NEW MEDICAL INSURANCE SCHEME – DOMICILIARY TREATMENT CLAIM SUBMISSION

Dear Comrades,

 

Please find attached Bank circular giving guidelines for submission of domiciliary treatment claim forms for the use of those who opted with domiciliary treatment during renewal of our health insurance policy.
The list of 59 diseases covered under Domiciliary treatment is also annexed to the Bank circular.
Brief procedure is as follows:
1. Member has to obtain a certificate from a regd medical practioner, mentioning about his domiciliary disease and the period for which the medicines are required for the insured patient.  If the certificate is silent about the period, the same will be valid upto 90 days from the date of the certificate. For the 4th month a fresh certificate has to be produced.
If the treatment is for lifetime, then the said certificate is valid for only 12 months, then a fresh certificate has to be obtained for the 13th month.
2. Prescription for medicines.  If the prescription contains the period for which the domiciliary treatment is required, then the separate certificate is not necessary.
3. Medicines Bill from pharmacy (this shall be for one month only since claims can be made only on monthly basis)
The member has to submit the Dr certificate, prescription and the medicine bills in original alongwith the claim form to PAD welfare section, IOB, Central Office, with a caption “MD India claim” or to
MD India Central Office at Pune or to MD India office at Chennai addresses of which are in the Bank circular. Claim for a particular month should be submitted to MD India before 15th of the succeeding month. Members can use either domiciliary claim form or normal hospitalisation claim form (Part A) with a caption “Domiciliary treatment claim” on top. For the first time, it is better to send them the ECS mandate form duly filled in alongwith a cancelled cheque leaf to have a smooth processing, though MD India has our pension savings bank account details. (For PF optees, this is a must).
For subsequent months, xerox copies of the Dr certificate and/or prescriptions self-attested by the members and the original bill for medicines should be sent alongwith the claim form. However, the members may make a mention that the original certificate/prescription had already been submitted to MD India alongwith the claim of so and so month.
Members may also claim the bills for lab diagnosis if advised by the doctor, by attaching the doctor’s prescription for the same, alongwith the lab report and the receipt from lab.
Members may please note the following additional Help Desk phone numbers at MD India, Chennai:  044 24364205,   044 24364206.
Members may please read the domiciliary disease serial no.43 and 44 as follows since the names shown in the circular is not legible:
43. Multiple sclerosis/motor neuron disease
44. Status asthamaticus.
Regards,
Krishnaraj P
Joint General Secretary

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