Discharge Summary, (detailed OT notes are required in case of uncoded procedures/ complicated procedure /if two or more procedures are performed)
Summary of all bills being claimed
Detailed bills including all break up details
All bills to be arranged chronologically and numbered
If outpatient emergency treatment was obtained prior to being admitted, kindly enclose such bills before indoor bill. Make sure that this amount is included in the summary of bills
Please ensure that total of all bills enclosed matches with the amount being claimed.
Original Invoice (collected from hospital) towards implants/stents/valves/ costly medications etc. In case of bulk purchase, photocopy of the invoice highlighting the item used and the rate, certified by the treating doctor that the same was implanted during the procedure and is functioning well.
Original Payment receipts matching with amount claimed.
If original documents/bills are lost, then affidavit in prescribed format to be enclosed.
In cases of claim from CGHS after claiming from any health insurance, following documents collected from the insurance company (not from hospital) are to be enclosed.
Certificate from insurance company addressed to CGHS indicating the amount claimed (as per the bills submitted to insurance company) and the total amount finally settled. Kindly do not enclose preauthorization letters or mails.
Photocopies of all documents including vouchers/ bills duly certified in ink along with stamp of the insurance company.
Enclose the Bank NEFT details (bank mandate form / cancelled cheque) of the claimant. Do not enclose NEFT details of any other person as the ECS PAYMENT fails due to name mismatch.
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