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Medical Reimbursement



DO's

  • Always make correct claim for the medical reimbursement.
  • Do remember that as per the existing Medical reimbursement scheme for Hospitalisation, payment is being made at the rates of Postgraduate Instittute (PGI)/AIIMS for Head Office and Branch Offices at Noida and Bangalore and at the rate of Nizam Hospital/VAIIMS for Gallium Arsenide Enabling Technology Centre (GAETEC) Project at Hyderabad.
  • Remember that for Medical reimbursement for Hospitalisation in respect of Head Office and Branch Offices in Noida and Bangalore, the basis of reimbursement are the rates as prevalent in Postgraduate Instittute (PGI)/All India Institute of Medical Sciences (AAIMS) and the rates of Nizam Hospital/AIIMS for employees at Gallium Arsenide Enabling Technology Centre (GAETEC), Hyderabad.
  • Submit the hospitalization claim on approved form duly signed immediately after discharge from the hospital.
  • Purchase all the medicines/ consumables used during the hospitalization from the registered chemist only.

DON'Ts

  • Don't claim medical reimbursement for your family members/relations who are not 'dependent' on you as per the Company Rules.
  • Never manage treatment your relatives in lieu of any of of your dependent family members viz. treatment of mother-in-law/father-in-law in place of your own mother/father; daughter-in-law/son-in-law in place of your daughter/son; cousin/sister-in-law for your wife etc
  • Never make bogus claims; this is misconduct and can lead to disciplinary action on detection.
  • Don't miss to give prior information of any procedure/operation mentioning the name and address of the hospital/nursing home.
  • Don't miss to mention about the tentative dates of admission as well as operation.
  • Don't miss to submit full particulars like E.C. No., Basic pay and name/relation of the patient to the claimant on the claim form.
  • Don't raise claim for an amount more than your eligibility for private room/general ward for hospitalization.

DO's

  • Be cautious that spurious drugs are not purchased.
  • Always check the expiry date before purchasing any medicine.
  • Ensure maintenance of stock registers for medicines, consumables etc. and make periodical check of the same.
  • Take advance action to dispose of medicines that are due to expire.
  • If there are no written instructions or procedural guidelines about various types of work Functions to be performed in your unit and the same are being carried out as per certain practices, it would be desirable to make a humble beginning to streamline those through written procedures. Display procedure in writing in the work place e.g. First-aid procedures, anesthetic checks etc.
  • Keep record of medicines, equipments & other hospital related assets/ consumables.

DON'Ts

  • Avoid excess procurement of medicines.
  • Do not use medicines after expiry dates.
  • Do not issue medicines to private patients.
  • Do not issue false medical certificates.
  • Do not associate yourself with private nursing homes in any manner.
  • Do not accept gifts from any suppliers.
  • Avoid procurement of medicines, vitamins dextrose etc., with short expiry dates.
  • Avoid local purchase at exorbitant rates on grounds of emergency.
  • Do not recommend false medical reimbursement claims for payment.

DO's

  • Do conduct periodical check of the stores for medicines, equipments on regular basis.
  • Always follow the prescribed procedure for procurement of medicines, except in an emergency where otherwise the life/health of the patient is at stake. Record justification for such purchases for any future scrutiny.
  • Always maintain proper medical records especially of employees who have suffered from serious ailment(s) or have been suffering therefrom; keep the same updated.
  • Do visit the patient referred to outside hospital for specialized treatment. This will generate confidence in the concerned employee and will also be a check on the line of treatment of the hospital authorities, besides any possible hefty hospital bills.
  • Do insist on scrutiny of the hospital bills before the same are processed for payment. This will not only add to your knowledge, but will also provide you an opportunity to put a check on any exaggerated bills/claims.
  • In case of a hospitalization case, do insist on the mention of the date and time of discharge of the patient employee in the discharge documents by the concerned hospital authorities.

DON'Ts

  • Don't misuse/permit misuse amenity for personal gain or for extending any personal favour to others at the cost of organization. Avoid prescribing medicines without physical examination of patients.
  • Avoid prescribing medicines for a long period of time.
  • Do not destroy medical records of:
    • Death cases
    • Medico legal cases
    • Litigation cases
    • Death of married woman within 10 years of marriage
    • Records of cases having any dispute or court case

DO's

  • For medical reimbursement for hospitalization, make the claim as per the latest guidelines in this regard.

DON'Ts

  • While submitting medical claims, don't miss to attach copies of discharge reports with pre-procedure history, treatment given during hospitalization with specific reference to the type of anaesthesia given i.e. (general or spinal).
  • Don't miss to attach original bills/vouchers of payment made to hospital/nursing home/chemist along with the claim form.
  • Don't delay the submission of medical claims for reimbursement.

DO's

  • Do remember to keep record of medicines, in case of chronic diseases, as prescribed by Doctors.

DON'Ts

  • Don't forget to submit the original medicines, in case of chronic diseases, films of radiological investigations.
  • Don't seek allopathic treatment from Company for the same. non-allopathic Doctors. Insist upon visiting the qualified Doctors only.

 


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Page last updated on September 1, 2014
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