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Step – 1
Insured intimates AML at least 3 working days prior to hospitalization
as per the format annexed along with the Doctor’s advice for hospitalization,
prescription/ consultation, all tests reports past-medical history and any other
relevant document(s) as requested by AML
Step – 2
AML issues an authorization / denial letter to hospital/Nursing
Home for covered services as per policy terms & conditions to network hospital.
Step – 3
Cashless treatment is extended / denied by network hospital based on AML
authorization letter.
Step – 4
At the time of discharge, insured signs the claim form, all the relevant bills &
keeps all original documents including photocopy of ID card with network hospital.
Emergency Admission
Step – 1
Insured approaches network hospital & submits the copy of ID card within 24hrs
of admission.
Step – 2
Network hospital forwards request letter (Annexure) to AML within
24hrs of hospitalization.
Step – 3
AML issued an authorization / denial letter for covered services
as per Mediclaim policy terms & conditions.
Step – 4
Cashless treatment is extended / denied by network hospital for covered services
as per the agreement.
Step – 5
At the time of discharge, insured/proposer signs the claim form and all the relevant
bills & keeps all original documents including photocopy of ID card with network
hospital.
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