claim
Have you recently subscribed to ManipalCigna Health Insurance and are looking to find out ways to claim it? Hold tight, the process is not going to be lengthy? ManipalCigna has gained a reputation for offering an easy, fast, reliable, and hassle-free claim process, with a record of settling 96% of its cashless claims within 2 hours.
The insurance provider has a large network of hospitals and has so far settled INR 1295+ crore worth of claims, carrying an incurred claim ratio of 61.13%. For cashless treatment, they offer support for both emergency and planned visits, while in reimbursement claims, the patient or policyholder is reimbursed for hospitalization charges initially, but can get their expenses reimbursed through an online claim.
How To Make a Health Insurance Claim With ManipalCigna?
Follow the steps below for both cashless claim treatment and reimbursement claim treatment.
For Cashless Claim
- Call on the toll-free number of ManipalCigna
You need to contact the insurance company three days ahead of time so that the officials of the insurance company can assist you with the process. In the event of an emergency, call the insurer within 24 hours of being admitted to the hospital.
- Verify your identity at the network hospital
You must visit the network hospital with the health insurance card given by ManipalCigna. Once you provide the card, the hospital will contact the insurer using the information offered like policy number, name, age, etc.
- Request for a Cashless Hospitalization Claim Form
Now ask for the cashless hospitalization claim form and complete all the required details including the patient’s medical history, treatment plan, and expected costs.
- The Insurer Contacts the Hospital in the Network
Once the insurer receives the information, they would verify it and then issue the
permission letter for the claim. In case of receiving insufficient documents, the insurer requests them from the hospital to satisfy the demands and issue the authorization letter.
- Claim Service Representatives
The insurer can give you a claim service associate to assist you while you go through the paperwork and other documentation if you request it.
- Authorization Request Final
The hospital sends a final request for authorization together with the final hospital bill and discharges summary once the treatment is over. A patient would only be granted discharge after the insurer provides the final approval.
- The Network Hospital is paid
The network hospital must give original documentation to the insurer. This is because the original documents would be used to analyze the claim and make payment.
- Payouts Prior to and After Hospitalization
In case you have selected comprehensive health insurance coverage, then make sure to submit pre and post-hospitalization expenses as well as medical bills to claim the money that you spent during the treatment.
For Reimbursement Claim
- Call on the toll-free number of ManipalCigna
Just like the cashless claim, you need to contact the insurance provider three days prior to the hospitalization so that they can help you. But in case of emergency, try to contact the insurance company within 24 hours of being admitted to the hospital.
Now you need to take advantage of all the network hospital services and pay all the expenses. ManipalCigna offers claims on costs incurred during the admission period as well as pre-and post-hospitalization. Make sure to gather all the necessary documents like hospital bills, pharmacy bills, discharge papers, etc.
- Make the Claim
In this step, take the claim form and submit all the documents demanded. This claim form can easily be downloaded from the official website of ManipalCigna.
- Send the claim
Once the form has been filled, send it to the insurance provider at the nearest office. Make sure to keep in mind that this process needs to be completed within 15 days of discharge.
- Claim Evaluation
After the claim form is received, you can expect the insurer to approve the request and process the claim. In case of more information is required, the insurer would ask for it to further proceed.
- Claim Service Representative
You also get a claim service associate to help you go through the paperwork and other documentation when requested.
- Claim Resolution
Once the insurer approves the claim, you would receive the amount to the bank account via NEFT or DD/Cheque.
Documents Required To File Reimbursement Health Claim
The key documents required to make a reimbursement health claim with ManipalCigna are listed below.
- Completely filled out and signed claim form
- Copy of patient’s photo ID and, if appropriate, KYC papers
- If the amount claimed exceeds 1 lakh, a PAN card is required.
- Original Hospital Discharge Summary Notes
- Operating room notes in the event of surgery
- Main original bill of the hospital
- Original split-up bill collected from the hospital
- Original investigation reports like X-rays, MRIs, CT films, HPEs, and ECGs, as well as doctor’s consultation letters and reference slips.
- Original Pharmacy Statements
- Implant invoices, lens stickers, and stents (if applicable) are all included in the MLC/FIR report.
- Original canceled cheque with the proposer’s name pre-printed on it.
How To Check ManipalCigna Health Insurance Claim Status?
ManipalCigna offers you a hassle-free way to check the insurance claim status. Therefore, this can be done by visiting the official website of ManipalCigna and clicking on ‘Claims’ in the top menu. A new page will open where you’ll have to enter your policy/certificate number of DOB and click on ‘Submit’. Once that’s done, the status will be on your screen.